Talk:Circumcision/Archive 12

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I aggressively archived this page, including the most recent discussions, because it was simply unreadable (and because Berserker Ben asked :-). The most recent stuff is in Archive 11. Nandesuka 14:16, 11 May 2006 (UTC)

Do Not Lie About What Citations Say

OK, I am now annoyed.

There's this thing. It's called a citation. A citation is a link to something that someone else has said. It turns out that when we at Wikipedia provide a link to something that someone else has said, our readers can sometimes use something called the "internet" to "click" on the link and read what we have cited. This is why it's really important that when we cite some third party source, and we describe what they say, we do so accurately, so that our readers don't get the impression that Wikipedia is full of things I like to call "lies" or "things we just made up because we felt like it."

My current example of this is this edit by TipPt, which removes the clause "benefits and" from the sentence where we cite this. So with this edit, Wikipedia says:

The American Academy of Pediatrics recommend that parents should be informed about 
the potential risks of the procedure.

While the paper linked to actually concludes:

Existing scientific evidence demonstrates potential medical benefits of newborn
male circumcision; however, these data are not sufficient to recommend routine
neonatal circumcision. In the case of circumcision, in which there are potential
benefits and risks, yet the procedure is not essential to the child's current well-being,
parents should determine what is in the best interest of the child. To make an informed choice,
parents of all male infants should be given accurate and unbiased information and
be provided the opportunity to discuss this decision.

So basically, as near as I can tell, this is a case where an editor, because of his personal beliefs, has decided to link to a source while providing an abjectly dishonest summary of what that source says. This is completely unacceptable, and it must stop.

TipPt, if you have an explanation for this egregiously inappropriate behavior, I suggest you provide it now. And make it good. Nandesuka 14:58, 11 May 2006 (UTC)

Dear Nandesuka,

We are talking about the risks of complications article. Why do you insist on citing "benefit" again?

Here's the deal I may have struck with Jakew ... either we both get to address benefits (he using the AAP and I using the BMA ... which sheds doubt on the benefits) or neither do. The latter is best, so I remove "benefits" from risk article text. Or we do it your way, but balanced...

Here's what it becomes: The American Academy of Pediatrics recommend that parents should be informed about the potential benefits and risks of the procedure.[30] The British Medical Association states “The medical benefits previously claimed, however, have not been convincingly proven, and it is now widely accepted, including by the BMA, that this surgical procedure has medical and psychological risks [31]TipPt 15:36, 11 May 2006 (UTC)

The section is on risks, not benefits. The quote from the BMA can be cut down to remove irrelevant detail without misrepresenting their position. The AAP's recommendation, however, refers to both, and removing one misrepresents their position. Jakew 16:04, 11 May 2006 (UTC)

PS, it's not in quotes, so it's not lying to remove a word.TipPt 15:38, 11 May 2006 (UTC)

It does misrepresent, however, making them appear to have a different position than they actually do. Jakew 16:04, 11 May 2006 (UTC)

The full BMA statement is one sentence. It is in context, pertinent, and balances the AAP statement. Cutting out half of that sentence, and leaving only the part you want (pro circ) misrepresents.TipPt 20:53, 11 May 2006 (UTC)

Could you please explain to me how the words "it is now widely accepted, including by the BMA, that this surgical procedure has medical and psychological risks" can be construed as pro-circ? I'm genuinely mystified. Jakew 20:56, 11 May 2006 (UTC)

Cutting out the first half of the sentence misrepresents the BMA postion, which works toward the pro-circ bias in this topic.TipPt 21:15, 11 May 2006 (UTC)

How does it misrepresent their position? Jakew 07:57, 12 May 2006 (UTC)

As with the American statement, risks are taken in context (with benefits). The BMA finds questionable benefits, and risks; The American both benefits and risks. Both perspectives help the reader understand the difficult nature of the research.

TipPt, I understand your dilemma here. You have a very important message you feel you need to get out. However, the reliable sources on the subject don't really agree with your position, and sometimes actually contradict it. However, the solution is not to misrepresent the sources, but rather to try to find other reliable sources which present other opinions. Jayjg ^(talk) 17:20, 14 May 2006 (UTC)

And you don't think the BMA is a reliable source? Very odd and biased. Note that their statement is more recent than the American association findings.

