Circumcision ques

[Carefree]

Parents have the right to make decisions regarding their children unless there is significant proof that the decisions they are making will have a direct negative impact on the health of the child.

 

The way I look at it is that parents have the right to seek certain medical procedures only if they can show that it is of some therapeutic value to their child. In terms of denying treatment options, parents have the right to refuse treatment for their child as long as the refusal does not have a direct negative impact on the child's health (ie. death/prolonged suffering).

 

In certain cultures in Africa, female genital mutilation has strong cultural ties, because they believe that it promotes abstinence. If a Canadian physician is approached by an African family, seeking such treatment for their daughter, should the physician follow their wishes? If the procedure is conducted in a Canadian hospital the chances of a "direct negative impact" on the child's health are minimal.

[Carabiner]

I personally think you're comment is ignorant. Sure you believe that the procedure serves no purpose and is only cosmetic but that does not give you the right to dismiss other people's belief.

 

An important part of being a doctor is not dismissing other people's cultural or religious beliefs. In fact, many Jews and Muslims routinely practice circumcision, not just because their ancestors have been doing so, but because they truly believe the procedure has medical benefits. So they are not merely chopping off a baby's body part.

Yeah, many Jews and Muslims routinely practice circumcision for religious purposes, but the religiosity of the operation is quite overrated. Traditionally, a Jewish circumcision is called brit milah, and it must be performed by a mohel using tools that may or may not be clean, and involves the mohel sucking the blood out of the penis with a glass straw-like implement, although this is a relatively recent development. This is the religious circumcision that you're referring to. However, almost all Jews who end up getting circumcised nowadays get circumcised at Gentile hospitals using Gentile methods alongside Gentile babies. Where's the religiosity of that act then? [i can't comment about Muslim practices, as I'm not as familiar about them.]

 

And don't even get me started on the question of consent and medical benefits of circumcision. Rather than listen to the professor you quoted, I'll leave it to the Canadian Pediatric Association, Canadian Medical Association, American Medical Association, American Pediatric Association, Royal Australasian Medical Association, British Medical Association, etc, that say that circumcision is not medically indicated, doesn't have clear benefits, and is not outrightly recommended.

Carefree:

In certain cultures in Africa, female genital mutilation has strong cultural ties, because they believe that it promotes abstinence. If a Canadian physician is approached by an African family, seeking such treatment for their daughter, should the physician follow their wishes? If the procedure is conducted in a Canadian hospital the chances of a "direct negative impact" on the child's health are minimal.

Interestingly, this occurred in Seattle in the late 1990s. Google "Seattle Compromise." A bunch of Somali mothers asked that the prepuces of their daughters' clitorises (the equivalent of a foreskin) be circumcised, just in the same way baby boys get circumcised. The hospital actually initially agreed to the procedure, taking a "harm reduction" approach; in the end, the situation became super controversial, death threats were sent to the hospital, and the initiative was cancelled.

 

I'm not an advocate of female circumcision either, but I do think that there's a little bit of cultural double-standards being demonstrated by the rejection of the "Seattle Compromise." If you're going to condemn female circumcision, it makes sense to condemn male circumcision as well. If I was a parent, I would not circumcise my son. As a doctor, I'd refer my patients to another doctor who performs the surgery, but I wouldn't do it myself.

if Ontario Health care plan no longer pays for circumcision.

The British national health care system stopped funding circumcision in the mid-1990s or late 80s, I believe; also, 15-ish states in the US stopped funding it as well.

[Jochi1543]

Traditionally, a Jewish circumcision is called brit milah, and it must be performed by a mohel using tools that may or may not be clean, and involves the mohel sucking the blood out of the penis with a glass straw-like implement, although this is a relatively recent development.

 

*vomits at the mental image*

[Carabiner]

*vomits at the mental image*

Hahaha. Now the straw-like things are used. Pretend it's more like a Bloody Mary or something.

[w8kg6]

Hahaha. Now the straw-like things are used. Pretend it's more like a Bloody Mary or something.

 

That's ****ing vile.

[Jochi1543]

Don't they use the thumbnail to take the foreskin off in the traditional circumcision? Urrgrhgrhgrhrg, *cringe*.

[champion_forever]

For those of you interested, the latest study on circumcision published in the The New England Journal of Medicine.

 

http://www.voanews.com/english/2009-03-25-voa75.cfm

 

I personally support it.

[Corsci]

For those of you interested, the latest study on circumcision published in the The New England Journal of Medicine.

 

http://www.voanews.com/english/2009-03-25-voa75.cfm

 

I personally support it.

