Talk:Medical analysis of circumcision/Archive 4

message: Wikipedia policy:
:Similarly, slander, libel, or defamation of character is not to be tolerated on Wikipedia; true instances of such writing, that might legitimately expose Wikipedia to legal sanction, should immediately be called to the attention of an administrator and/or the community at large. Disagreements as to the identity of a person, their motivations for a given action, opinions of third parties about them, etc. do not fall under slander, however, and you should not use legal threats as a bludgeon to get your POV enshrined in an article.
References to Robert S. Van Howe, M.D., M.S., F.A.A.P. impugn his scientific credibility and are libelous statements that are likely to get Wikipedia in trouble if he see them. Such characterizations violate Wikipedia policy.
Robert Blair 01:11, 13 Dec 2004 (UTC)
replies: text: If you search any medical database on breast cancer, it's always aimed toward preserving the breast, instead of amputating as a cautionary matter of statistics or risks.  If your view that "evidence-based" medicine is appropriate, where is the evidence of foreskin disease in a newborn?  It is almost always absent.  That isn't bias, that is fact.  You've struggled to delete that fact over and over using a probabilistic and interpretation-based approach toward this matter, and now you say a well-defined process should exclude one that will perform some analysis using the existing medical literature.  If that is the case, we should immediately purge Wikipedia of all claims of both benefit and harm from circumcision, since Wikipedia is now such a repository of re-analysis.  Isn't that correct, or did I misread the title of this article?  My only suggestion is that we mention Van Howe's work without judgement, of him or his work, except to say that the paper asserts such things.  These accusations work both ways, and numerous "circumcision benefit" links in this article are mentioned without hinting that the author is a single-issue lunatic. DanP 18:50, 17 Dec 2004 (UTC)
replies: text: Dan, I most certainly do not say that Van Howe's work should be excluded because it "perform(s) some analysis using the existing medical literature", and I'm sorry if I gave that impression. It is entirely valid to analyse using the existing literature, and indeed beneficial. When doing this, one has to use a well-defined approach. One can't just be arbitrary. The problem with his work is that instead of being systematic in his review of the literature, he has been selective and arbitrary (see my notes above). In itself, that would be alright (though it would make his paper appear as cranky as it really is), but the trouble is that Van Howe lies, and claims to have used a systematic approach. That's readily disproven by repeating his claimed method, and seeing the papers he chose to omit. - Jakew 00:14, 18 Dec 2004 (UTC)
replies: text:  It is easy enough to say Van Howe's perspective is a lie.  Even that judgement is somewhat arbitrary in what you are willing to accept, and what you reject.  Many systematic refutations of pro-mutilation junk science are available online.  But that has never been sufficient to exclude them from Wikipedia.  Why not let the reader decide on their own?  I'm sure plenty of research is out there explaining how to save money and avoid surgery, and how to seek alternative treatment for many diseases or disorders involving non-vital organs.  Yet that same candle of truth must in no way go near the male genitals?  I have difficulty seeing the non-arbitrary systematic approach there, or how Van Howe work differs from any other less-blatantly mutilating fields of medicine.  Perhaps you can explain why this is so?  DanP 01:36, 29 Dec 2004 (UTC)
replies: text: Dan, would you please realise that we're not talking about whether to delete Van Howe - we're just discussing whether to include commentary. You say that systematic refutations are available online - so where are they? - Jakew 12:21, 29 Dec 2004 (UTC)
replies: text: Commentary or not, the same standards should apply to the circumcision advocates as to genital integrity.  Do you dispute this, or should commentary only be valid from your side?  As to systematic refutation, every time CIRP article are linked, or commentary as to failures of pro-mutilation arguments are detailed, you oppose them as selective or biased.  Yet your wild rampage against Van Howe is warranted?  Why? DanP 23:24, 29 Dec 2004 (UTC)
replies: text: DanP, my "wild rampage against Van Howe" consists merely of noting that he's an anti-circumcision activist. Please keep a sense of proportion here. It's unclear what you mean by "CIRP articles" - do you mean a paper that happens to be hosted at CIRP, or do you mean one of CIRP's own discussion pages? While the latter are absurdly biased, I don't object too much to the former. My main gripes with CIRP's pages are a) their little "explanatory notes", designed to guide the reader towards their way of thinking, and b) their highlighting of passages that they like, and c) their habit of linking to only the references that support their position. If they just presented the paper as it was in the journal, I'd have no objection. -Jakew 12:32, 30 Dec 2004 (UTC)
thread_title: Libel