Again, it's you pro-circ guys that insist on citing "benefits" in the "risk" article, odd in itself, but biased when I try ... but fail because you guys delete it ... to include the full sentence from the British Medical Assoc.TipPt 00:09, 16 May 2006 (UTC)

Hi, I'm not pro-circ. I'm anti-POV pushing. Thanks for remembering that the next time you decide to start slinging around argumentum ad hominem. Nandesuka 00:57, 16 May 2006 (UTC)

I'm not "pro-circ" either. I'm pro-Wikipedia policy. Feel free to describe me as the latter, not the former. Jayjg ^(talk) 17:08, 17 May 2006 (UTC)

You missed the compromise Jakew offered (to find another AAP quote ... that didn't cite "benefits" ... to go in the risks article:

Note, jakew, that if you insist on saying "benefits and risks" instead of just "risks" in the risk article, I should include the full BMA statement (including the sentence "The medical benefits previously claimed, however, have not been convincingly proven") —The preceding unsigned comment was added by TipPt (talk • contribs) .

Ok, I'll find an alternative quote. Jakew 15:07, 9 May 2006 (UTC).

I assumed that the bad text should be removed until the fix was found. Then you jumped in "angry" at my removal of the word "benefit" from the risk of circ article.

I don't know your stance, and did your refer to you directly. The current version shows bias.TipPt 17:50, 16 May 2006 (UTC)

This issue is discussed in #Jake, why did you remove this?. Must you insist upon wasting space and other editors' time by repeating things? Jakew 17:56, 16 May 2006 (UTC)

That promise to find an AM ASSOC quote without "benefits" was not made in that discussion. Regardless, it was not honored.TipPt 16:53, 19 May 2006 (UTC)

Address cultural ritual/health reasons

Through the ages, circumcision has been a cultural ritual. Medical applications may have changed things...

I'd like these sentences at the end of the second paragraph:

"Parental decisions regarding circumcision are dominated by cultural ritual considerations [1]^[2][3][4]or religious beliefs, not by potential medical applications[5], though a 2001 study reported that "The most important reason to circumcise or not circumcise the child was health reasons."[6] In two studies, strong parental cultural expectations clashed with deliberate informed consent, and “a significant number of parents in the studies mentioned expressed animosity toward the care provider.”^{[7] [8]}

Jakew wanted Adler represented.TipPt 15:27, 11 May 2006 (UTC)

This is now self-contradictory. Either "Parental decisions regarding circumcision are dominated by cultural ritual considerations" is true or "The most important reason to circumcise or not circumcise the child was health reasons" is true. It is impossible for them both to be true.

Regardless, it does not belong in the introduction, because a) it is specific information about one of the 192+ countries in the world, b) the evidence is conflicting and introductions should be straightforward, and c) it is better discussed elsewhere in the article, such as in the 'since 1950' section where it is already mentioned. Jakew 15:58, 11 May 2006 (UTC)

We have several cites finding cultural ritural, including an AAP cite. Remember, this is a historically common human trait.

We have Adler [9] finding "health reasons" 39.6% of the time. Stronger "Reasons Given for Decision" included "Mother's choice" at 59.7% or "Father's choice" at 49,7%. The questions that pick up ritual were "So child looks like father," "So child looks like his brothers, "So child looks like other kids."

That is why when you quote Adler, you should include the other listed potential answers to the question, so the reader knows the limited context.TipPt 21:13, 11 May 2006 (UTC)

The questions were not mutually exclusive, Tip. The reason for the choice is independent of who makes the choice.

As for having several cites, it doesn't matter. You still cannot present it as fact when there is evidence to the contrary. Jakew 07:55, 12 May 2006 (UTC)

The question asked for ONE answer from those choices listed. You present your cited facts, and I should be able (not blocked by you alone for pro-circ reasons) to present properly conducted research. Let the reader decide the better research.

You must know that the Adler metholology was horrible, and the survey simimplistic.TipPt 00:24, 16 May 2006 (UTC)

PS the Adler study is so poor, that it's evidence of your lack of good faith. Using that one study to refute several (reviewed) studies is biased.TipPt 00:28, 16 May 2006 (UTC)

These studies are already mentioned in the article, Tip. Your proposed inclusion is POV, however. Jakew 08:45, 16 May 2006 (UTC)

There is a difference between circumcisions that are done because there is a valid medical indication, i.e. there is a medical condition present that requires surgery for treatment, and circumcisions that are done because the parents believe there are "health reasons". The number of circumcisions that are done to treat a medical condition that requires surgery for treatment is low. -- DanBlackham 04:59, 12 May 2006 (UTC)

Both therapeutic and prophylactic circumcisions are done for health reasons, Dan. Jakew 07:55, 12 May 2006 (UTC)

Again, we have many good cited finding prophylactic (neonatal) circs as cultural ritual, not health, save the (lousy methodology) Adler study.