 

I know this is gonna sound extreme, but does that mean there is a case for preemptive mastectomies? Gonna go out on a limb and say breast cancer is a lot more prevalent than AIDS...

 

And what the heck, another extreme one... would you cut your lips to prevent a cold sore?

 

yes I am fully aware of the blatant functionality of lips and breasts but people could still live without them.

[AndrewB]

Well if we lived in a country where 25% of women were going to develop breast cancer, preemptive mastectomies would make a lot of sense. There are several countries in Africa where the prevalence of HIV infection is 25%. I think that is where the utility of routine circumcision lies, not necessarily here in N. America.

[Jochi1543]

Well if we lived in a country where 25% of women were going to develop breast cancer, preemptive mastectomies would make a lot of sense. There are several countries in Africa where the prevalence of HIV infection is 25%. I think that is where the utility of routine circumcision lies, not necessarily here in N. America.

 

Or maybe money should be used and people should be encouraged to use discretion in choosing partners, use protection, respect women, and to learn more about the disease and how it's transmitted, controlled, and potentially cured.

[champion_forever]

Well if we lived in a country where 25% of women were going to develop breast cancer, preemptive mastectomies would make a lot of sense. There are several countries in Africa where the prevalence of HIV infection is 25%. I think that is where the utility of routine circumcision lies, not necessarily here in N. America.

 

I agree. but don't forget HPV.

Its a personal choice, weigh the evidence and make an informed decision for your kids (whether religious or scientific).

[AndrewB]

Or maybe money should be used and people should be encouraged to use discretion in choosing partners, use protection, respect women, and to learn more about the disease and how it's transmitted, controlled, and potentially cured.

 

Of course...I think we do a decent job of that here in Canada. I was referring to regions where HIV is pandemic. Anything to reduce the potential spread seems wise to me, even if it means cutting a infant's foreskin.

[Satsuma]

I just wanted to clarify some things about female genital mutilation. Which is in no way comparable to male circumcision.

 

"WHO adopted the term "female genital mutilation" in 1996 to describe any of 4 forms of the procedure. The least invasive is the clitoridectomy, also known by the Arabic term sunna, which involves excision of the prepuce and part or all of the clitoris. The second form, "excision," involves removal of the clitoris and part or all of the labia minor. "Infibulation," which means "to fasten with a clip or buckle," is the most invasive form and is most common in Somalia, Ethiopia, parts of Kenya and the Sudan. It involves removal of the clitoris, all of the labia minor and part or all of the labia majora, and the pinning or stitching of the two sides of the vulva closed. A narrow opening is left for urinary and menstrual outflow.

 

A fourth, unclassified type includes procedures such as pricking, piercing, stretching, scraping or cauterization. "

 

 

These procedures are not carried out for medical purposes. They can result is extreme pain, hemorrhage, sepsis, difficulty urinating, recurrent urinary infections, infertility and problems with child birth. In the most severe forms it also exposes the person to more surgeries...since more surgery is required to reopen the vagina to allow for intercourse and childbirth...and then they will close it back up again after.

 

It is discriminatory against women and since the procedure is usually done on children, it is child abuse.

 

There are no religious writings that endorse this procedure.

 

In Canada there is a precedent to obtain refugee status in the case of a mother trying to protect her daughter from undergoing the same procedure she endured.

 

In Canada you would not be able to perform this act as a physician.

 

"In Canada, FGM is considered child assault and prohibited under sections 267 (assault causing bodily harm) or 268 (aggravated assault, including wounding, maiming, disfiguring) of the Criminal Code.4 Some provincial colleges have issued statements advising physicians to refuse requests to perform FGM or reinfibulation.6,7 " (reinfibulation is the process to close the vagina back up after childbirth)

[Atreides]

that quote just leads to a culture-coexistance question that I really don't want to be the one to put forward.

 

Lol, sorry, I suppose its our fault for jumping on you in the other thread

[Atreides]

I understand circumcision is a religion based issue in Islam , jews. What other ethical issues are involved in this procedure if Ontario Health care plan no longer pays for circumcision.

 

THanks

 

I would say that the Ontario Health care plan does not pay for the procedure as the Pediatric associations of multiple countries, including our own, have determined that there are no clear medical benefits to the procedure so it would not be covered by the government.

 

The legality of performing the procedure for pay is a separate issue which seems have been discussed in detail in the thread though it is still considered acceptable in Canada as far as I know.

[abcwxyz]

Honestly, I don't get what the big deal is.

 

The complication rate is low. The health benefits are situational and questionable at best. It's effectively a neutral procedure. I haven't seen any credible studies that show significant positive or negative effects in a regular Canadian person.

