I have been a listener and fan of your show since the late 1990s. I was horrified at the advice you gave your caller yesterday. Parents must protect their children from harm. Your advice telling a caller to circumcise her son seems out of place for you.
Your comparison of male circumcision to other parenting decisions such as vaccines and discipline was inaccurate. Male circumcision removes 50% of the skin of the penis and 20,000 nerves. Vaccines do not permanently remove healthy tissue from the body. Neither do parenting choices relating to discipline. Your analogy did not make sense.
Circumcision is a violent surgery that involves giving the child an erection, tearing the foreskin from the glans, crushing, and cutting. Please go see a video if you don't believe me. Anesthesia is only used 45% of the time. The baby is strapped down and oftentimes soils himself.
The claims of "health" and "medical benefits" are dubious at best. The following article helps to clarify:
Circumcision removes the most sensitive parts of the penis:
The recent study on the benefit of male circumcision in reducing HIV has been discredited due to unscientific methods used:
A recent US Navy study showed no health benefits to male circumcision.
Sunat, a muslim tradition that removes the female prepuce is common in southeast Asia and is typically described as less invasive than the male form. Certainly, you are not OK with that?
But again, thsese muslim female parents are advocating "parent's choice" just as you were doing for male circumcision.
The truth is that male circumcision is an ethical issue, not a medical one. It is not ethical to remove healthy, erogenous tissue from any child without consent. It's not OK for girls, and it's not OK for boys either.
The worldwide medical community generally regards male circumcision as an ethical violation. 70% of the world's men are intact with the US being one of the few that practices circumcision for non-religious reasons. No medical organization in the world (AAP included) recommends routine infant circumcision.
Thursday, January 31, 2013
Wednesday, January 30, 2013
It has really started irritating me of late the number of folks who think it is acceptable to hold a view about an issue without being able to back up their viewpoint. Oftentimes these folks aren't even well educated on the issues behind their point of view. When challenged, these people get defensive, resort to personal attacks, refuse to look at resources you send, and finally, ignore you.
If you are confident in your beliefs and are well-educated on the issues, the convincing responses should be at the ready. There is no need to be defensive because you have all the facts on your side.
What Is a Fact?
I have heard this silly statement more than once: "I don't believe your facts." Facts are derived from evidence and findings and represent reality: "not "believing facts" is nonsense. There are claims that people make and state as fact. These claims can be disputed if the evidence used to back them up is disproved. Dismissing a proven fact out-of-hand is to remain willfully ignorant.
Another dangerous assumption to make is that any particular source is infallible and has all facts on a subject. A good example is that you cannot rely on any single medical study as fact. Not only is this imprudent, but it is not good science. Science relies on a preponderance of evidence to establish fact. This helps to weed out incompetent or biased researchers. The scientific method also requires reproducibility so looking at a single study fails this test too.
Technically, medicine is an applied science, but I believe it falls far short of that goal. The article "How Scientific Is Modern Medicine Really?" gives some insight into the issue. Time and time again, money funds studies that benefit medical device makers, pharmaceutical companies, doctors, and hospitals. These studies are published and are now considered "evidence". Five studies that show favorable results vs. one study that shows unfavorable results must mean that it is a medical fact that the procedure is beneficial, right? Now that's not to say that medical device makers and pharmaceutical companies shouldn't do studies to show that their devices are beneficial—obviously, they should prove their product works. But given the state of peer review in medical journals, their bias, if it exists, won't be uncovered. Which means that these studies must be scrutinized even after they are published in a respectable journal.
After some searching on Google, I find no indication that anyone has made an attempt to define the term "medical fact" or enumerate what is required for a medical fact to be established. The criteria that Wikipedia uses certainly doesn't bring us even remotely close. Wikipedia places absolutely no value on "truth" or "correctness". Its numerous policies establish "fact" primarily through reliable secondary sources. Claims made by reliable secondary medical sources cannot be questioned by Wikipedia editors and must be included as evidence. Wikipedia editors must only consider the type of study and not consider methods, conflict of interest, or other factors. Wikipedia's assumption is that these factors should have been considered by the medical journal or other peer review processes in the medical community:
"Assessing evidence quality" means that editors should determine the quality of the type of study. Editors should not perform a detailed academic peer review. Do not reject a high-quality type of study due to personal objections to the study's inclusion criteria, references, funding sources, or conclusions.
As I mentioned above, peer review fails to properly vet medical research most of the time rendering Wikipedia's policy broken and untrustworthy with regards to properly establishing medical fact. Although Wikipedia's policies produce accurate, correct entries most of the time, I consider it broken because it is unable to cope with biased research.
Wikipedia is unable to cope with controversial issues in which the viewpoints of one culture are reflected in a large amount of published (albeit dubious) research and the opposing viewpoint (where research on the issue isn't necessary because the results are obvious) is ignored. The issue that I have in mind is the one of male circumcision. The worldwide medical community doesn't bother researching foreskin sensitivity because it is obvious that it is. It would be like researching if fingertips are sensitive. Everyone knows that they are. Why do we need a study? Americans and American doctors who are trying to promote male circumcision want to do research in this area to show that the foreskin is worthless and vestigal. And so we end up with articles that, while keeping with Wikipedia policy end up being devoid of the truth.
The reason why I spend so much time talking about Wikipedia is that the standards that Wikipedia uses seem to be similar to the standards that the American medical community, in general, uses to justify beliefs and establish "medical fact". Even though the definition of medical fact is elusive, I see lots of evidence for the harm of male circumcision dismissed because it doesn't meet a certain standard—that "standard" seems to be similar to the standards that Wikipedia uses. Obviously, there should be standards and policies and research of any type should be reliable and accurate. My point is that individual studies must be properly vetted and we can't count on peer review to do this for us.
No matter what the issue, I expect those who openly profess their opinions and beliefs to be able to back them up. If you can't back up your views, it's time to do some research or consider whether your view was worth holding in the first place. I also believe it is time for the medical community to become more scientific. It is time for the media to become more scientific as well; instead of reporting each individual medical study as "a new fact", it should look at the wider body of scientific evidence and report medical consensus. The general public is easily confused by conflicting studies where each new study is reported as fact The media's approach gives the impression that the scientific community is confused or "keeps changing its mind". It is also time for Wikipedia to allow editors to vet research. It's obvious that the peer review process has its limitations. I would like to see Wikipedia as an authoritative resource rather than a clearinghouse for opposing viewpoints juxtaposed in adjacent sentences.