"Cultural ritural" is (has been for thousands of years) intergral to the topic, and must be fully addressed in the introduction.TipPt 18:13, 16 May 2006 (UTC)

Well, as you note, the most recent study - Adler's - would disagree with your assessment. Regardless, I'm not aware of any study that states that no parents choose circumcision for health reasons. 41% did in Tiemstra's study, for example. That's quite a few. Jakew 18:18, 16 May 2006 (UTC)

The idea of "prophylactic circumcisions" indicates a pro-circumcision POV. There is a very broad consensus in the international medical community that there is no NET medical benefit from circumcising healthy boys. Only a few pro-circumcision activists still discuss circumcision of healthy children as a prophylactic medical procedure.

The College of Physicians and Surgeons of British Columbia 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." [10] -- DanBlackham 22:59, 16 May 2006 (UTC)

Image warning

I was wondering if a warning can be place on top of the page, something not to blatant but that describes that gratuities images are present on this page. I’m not asking for censorship (god forbid anyone censors anything on wikipedia) rather all I ask for is just a small, fair and specific warning on the top of the page. Something like this maybe:

This article contains pictures of human nudity, do not edit the article to censor images, see wikipedia disclaimer for detials.

--BerserkerBen 19:02, 11 May 2006 (UTC)

I've proposed such things in the past myself, out of a desire to cut down on self-righteous blanking vandalism. I was informed that, in general, the Wikipedia Content Disclaimer handles all need for such warnings, and there is no requirement or onus upon editors to include any warnings whatsoever. On the other hand, such warnings could be interpreted as implicit support of the concept that such images are objectionable. Having considered this, I side with those who are against any warnings. The general disclaimer should suffice. Wikipedia shouldn't make any gesture to imply that it sides with those who find any particular image objectionable. Kasreyn 00:19, 12 May 2006 (UTC)

Ya who ever sees that disclaimer at the BOTTOM of the page in very small text? Apparently not enough considering how often those images in the past got edited. Ok ok the warning can be more neutral:

It shocked me when I first looked at the page! I'd like a little warning before a pair of dicks pop up on my screen.--Dr.Worm 22:23, 17 May 2006 (UTC)

This article contains pictures of human genitals; discuss any edits to the images before editing. --BerserkerBen 03:41, 12 May 2006 (UTC)

I agree with Kasreyn. No warnings are necessary, and would imply that there is something objectionable about the images. To explain why, consider the hypothetical case of a similar warning appearing in the radish article ("This article contains pictures of root vegetables; discuss any edits to the images before editing"). How would you, as a reader, take that? Would it not imply that Wikipedia, somewhat bizarrely, feels that there is something troubling - even offensive - about root vegetables? My point is that while someone might conceivably be offended by radishes, that (assuming that it occurs at all) is an individual matter, or perhaps of an individual culture. Like genitals, there is nothing inherently objectionable about them, and if we add warnings to everything that someone might conceivably be offended by, we will have little but warnings in this encyclopaedia.

Rant over. :) Jakew 09:51, 12 May 2006 (UTC)

Well if editing to the radish image happens because of it's controverisal nature (or any preception there of by editors/viewers) then yes I would want to place such a tag. Rather then add tags to what everyone conceivable object to, we add tags to what has been objected to, if not then we would have NPOV on every article, heck we would have just about every tag there is on every article! --BerserkerBen 11:22, 12 May 2006 (UTC)

What that results in is a Wikipedia that spends all its time bending over backwards for the most thin-skinned and easily offended amongst its readers. It's not really a reasonable standard to try to attain, because no matter how much we do, there can always be someone who comes along and claims to be even more easily offended, and then we have the same problem all over again. Offendedness is the product of a self-important mind, in my opinion. It's not our problem. Kasreyn 11:44, 12 May 2006 (UTC)