 

If people want to get it done because it's part of their culture, let them. Parents are only expected to not do their kids medical harm at this age; nothing more. Medically, the procedure is questionable and unnecessary but not harmful. If parents feel that it's necessary for their child's spiritual well-being, the procedure now becomes beneficial. We aren't talking about FGM here.

 

I haven't read the papers on whether it's a good public health policy for AIDS, but if it is, go ahead. If it even helps marginally, in addition to other programs, it's probably worth it. There isn't one single solution to public health problems.

 

Under no circumstances should it be funded by OHIP though. It's not a medically necessary procedure; it should be paid for privately.

[abcwxyz]

I personally think you're comment is ignorant. Sure you believe that the procedure serves no purpose and is only cosmetic but that does not give you the right to dismiss other people's belief.

 

An important part of being a doctor is not dismissing other people's cultural or religious beliefs. In fact, many Jews and Muslims routinely practice circumcision, not just because their ancestors have been doing so, but because they truly believe the procedure has medical benefits. So they are not merely chopping off a baby's body part.

 

In fact, there has been research to prove that circumcision serves protection against local infections in the penis, infections of the urethra, protection against cancer of the penis, sexually transmitted diseases, and cervical cancer in women.

 

Dr. Muhammad 'Ali al-Baar (a member of the Royal College of Surgeons in the UK and a consultant to the Islamic Medicine department of the King Fahd Centre for Medical Research in the King Abdul Aziz University in Jeddah) says in his book al-Khitaan (Circumcision):

 

"Circumcision of newborn boys (I.e., within the first month of life) brings numerous health benefits, including:

 

1 – Protection against local infection in the penis, which may result from the presence of the foreskin, causing tightening of the foreskin, which may lead to retention of urine or infections of the glans (tip) of the penis – which require circumcision in order to treat these problems. In chronic cases, the child may be exposed to numerous diseases in the future, the most serious of which is cancer of the penis.

 

2 – Infections of the urethra. Many studies have proven that uncircumcised boys are more exposed to infection of the urethra. In some studies the rate was 39 times more among uncircumcised boys. In other studies the rate was ten times more. Other studies showed that 95% of children who suffered from infections of the urethra were uncircumcised, whereas the rate among circumcised children did not exceed 5%.

 

In children, infection of the urethra is serious in some cases. In the study by Wisewell on 88 children who suffered infections of the urethra, in 36 % of them, the same bacteria was found in the blood also. Three of them contracted meningitis, and two suffered renal failure. Two others died as a result of the spread of the micro-organisms throughout the body.

 

3 – Protection against cancer of the penis: the studies agree that cancer of the penis is almost non-existent among circumcised men, whereas the rate among uncircumcised men is not insignificant. In the US the rate of penile cancer among circumcised men is zero, whilst among uncircumcised men it is 2.2 in every 100,000 of the uncircumcised population. As most of the inhabitants of the US are circumcised, the cases of this cancer there are between 750 and 1000 per year. If the population were not circumcised, the number of cases would reach 3000. In countries where boys are not circumcised, such as China, Uganda and Puerto Rico, penile cancer represents between 12-22 % of all cancers found in men; this is a very high percentage.

 

4 – Sexually transmitted diseases (STDs). Researchers found that the STDs which are transmitted via sexual contact (usually because of fornication/adultery and homosexuality) spread more among those who are not circumcised, especially herpes, soft chancres, syphilis, candida, gonorrhea and genital warts.

 

There are numerous modern studies which confirm that circumcision reduces the possibility of contracting AIDS when compared to their uncircumcised counterparts. But that does not rule out the possibility of a circumcised man contracting AIDS as the result of sexual contact with a person who has AIDS. Circumcision is not a protection against it, and there is no real way of protecting oneself against the many sexually transmitted diseases apart from avoiding fornication/adultery, promiscuity, homosexuality and other repugnant practices. (From this we can see the wisdom of Islamic sharee'ah in forbidding fornication/adultery and homosexuality).

 

5 – Protection of wives against cervical cancer. Researchers have noted that the wives of circumcised men have less risk of getting cervical cancer than the wives of uncircumcised men.

 

Thus, male circumcision has the potential to provide benefits. And for some religions and cultures, it may me be just as important or even more important than a vaccine.

 

So, I don't think that there is reason to deny circumcision to parents who want to have the procedure done on their sons, especially if the reason is religious.

 

Parents have the right to make decisions regarding their children unless there is significant proof that the decisions they are making will have a direct negative impact on the health of the child.

 

You look foolish for posting this.