message: To keep a sense of proportion here one needs to remember that there is no medical indication for neonatal circumcision, in other words neonatal circumcision is not medically necessary.  There is no other part of a child's body that doctors will cut off without a valid medical indication.  The College of Physicians and Surgeons of British Columbia policy statement says:
:"Infant male circumcision was once considered a preventive health measure and was therefore adopted extensively in Western countries.  Current understanding of the benefits, risks and potential harm of this procedure, however, no longer supports this practice for prophylactic health benefit.  Routine infant male circumcision performed on a healthy infant is now considered a non-therapeutic and medically unnecessary intervention."
--DanBlackham 18:27, 30 Dec 2004 (UTC)
replies: text: Robert, while your contributions are valuable, why would you criticise someone for having a viewpoint.  Are you saying you do not?  NPOV does not say eliminate POV.  In fact it welcomes both sides, which apparently is something you hate.  Go read NPOV and come back and tell us whether your POV is missing from the article.  Then let's discuss it.  DanP 01:14, 5 Jan 2005 (UTC)
replies: text: *I don't think we need to indulge in smoke and mirrors to apply some spin to the NPOV definition. There is about to be a ruling made by the AC which will confirm that "Wikipedia is not a vehicle for propaganda or advocacy." This then read in conjunction with the following emails  will effectively bring the activities of targeting Wikipedia by one particular fringe group to an end. Wonderful. - Robert the Bruce 04:44, 5 Jan 2005 (UTC)
replies: text: Whenever the microscope looks at your circumcision advocacy efforts, you would not be happy either.  Like it or not, your viewpoint is in the minority worldwide.  But I do not promote giving it less prominence in Wikipedia.  Both sides of many ethical debates are presented in Wikipedia, the pros and the cons.  Saying "no propaganda" is fair enough.  But I believe you have tossed the first stone in nearly every instance, and our rules must apply to both sides.   By your logic Wikipedia should delete pro-choice or pro-life and declare one "the truth" and the other propaganda.  Is this what you are saying?  Please clarify what you mean so we can all understand.  DanP 18:49, 5 Jan 2005 (UTC)

text: *Yes I thought you would take the news badly. But all is not lost yet, however, you can rely on a rearguard action of 5th Cloumnist sympathisers around here to provided an imaginative "interpretation" to help your cause. Again sadly you misrepresent the "worldwide" view. Where is your evidence that any more than a pathetic "worldwide" minority share the level of activism towards male circumcision issues as do you and your "friends"? My point is simple. Just as with Bin Laden there is no possiblity of reaching compromise or achieving consensus. Finally, please don't speak for me, I am happy to be judged my owm words and not those that others put in my mouth. - Robert the Bruce 03:28, 6 Jan 2005 (UTC)
thread_title: A sense of proportion

message: The article that I found read as follows:
:where circumcision was carried out before the age of 12 it results in a reduction to 0.39 of the odds of an uncircumcised man. The degree of protection changed according to the age at which circumcision was performed, however, with those circumcised at between 13 and 20 years at an odds ratio of 0.46, and those circumcised after the age of 20 at an odds ratio of 0.78. The researchers concluded that "Prepubertal circumcision is associated with reduced HIV risk, whereas circumcision after age 20 years is not significantly protective against HIV-1 infection."
However, a closer reading of the source reveals that those who were circumcised at the age of 21 or more had a higher rate of infection than those who remained uncircumcised. It said:
:"HIV-1 prevalence was 14.1% in uncircumcised men, compared with 16.2% for men circumcised at age > or = 21 years."
I believe it is important to state this if only to show that circumcision alone is not a sure protection against HIV.
Michael Glass 04:14, 6 Jan 2005 (UTC)
replies: text: Robert, this is a fine piece of invective, but it is without substance. I left the quotation that I found but added another quote to point out that those circumcised after the age of 21 had a higher rate of infection than those who remained uncircumcised.  The last two sentences of your paragraph are simply speculation. That is why I removed them. However, if you have solid evidence for them, by all means post it for everyone's consideration.211.31.53.27 06:56, 6 Jan 2005 (UTC)
thread_title: The Rural Uganda Study [http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=10199231]

message: Michael, nobody disputes that Van Howe is a doctor. However, if you read the rest of the article, you'll see that in accordance with academic tradition, authors are introduced by surname only. In no other cases do we introduce titles or first names - why should we make a special exception? If you decide to change it to "Dr Robert Van Howe" again, I hope that you'll be consistent and change every other author, too. - Jakew 14:22, 8 Jan 2005 (UTC)
thread_title: 'Doctor' Van Howe