I think we can put a threshold on how low the offense goes to warrant action, say for one it would take multiple editors to agree on such action. Your argument is again a slippery slope, if we bended backwards as such we would have a NPOV tag above every article (not to mention every other kind of tag), obviously we don't have enough "easily" offended readers for that fate to be happening. There can be legitimate reasons for offense rather then one’s personal beliefs: would you casually browse pornography on an educational facilities computer? What if you had no prior knowledge that a said link would take you to an image that could get you in trouble with the schools authorities?, I guess you could claim ignorance "hey I was just looking it up cause I didn't know what it meant" but now you look stupid and to those that don't beleive you, you look like a pervert. But hey maybe your right, its not our problem: there is already a disclaimer about how wiki articles can be factually inaccurate or bias, why do we need NPOV tags? --BerserkerBen 12:19, 12 May 2006 (UTC)

Well if no one is going to counter my argument I'm going to put the warning up.--BerserkerBen 20:16, 16 May 2006 (UTC)

I'm just gonna throw my two peneth in here; I'm pretty divided on whether there should be a waning or not, i can see both sides. But, other pages do not have such a warning (e.g. Penis) and the little caution sign makes me, personally, think "page under construction". I've also moved the 2nd caution in this section so it appeared next to the cautioning word rather than someone elses comments (nit picking). --Alex uk 86 20:36, 22 May 2006 (UTC)

I'm sorry, Ben. I should have been more clear. My failure to respond to you was impolite. I've been rather busy, I've also had a computer crash recently which I'm still recovering from. I didn't mean to imply by my silence that I had conceded my position. I still believe we should not have a warning tag on Circumcision. I don't think any reader has a legitimate reason to complain about being offended by any particular image, assuming the image meets standards of notability and copyright. This is an encyclopedia for grown-ups. If a child reads it, and its parents complain, then that child should be better supervised. It's not our problem. Kasreyn 22:33, 25 May 2006 (UTC)

Countless warning tags have been rejected by the community on WP:TFD. The overwhelming consensus is that Wikipedia is not censored and it would be morally judgmental to place warning tags on certain articles but not others. We are in no position to judge what may be offensive to readers. The Wikipedia:Content disclaimer already covers every article. For precedent, please see the TfD's for {{Adult}}, {{Offensive}}, and I see you created your own {{Nudity warning}}. I don't think it's appropriate to continue adding warnings to articles even after your own warning template was deleted. Rhobite 19:03, 25 May 2006 (UTC)

Jake, why did you remove this?

"the medical benefits previously claimed, however, have not been convincingly proven,"

I'm very curious as it is a direct quote from the source. This article already gives a great deal of undue weight to American opinions of the procedure. I'd say what it needs is more non-American material for balance, not less. Kasreyn 00:09, 12 May 2006 (UTC)

I don't see a problem with including it somewhere, but the risks section is not an appropriate place for discussion of benefits. Jakew 07:49, 12 May 2006 (UTC)

I agree, so why do you insist on "benefits and risks" from the American Assoc? Looks like a double standard!TipPt 00:29, 16 May 2006 (UTC)

Because they make a recommendation that both are discussed. They are inseparable. Quoting one but not the other changes the meaning, like changing "recommend that you extinguish naked flames and turn off electricity if you smell gas" to "recommend that you turn off electricity if you smell gas". In contrast, the BMA quote is not a recommendation but commentary, and the sentence structure is such that no meaning is lost by partially quoting. Jakew 08:59, 16 May 2006 (UTC)

European circumcisions

Jake wrote, "In the UK and much of Europe, almost all circumcisions are performed for medical reasons." That is not accurate. In the Europe almost all circumcisions of children are done because the parents are Muslim or Jewish. In Europe circumcisions that are done to treat an existing medical condition are rare. -- DanBlackham 05:00, 12 May 2006 (UTC)

In the UK, Dan, Jews and Muslims together represent about 3.1% of the population, but surveys indicate that 10-15% of young men are circumcised. Jakew 07:48, 12 May 2006 (UTC)

Jakew, out of curiosity: what is the margin of error for those surveys? I'm assuming that the margins of error are included in the published texts, as is customary. I'd say if it's 5% or greater, the difference between the percentages becomes to slim to support the phrase "almost all". Kasreyn 10:32, 15 May 2006 (UTC)

