Talk:Medical analysis of circumcision/Archive 6

message: I'd like to direct those interested in this topic to a journal article I found which, I believe, present an objective review of the literature surrounding circumcision.--Jfurr1981 15:52, 11 November 2005 (UTC)
thread_title: Review of the Literature on Circumcision

message: I'm going to try to cleanup this article in the next few days.  I won't make any major changes in the content of the article.  This article does need to be re-written, if possible, to make it more valuable to our readers.  If there are any specific suggestions, please feel free to send me a message on my talk page.
Cheers!--Jfurr1981 05:22, 10 November 2005 (UTC)
thread_title: Cleanup

message: Usually doctors only perform surgery on children when the medical benefits of the surgery far outweigh the medical risks and harms.  Non-therapeutic circumcision does not come close to meeting that standard of care.  Can anyone cite another surgery that doctors will perform on children where the medical benefits of the surgery do not far outweigh the risks and harms and the surgery does not correct a birth defect? -- DanBlackham 03:05, 19 Mar 2005 (UTC)
thread_title: Is there any other surgery like circumcision?

message: Just a quick note to Jayig. Your edit made it clear that my previous wording may have been construed as implying that opponents of circumcision had documented evidence of foreskin sensitivity. This was not the intended meaning. What was documented was evidence of a belief that the foreskin was sexually sensitive. I hope that my latest revision makes that clear. Michael Glass 07:45, 17 July 2005 (UTC)
thread_title: Clarification of wording

message: I removed the following passage from the section on skin diseases:
:In a study relating to Epididymitis  Epididymitis in children: the circumcision factor? demonstrated with highly statistical significance that a relationship exists between epididymitis and the presence of a foreskin. It was found that an intact foreskin is an important etiological factor in boys with epididymitis.
There is a section on epididymitis in the article where the same article is commented on. However, because that comment covered the same ground in clear and simple English, and the link to the Pub Med article was there as well, I did not change that section. Michael Glass 02:58, 27 August 2005 (UTC)
thread_title: Epididymitis

message: Edits by banned editors (such as Robert Blair's insertion of a book name) should be reverted automatically.  As well, References sections are for books that were used in writing the article; the added book was clearly not used in writing this article. Jayjg (talk) 22:41, 20 September 2005 (UTC)
thread_title:  Banned editors 

message: I rearranged this section, adding some new material which I think is important. I have also added a link to the relevant section of the Wiki article [Breastfeeding]. Michael Glass 22:55, 24 September 2005 (UTC)
replies: text: I've made some changes, and have created a table to summarise relevant findings. It needs some work, but I think it's a good start. Jakew 10:23, 25 September 2005 (UTC)
thread_title: Breastfeeding and circumcision

message: The following addition by AlbertCahalan belongs on the Talk page, not in the article.
*It should be unsurprising that we can reduce cancer and other diseases of the penis by removing part of the penis. This method of disease prevention works for all body parts. Complete prevention from disease of a body part can be had by complete removal of that part.
-- DanBlackham 08:14, 26 September 2005 (UTC)
replies: text: Agreed. Jayjg (talk) 14:45, 26 September 2005 (UTC)

text: Don't confuse lifetime risks with annual risks. Also be aware of the ecological fallacy. Jakew 12:47, 21 October 2005 (UTC)
replies: text: Yes you are right, I was confusing lifetime risks with annual risks.--Dumbo1 16:06, 21 October 2005 (UTC)
thread_title: Penile cancer