message: NPOV requires that opposing viewpoints are equally acceptable and both should be presented without bias. This means that pro-circumcision and anti-circumcision viewpoints must be allowed. Robert the Bruce simply cannot delete material that does not conform to his mind-set. 
Factual material may be presented also.
HIV
Van Howe's point of view is offset by O'Farrell. Likewise, Kebaatetswe's viewpoint is offset by Hill-Denniston and by Boyle. These are opposing viewpoints and are entitled to be represented.
Robert Blair 12:09, 9 Jan 2005 (UTC)
thread_title: NPOV

message: I've corrected a typo and removed the "Dr Robert" from Van Howe, for reasons discussed above. I've also made some stylistic changes.
I've removed the paragraph about the finer points of the Uganda study. What on earth is the point of discussing something that we already know is not statistically significant (as noted in the quoted conclusion in the previous paragraph)?
I've shortened the quote from Kiwanuka so that we just include the conclusions. After all, we're providing a link to the study itself, so it seems overkill (and from a copyright perspective is also dubious) to quote the entire abstract.
I've incorporated Robert Blair's version of the RCT paragraph, but have removed the sentence about researcher bias (citations?).
Describing Kebaatetswe as an opinion piece is false, since it is based upon surveys. And I'm adding the fact that the criticisms are from anti-circumcision activists.
I've also made some stylistic changes to Lagarde. - Jakew 12:18, 9 Jan 2005 (UTC)
replies: text: There is debate on the role of male circumcision in HIV transmission. Most case-control and cohort studies from Africa have shown an association between a lack of circumcision and an increased risk of HIV infection in men. The evidence is conflicting, however, with cross-sectional surveys from Tanzania and Rwanda either showing no relationship or an association in the opposite direction.
I believe it is important to point out that there is conflicting evidence about the relationship between circumcision status and incidence of HIV. This backs up what the Cochrane Library said and helps to explain where Van Howe got his raw data. In turn, this puts the reader in a better position to understand and assess the comments of Moses et al in criticising Van Howe's meta-analysis.  I originally broke the quotation into two parts: one that dealt with the conflict in the evidence and the other that dealt with the criticism of Van Howe. I think this is clearer than having one long quotation. However, I can quite understand if others felt the passage should be quoted in one block.Michael Glass 13:51, 12 Jan 2005 (UTC)

text: I disagree, Robert. I think it important that people should be aware of the flaws in Van Howe's work, and for that reason alone, we should discuss it. I'd have a great deal more respect for CIRP if they had the decency to include one of their little notes, directing readers to the relevant letters, but unfortunately they don't appear to have that much integrity. The burden of exposing the facts about circumcision - and about Van Howe - thus falls to us. - Jakew 22:41, 12 Jan 2005 (UTC)

text: *The fact that CIRP continues to display the trash on its website says all that needs to be said about the lack of integrity of that organisation ... but it goes further ... what does it say about the integrity of those POV warriors that continue to relentlessly present this Van Howe trash as being a scientific counter to the ever mounting evidence of the relationship between the lack of circumcision and a higher risk of HIV infection among the uncircumcised and their partners? Here it is called a Wikicrime ... but don't hold your breath for any sysop to take action in this regard. - Robert the Bruce 04:23, 14 Jan 2005 (UTC)
thread_title: HIV/AIDS

message: From Slashdot " I remember back to when I was only 2 years old- I had had surgery on ... well, we'll call it a sensitive part of the body.
Now I don't remember the surgery, and I don't remember the antics I pulled at showing nurses why I was in the hospital... but I *do* remember the first time I had to goto the bathroom after surgery.
That memory is so seared into my brain I can even recall I was high enough to look out a window over the cityscape, and that there was a bricked church in the background and the window had blinds (the black slatted ones) on it.
And I remember so much so terribly much pain I don't know how I survived it.
My parents tell me that after that brief moment of screaming I was OK... and I don't remember anything else of that event save for that moment.
And just for comparison (of a little kid) I've had 18 kidney stones... I have a good memory for pain. But that memory makes me cringe and shiver every time I have it."
labeled " Pain for me (Score:5, Interesting)
by purduephotog (218304) <hirschNO@SPAMinorbit.com> on Monday January 24, @08:17PM (#11463523)
(Last Journal: Wednesday August 13, @11:49PM)"
in article "
Volatility of Human Memory
Posted by samzenpus on Monday January 24, @08:13PM
from the help-finding-your-keys dept."
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OK.  Now why is this FYI section in this particular discussion?  DanP 21:34, 27 Jan 2005 (UTC)
thread_title: FYI