The 3.1% figure comes from UK census data, which is (in theory) a 100% sample, and is generally believed to be accurate. As for the other figure, it's my own summary of several studies. Unfortunately, I don't have the full text of all of them to hand, only summaries. One gives a 95% confidence interval of 9.0% to 15.2% for 16-19 year olds. Taking the low end of that range, there's roughly a 2:1 (5.9:3.1) ratio of medical to religious circumcisions. At the high end, it's roughly 4:1 (12.1:3.1). I was incorrect when I said 'almost all', but this is a clear majority. Jakew 11:02, 15 May 2006 (UTC)

As in the US, most circs are done as "cultural ritural" in the UK. Just in the UK, it's mostly upper middle class folks. Next come medical (as boys or adults), then come religious. "Health" reasons, are different from "medical" if there is no disease present.TipPt 17:36, 19 May 2006 (UTC)

Strange edit

I've reverted Alienus' revert which, among other things, reintroduced some POV commentary about the BMA's statement, and inappropriately discussed the BMA's assessment of benefits in the risks section. Jakew 10:05, 15 May 2006 (UTC)

Need more eyes on Circumcision advocacy

Jakew and I seem to be at something of an impasse on Circumcision advocacy, so it might be helpful if others got involved. Al 20:01, 15 May 2006 (UTC)

I'm about to file another Rfc regarding the bias in the Topic ... you will find Jakew clever and obsessed.TipPt 00:16, 16 May 2006 (UTC)

Please refrain from making personal attacks. Next time I will report it. Jakew 08:45, 16 May 2006 (UTC)

Tip, while I do see some bias here, I'm not sure that filing an RfC makes sense while an RfM is still floating around. On a purely procedural basis, they may require one to finish before the other starts. As for personal attacks, Jake, he called you clever, which is usually a compliment, and obsessed, which may well be a value-neutral reference to your track record of editing only circumcision-related articles. In short, while his word choice could be improved, it's not clear that he intended any insult. Perhaps this would be a good place for you to WP:AGF by giving him the benefit of the doubt. Thank you for understanding. Al 11:36, 16 May 2006 (UTC)

My goal in filing is to seek a wider audience for additional issues. I have not properly studied the Wiki procedures, and don't know much about RfM's. I do remember reading something about a "2 week" ... long past ... time frame, and assumed it had expired??

I can't find that RfM (to add issues), so I may file an RfC. If someone can link me to that page ... please do.

I gather that the Wiki community is sick and tired of the endless circ topic problems. It's an example of Wiki gone wrong. I hope that if interesting issues are prominent, editors will take a look!

Jakew, I'm sorry you took offense at the word obsessed. My meaning could have been adequately expressed with "persistent."TipPt 17:01, 16 May 2006 (UTC)

I just finished reading the text Jakew deletes, and found it interesting, well written, and pertinent. What problems do you have with that text Jakew?TipPt 17:20, 16 May 2006 (UTC)

Out of respect for other editors, and to ensure that editors can easily read discussion of articles that they are interested in, I don't discuss other articles except at the relevant article's talk page. Jakew 17:42, 16 May 2006 (UTC)

Jakew you keep putting in a misquote!

Here's the sentence Jakew insists on ... "Meatal stenosis has been reported in 0.9%[38] to 20%[39] of circumcised boys."

Here's my quote: Meatal stenosis may be the most common longer-term complication from circumcision, and is variously reported to occur in .9%,[11]9% - 10%, [[12]] and 7.29% of circumcised boys. [[13]].

Jakew ... please read the citation, and you will find that 20% is for meatitis not meatal stenosis.

Second, the reader benefits from links to all three studies.

Here's the (neutral) full paragraph I would recommend: Meatal stenosis may be the most common longer-term complication from circumcision, and is variously reported to occur in .9%,[14]9% - 10%, [[15]] and 7.29% of circumcised boys. [[16]]. The AAFP states : “One author(10) reports that meatitis, meatal ulcer and consequent stenosis occur in an estimated 8 to 31 percent of circumcised infants, while another(11) states there are no well-controlled cohort related studies to document their relation.”[17] Meatotomy is the definitive curative treatment to resolve meatal stenosis, though recently home-dilation has been shown to be successful for most boys. [18]TipPt 00:32, 16 May 2006 (UTC)

Note that meatotomy (since that's what almost all doctors will currently do to treat meatal stenosis) becomes a complication of circumcision. Consider what you do Jakew ... a young man suffers from (generally painful) meatal stenosis and goes to the doctor ... having looked at Wiki to see what's up ... and gets a meatodomy instead of asking for dilation instructions.