message: The recent study into HIV/AIDS transmission and circumcision did not take into account the practise of Dry sex, which is relatively common in sub-Sarahan Africa. Dry sex increases the chances of foreskin ripping and tearing substantially, increasing the risk of STD infection. As such it is possible that the results of the recent study should not be extrapolated across the rest of the population, as during lubricated sex the foreskin does not rip as easily as in dry sex. It would be good to see a similar study in an area where dry sex is uncommon. It is possible that the results would be the same. It is also possible that results would be very different. It has been put forward that one fo the reasons that HIV/AIDS is more common in Sub-Saharan Africa is due to the high transmission rate caused by the practise of dry sex. Certainly the transmission rate per sexual encounter is higher in sub-Saharan Africa than elsewhere, although the reasons for this are as yet unknown. --Dumbo1 13:55, 19 October 2005 (UTC)
replies: text: You might like to familiarise yourself with the policy on original research. Jakew 12:49, 21 October 2005 (UTC)
replies: text: You might like to familiarise yourself with the Wikipedia article which I linked above and shall link again: Dry sex. This contains the following reference which you may like to familiarise yourself with: Beksinska ME, Rees HV, Kleinschmidt I, McIntyre J. The practice and prevalence of dry sex among men and women in South Africa: a risk factor for sexually transmitted infections? Sex Transm Infect. 1999 Jun;75(3):178-80. It is this that I have paraphrased above. It is not original research on my part. (Put STD and Dry Sex into Google and see what comes out!). The paper shows that there may be higher transmission of STDs for men practising dry sex, however the sample size was not large. Additionally the study looks at STDs as a whole as opposed to specifically HIV/AIDS. That study has not yet been done or published, however the results in the paper above should make us consider whether the South African research could be repeated in a population where dry sex is rare. I would have thought that you might have looked at the link that I included in this talk page, rather than just assume that I had made it up!  The validity of the HIV/AIDS and circumcision research is very important. I don't have a vested interest in proving the research wrong. Do you have a vested interest in showing that circumcision can only be beneficial?. So much has been made of the recent HIV/AIDS and circumcision research, if there are any other factors that might have skewed the results, surely we should be interested in them. Hopefully we are all interested in reducing the risk of HIV/AIDS and other STDs, and hopefully we are all interested in finding out whether circumcision really does reduce the risk of HIV/AIDS transmission across the entire population. Of course what we should all be doing is practising safe sex, but then thats another discussion! --Dumbo1 15:42, 21 October 2005 (UTC)
thread_title: Current studies on HIV/AIDs transmission in Sub Saharan Africa

message: I'm uncertain here as I am a new contributor, but with this topic being under discussion for greater than 12 months, wouldn't it make more sense to remove the theories/hypotheses/estimates without proof and leave only the facts?
From scanning through the talk page history, it seems that more argument/discussion/thought has been afforded to those topics discussed within the article rather than to the overall weight/veracity of the article itself.
Is the community not here to maintain articles? How are we maintaining the article in this manner? Are we methodical in determing the article's POV? And is not the only way to guarantee a NPOV to relate fact and only fact? Hence should a dispute arise on the NPOV of an article, would that not be a dispute as to the veracity of the facts in the article? So, would the next step in solving the dispute be to remove any statements which are conjecture/supposition/exaggeration/assumption rather than fact?
Please clarify. Xyybyral 09:44, 8 November 2005 (UTC)
thread_title:  Objectives 

message: Most civilized countries have some sort of democratic organ where medical professionals come to discuss issues. Where there is a consensus, a public statement will be made.
Create a list of the countries where democratic organs have issued statements regarding circumcision. Provide their findings -- the concluding ones! Then separate them into proper groups.
I'll start the list for you.
Australia: Royal Australasian College of Physicians' Health Policy Unit Findings: Review of the literature in relation to risks and benefits shows there is no evidence of benefit outweighing harm for circumcision as a routine procedure in the neonate
Canada: Canadian Paediatric Society Findings: The overall evidence of the benefits and harms of circumcision is so evenly balanced that it does not support recommending circumcision as a routine procedure for newborns
Norway: Norwegian Council for Medical Ethics Findings: ritual circumcision of boys has no established medical benefit
The main argument for this approach:
Medical studies are often too complex for the general public to understand. Some studies, claiming to be objective, are in fact biased. Others do not state non-obvious facts, such as that the study was conducted in an area where a large majority are or are not circumcised.
Instead, allow the medical professionals themselves to interpret the studies their peers have conducted. In the case of the Norwegian Council, their statement was published in a journal all medical professionals in Norway read. The same will be the case for other countries.
Don't get hung up on individual studies. Tabloid media is ripe with presentations of individual studies, each showing a tendency towards one or the other. Wikipedia should have higher standards. Articles claiming to be scientific, like this one, should approach subjects in a scientific manner. Refer to the consensus of the medical community. People will then be able to make an informed decision, not based on the intentions of the author of the article, but based on the position of the professional medical communities of the world. Then start a new page where you can take this never-ending debate.
--Superdix 20:25, 22 November 2005 (UTC)
replies: text: I see no reason why we shouldn't create a position statements on circumcision article, but Wikipedia should not be dumbed down. Presenting these conclusions alone tells the reader nothing whatsoever about the benefits and risks - it only tells you what various the opinions of these authorities: hardly scientific (indeed, a logical fallacy). Jakew 21:00, 22 November 2005 (UTC)