[abcwxyz]

http://en.wikipedia.org/wiki/David_Reimer

 

This outcome had nothing to do with his circumcision and everything to do with his mandated gender reassignment.

[Guest viscous]

You look foolish for posting this.

 

since you got 10 interviews, you are the smart one?

[abcwxyz]

since you got 10 interviews, you are the smart one?

 

I don't have 10 interviews. And if I was the smart one, it's because I don't post crap evidence to backup my point of view.

[Wolvenstar]

For those of you interested, the latest study on circumcision published in the The New England Journal of Medicine.

 

http://www.voanews.com/english/2009-03-25-voa75.cfm

 

I personally support it.

 

 

Having read this article, I wish i was subscribed to the New England Journal of Medicine.

 

Here's my questions:

 

1) were the social/religious implication adjusted for?

- many who get circumsized do it for religious reasons, which means they will grow up will a specific set of moral values and social practices that are common to that religion. How can we be sure that it is not for these reasons that there was a lower infection rate amongst them

-as well how do we know those who participated in this study are not those who are actually concerned about HIV. If there majority of those who underwent circumcision did it because they were concerned about HIV transmission, it is logical to assume they would take other steps to prevent transmission as well. Whereas a large number of those who weren't circumsized may not have been as caring about whether or not they get HIV/transmit it.

 

2) How long was the study undertaken for?

-This may only be a short term effect that changes after a significant time peroid

 

3) how controlled was the test population?

I have already stated the flaws in another study done in africa over this, I honestly don't know who ran the study or what journal it ended up being published it. I wouldn't be surprised if this was the same one I was discussing earlier in this thread.

 

 

 

 

 

I just wanted to clarify some things about female genital mutilation. Which is in no way comparable to male circumcision.

 

"WHO adopted the term "female genital mutilation" in 1996 to describe any of 4 forms of the procedure. The least invasive is the clitoridectomy, also known by the Arabic term sunna, which involves excision of the prepuce and part or all of the clitoris. The second form, "excision," involves removal of the clitoris and part or all of the labia minor. "Infibulation," which means "to fasten with a clip or buckle," is the most invasive form and is most common in Somalia, Ethiopia, parts of Kenya and the Sudan. It involves removal of the clitoris, all of the labia minor and part or all of the labia majora, and the pinning or stitching of the two sides of the vulva closed. A narrow opening is left for urinary and menstrual outflow.

 

A fourth, unclassified type includes procedures such as pricking, piercing, stretching, scraping or cauterization. "

 

 

These procedures are not carried out for medical purposes. They can result is extreme pain, hemorrhage, sepsis, difficulty urinating, recurrent urinary infections, infertility and problems with child birth. In the most severe forms it also exposes the person to more surgeries...since more surgery is required to reopen the vagina to allow for intercourse and childbirth...and then they will close it back up again after.

 

It is discriminatory against women and since the procedure is usually done on children, it is child abuse.

 

There are no religious writings that endorse this procedure.

 

In Canada there is a precedent to obtain refugee status in the case of a mother trying to protect her daughter from undergoing the same procedure she endured.

 

In Canada you would not be able to perform this act as a physician.

 

"In Canada, FGM is considered child assault and prohibited under sections 267 (assault causing bodily harm) or 268 (aggravated assault, including wounding, maiming, disfiguring) of the Criminal Code.4 Some provincial colleges have issued statements advising physicians to refuse requests to perform FGM or reinfibulation.6,7 " (reinfibulation is the process to close the vagina back up after childbirth)

 

 

Please explain to me how female mutiliation can not be comparable to male mulitilation. It is a painful, non-medicallly prevelant procedure done on boys. The only difference I see between them socially is that circumsicion is most prevalent amongst jews (mainly white), while female circumcision is mainly prevalent amongst certain african tribes (non-white). You can see that your point may have certain sexist and or culturally biased problems with it. I certainly hope you do not mean to imply that somehow it is more acceptable to mutilate the genitalli of males than that of females.

 

(hey hey, look at that, I pointed out a potential problem in his/her statement without going apesh*t on her. too bad everyone can't be so mature.)

 

 

Lol, sorry, I suppose its our fault for jumping on you in the other thread

 

lol exactly. I could have brought it up. but no one would want to argue the point, they would be to busy debating whether I hate muslims or not. I would love to debate it with people, but not many on here is that mature.

[Laika]

Having read this article, I wish i was subscribed to the New England Journal of Medicine.

 

If you're in university, you should have free access through your school.

 

Please explain to me how female mutiliation can not be comparable to male mulitilation.