TipPt 00:35, 16 May 2006 (UTC)

Ok, I've updated the article with part of that text. I've left out the last sentence, though, because a) it's POV, and b) the scope of the article is circumcision, not treatment of meatal stenosis. Using the word 'common' rather than 'definitive' would fix the first problem, but the latter would remain. Jakew 08:53, 16 May 2006 (UTC)

Not OK. First, it's not POV ... You must not have read those citations for meatal stenosis. [19] and [[20]].

Second, your right about "common" versus "definitive" IF you assume the medical community takes note of the new research. Meatodomy is still taught in medical school as the curative for meatal stenosis ... just like circumcisions are still performed for phimosis, and just like (for 10 - 15 years!!) peptic ulcers were "treated" with Tagamet instead of following research finding bacterial causation and treatment with antibiotics. In addition, you'll note that diliation doesn't always work, leaving meatodomy as "definitive." Therefore, you are wrong.

Meatodomy is the common treatment for meatal stenosis, so meatodomy becomes a complication of circumcision. Therefore, it belongs in the Topic.TipPt 14:36, 16 May 2006 (UTC)

First, yes it is POV. Evidently the doctors who did the dilation study didn't consider meatotomy to be definitive, otherwise they wouldn't have conducted it in the first place.

Second, meatotomy is commonly performed for meatal stenosis. That's a fact. Arguably, this is unnecessary, since dilation could work just as well. We don't describe circumcision as the definitive treatment for phimosis, we only note that it is commonly performed.

Third, your argument is ridiculous. We don't describe treatments for conditions that circumcision protects against, do we? Jakew 14:48, 16 May 2006 (UTC)

No, it's not POV when it's cited in current research and texts (which is evidently is). They did the study to see if another procedure would work.

It does work for most, but not all boys with meatal stenosis ... so dilation is not definitive. It certainly does not work "just as well."

Your "third" sentence doesn't make sense. We writing about risks of circs, which includes meatal stenosis. If a boy gets that complication, the result is the standard treatment ... meatodomy. We actually should describe common treatments, since they give the reader objective measures of the costs or benefits.

For example, I personally discount the UTI benefit because I've had a couple UTI's ... like a few sore throats ... that required antibiotics ... that still work very well ... so I do not consider them a significant health problem. The reader gains from honest context.TipPt 15:19, 16 May 2006 (UTC)

Please review WP:NPOV. Jakew 15:38, 16 May 2006 (UTC)

You love to put in that stuff ... WP:NPOV ... and I respect it's true application. But costs and benefits can, and should, be quantified. An objective measure of the UTI "benefit" is the difficulty of the cure. An objective measure of a complication is it's ramifications (meatodomy). The reader gains from perspective.TipPt 17:28, 16 May 2006 (UTC)

I really don't think there's anything to be gained by discussing treatments for each of the conditions discussed. Such detail is better reserved for the articles on those particular subjects, which the reader can easily find. Jakew 17:39, 16 May 2006 (UTC)

That would be generally true, but in this case, meatodomy is the standard treatment. Basically, circs can result in meatodomy treatments. It the only reason boys are given the surgery. There is no question about the nature of the cure (versus UTI's where the treatment and results are more variable).TipPt 17:55, 16 May 2006 (UTC)

"Standard treatment" is much less POV, but it's still beyond the scope of this article. Jakew 17:58, 16 May 2006 (UTC)

"This article" is about complications. We have valid cites finding meatal stenosis, and valid cited finding meatodomy as curative. Meatodomy is a complication of circs (until doctors, possibly reading Wiki, learn new techniques) and the topic is complications. You are free (encouraged!) to add benefits that directly flow from a specific benefit of circ's.TipPt 18:05, 16 May 2006 (UTC)

The section of this article is indeed about complications. Meatal stenosis is (perhaps) a complication. Meatotomy is not. It is a treatment. It is no more a complication of circumcision than antiretroviral therapy is a complication of non-circumcision.