text: And in these journals - and in the community too - there is significant disagreement. WP:NPOV demands that we discuss the main relevant views and their supporting evidence. Jakew 22:07, 22 November 2005 (UTC)

text: Please see the section entitled 'costs and benefits'. Jakew 12:13, 23 November 2005 (UTC)
thread_title:  Here's one way to end a meaningless debate 

message: Nandesuka asked me to bring this section to the talk page. Said and done.
:As with all types of surgury there are risks connected with circumcision. How great the risk is difficult to find out since the death is reported as cused by the side effect, such as infection or bleeding. The cicumcision may cause liver failure, kidney failure, pneumonia, and blood poisoning. Dr Douglas Gairdner reported 16-19 actual deaths a year in England and Wales from neonatal circumcisions in the 1940s. Br Med J 1949; 2:1433-1437. Dr Robert Baker estimated 229 deaths per year from circumcision in the United States.Sexual Medicine Today 1979;3(11):35-36. African tribal ritual circumcision produces reports of death or serious injury every year. BBC reprorts about the deaths of about 20 youths and another 100 injured from failed circumcisions in the past few weeks.	 
:The use of anastethics on infants is also a problem. If an anastethic is used there is a risk involved with that, if the infant is given too much it may cause death. In older days and in developing counties the surgery may be done without the use of anastethic and this may cause the child to go into a pain induced shock that also may be fatal.	 
:Even if it doesn't cause death there may be complications. One famous example is David Reimer who got his penis amputated following a failed circumcision and was rasied as a girl.
I see several problems with this. Firstly, a minor one - you need to check it for spelling and grammar. If this were the only problem with it, I would have corrected it, however.
Next, there are unsourced claims. Who says that the risk is difficult to assess because of this reason? Who says that African tribal circumcisions produces these reports every year? The paragraph on anaesthetics is completely unsourced.
Next, the tone is alarmist and poorly balanced. It looks like propaganda. Baker's estimate, which is based on Gairdner's figures, is all very well, but overlooks the fact that Gairdner's figures included complications of general anaesthesia. American studies have found a much lower death rate. The most commonly cited death rate is 1/500,000, from Speert, H.: Circumcision of the newborn: An appraisal of its present status, Obstet Gynecol. 2: 164, 1953.
Next, it's redundant. The section details these risks further on. What is gained by mentioning them twice? Jakew 16:51, 26 November 2005 (UTC)
replies: text: The previous version was far more NPOV; repeating detail is POV. Jayjg (talk) 22:14, 29 November 2005 (UTC)
thread_title:  "Please discuss this on the talk page. Thanks." 

message: The article includes two books in the 'references' section, yet the article itself does not refer to them in the text. This is not helpful to readers, is unprofessional, and is likely to cause confusion.
I therefore propose to do one of the following:
# Delete this section.
# Rename it to something more appropriate ('further reading' springs to mind).
Comments? Jakew 10:50, 13 March 2006 (UTC)
replies: text: Good idea.  If it's not really used as a reference, then it should be descibed as "Futher reading" or something similar. Jayjg (talk) 18:26, 13 March 2006 (UTC)
thread_title: References