 

If you can't see the different between the removal of foreskin and the "removal of the clitoris, all of the labia minor and part or all of the labia majora, and the pinning or stitching of the two sides of the vulva closed," you don't belong in med school.

[Satsuma]

Please explain to me how female mutiliation can not be comparable to male mulitilation. It is a painful, non-medicallly prevelant procedure done on boys. The only difference I see between them socially is that circumsicion is most prevalent amongst jews (mainly white), while female circumcision is mainly prevalent amongst certain african tribes (non-white). You can see that your point may have certain sexist and or culturally biased problems with it. I certainly hope you do not mean to imply that somehow it is more acceptable to mutilate the genitalli of males than that of females.

 

(hey hey, look at that, I pointed out a potential problem in his/her statement without going apesh*t on her. too bad everyone can't be so mature.)

 

 

Well, the glaring difference is that it results in alot of harm to girls who have genital mutilation performed. (as I listed in the potential complications - which are common complications...not 1 in a million complications)

With male circumcision the harm is much more debatable.

 

I am not expert in religion. But I do believe that male circumcision has a true religious basis. Whereas for female genital mutilation, there is none.

 

Whereas female genital mutilation is done in an attempt to control females, male circumcision is not done for this purpose at all.

 

I do not advocate the mutilation of genetalia of either sex.

 

But removing the foreskin from a penis is not the equivalent of removing the clitoris. The clitoris is homologous to the glans of the penis...and no sane person would go around cutting that off. And removing the clitoris is the least aggressive of the procedures done on girls.

 

I don't think it is a race issue either. There are alot of muslims in Africa who perform circumcision.

 

By saying that the 2 procedures are not equivalent, I was not implying that it is acceptable to multilate male genitalia and not the genetalia of females. They are simply 2 different things....the procedures are different, the reasons for doing it are different, and the complications are different.

[A-Stark]

Very well said - and the attempt to make this some sort of racial issue is, frankly, beyond the pale. It isn't in the slightest.

[Carabiner]

Satsuma:

Well, the glaring difference is that it results in alot of harm to girls who have genital mutilation performed. (as I listed in the potential complications - which are common complications...not 1 in a million complications)

With male circumcision the harm is much more debatable.

 

I am not expert in religion. But I do believe that male circumcision has a true religious basis. Whereas for female genital mutilation, there is none.

 

Whereas female genital mutilation is done in an attempt to control females, male circumcision is not done for this purpose at all.

 

I do not advocate the mutilation of genetalia of either sex.

 

But removing the foreskin from a penis is not the equivalent of removing the clitoris. The clitoris is homologous to the glans of the penis...and no sane person would go around cutting that off. And removing the clitoris is the least aggressive of the procedures done on girls.

 

I don't think it is a race issue either. There are alot of muslims in Africa who perform circumcision.

 

By saying that the 2 procedures are not equivalent, I was not implying that it is acceptable to multilate male genitalia and not the genetalia of females. They are simply 2 different things....the procedures are different, the reasons for doing it are different, and the complications are different.

I don't agree with either female or male genital alterations that have no recognizable benefits on the infant. I also don't think that the two are comparable, as female genital alterations generally are more invasive than male. However, there is a wide range of the operations done, with the most mild form (a pricking of the prepuce) being in fact less invasive than traditional male circumcision.

 

Also, I do think there is a certain double-standard involved. I don't know if you saw my previous post a few pages before about the "Seattle Compromise," but when some mothers tried to get their hospital to perform a female circumcision operation (a mild pricking of the prepuce, using anaesthetic), the controversy surrounding the issue prevented the compromise occurring, ending the first attempt at harm reduction in the States.

 

I don't think little boys or girls should be getting their genitals irreversibly operated upon for non-essential reasons, but I don't see why there's so much resistance against non-invasive female circumcision when there's so little resistance against male circumcision. If non-invasive female circumcision is still regarded as child abuse, why isn't male circumcision, besides the fact that it's received the seal of approval of "tradition"? I see ethical issues in both male and female circumcision as non-essential, non-reversible operations.

 

As well, if you read up on the accounts of female genital alterations in Africa, they are done for a multitude of purposes, not just for male domination. It can occur anywhere from the ages of 2 or 3 to the teens. In some areas, it is a ritualistic bonding for women, or a coming of age, or a way to give empowerment to women. Whether or not these accounts are based on "false consciousness" is a debate that can go on forever; I'm just saying that I don't think the issue is as black and white. Also, demonizing the women who continue the practice (least of all by using the word "mutilation") only results in alienation and less safe conditions. At the end of the day, I support doing whatever operations are the least invasive and most safe for both genders, though I'd prefer if the operations didn't happen at all.