I have no intention of listing treatment of the conditions against which circumcision is protective, for exactly the same reason that I oppose inclusion of this: it is beyond the scope of this article. Jakew 18:08, 16 May 2006 (UTC)

It is highly relevant. The nature of the treatment is a measure of the degree of the complication or benefit. The goal is to inform the reader.TipPt 18:27, 16 May 2006 (UTC)

Antiviral treatment for HIV is not immediately and perminantly damaging to the patient. Meatal stenosis is commonly treated with a meatodomy, which is immediately and perminantly damaging.TipPt 16:27, 17 May 2006 (UTC)

Anomaly re: rate of circumcision in Canada

There appears to be a radical inconsistency in the article. Under the heading, "Aesthetics," "In Canada, the infant circumcision rate is about 50%." It appears to have been reverted several times from previous editor's statement that it is much lower than this. On the other hand, under the heading "Circumcision since 1950," "The infant circumcision rate in Canada has fallen from roughly 50% in the 1970s to 13.9% in 2003. However, the figures varied from 29.5% on Prince Edward Island to zero in Newfoundland and Labrador." Would someone more familiar than I with the literature (and the proper weight to be given to various sources) care to deal with this anomaly? Conceivably the contradiction arises from an ambiguity as to the incidence in the population at large versus the rate of circumcisions being performed on infants nowadays. Masalai 09:43, 16 May 2006 (UTC)

The problem appears to be that one conforms to WP:RS, while the other does not. From the AAP's policy statement (which is a RS), we have "In Canada, ~48% of males are circumcised.". On the other hand, we have an anti-circumcision activist site (courtchallenge.com, which is not a RS) telling us the latter rates.

I've temporarily commented out the latter claim, in the hope that a reliable source can be found for it. Jakew 11:25, 16 May 2006 (UTC)

Circs were commonly performed in Canada until the mid-70's, so many men are circumcised. But the current RATE of neonatal circ's is much lower.TipPt 14:39, 16 May 2006 (UTC)

Can you find a reliable source telling us what the current rate is? Jakew 14:49, 16 May 2006 (UTC)

I'll try to remember to come back to the issue if I find it again. It doesn't really matter, since the quote ... 48% ... sounds about right for all males. "In Canada, the infant circumcision rate is about 50%" ... should be removed until we find the true rate.TipPt 15:01, 16 May 2006 (UTC)

The reference supporting the AAP's statement on the number of Canadian males circumcised is 36 years old!

"In Canada, ~48% of males are circumcised.[8]"

8. Leitch IO. Circumcision: a continuing enigma. Aust Paediatr 1970; 6:59-65

DanBlackham 22:28, 16 May 2006 (UTC)

And moreover, the wording is ambiguous. "~48% of males are circumcised" could mean that in 1970 48% of infants were being circumcised, or it could mean that 48% of the male population at large were circumcised. Doesn't really matter how authoritative the source if the statement itself is open to a range of interpretation. In any case, a statement as to the situation in 1970 is quite meaningless as to the current state of affairs.Masalai 23:53, 17 May 2006 (UTC)

The preceding sentences help to clarify. "The percentage of male infants circumcised varies by geographic location, by religious affiliation, and, to some extent, by socioeconomic classification. Circumcision is uncommon in Asia, South America, Central America, and most of Europe. In Canada, ~48% of males are circumcised." Jakew 13:10, 18 May 2006 (UTC)

Well indeed, that was what I was getting at. The statement is curious. In the context of the paragraph it suggests that as of 1970 48% of newborns were being circumcised nation-wide, yes. It seems consistent with the general perception that francophone and maritime Canada never took up circumcision; but this was before provincial medical associations began lobbying urgently in anglophone Canada for the practice to be abandoned: by 1980, when this began to be of minor interest to me because I was myself reproducing, the urgency to desist from circumcision was fairly considerable on the part of medical personnel. Obviously my personal observation has no relevance in terms of documented statistics, but I would seriously challenge accuracy of the 48% of 1970 — whether it means the rate of circumcision of newborns or the incidence in the general population — as persisting into the 80s and beyond.Masalai 13:42, 18 May 2006 (UTC)

The AAP or AAFP as a "reliable source" ... NOT

...twenty-four years after the first AAP task force report on circumcision and a decade after the 1989 report, the AAP still could not authoritatively cite a complication rate for circumcision. The task force once again provided an estimated complication rate of 0.2% to 0.6%, citing the figures obtained by Harkavy and Gee & Ansell.171 First, the AAP again avoided or missed the fact that the Gee and Ansell study had already discounted the occurrence of what were considered minor (but signficant beyond the normal tissue trauma to warrant intervention and recording) complications.172 Second, following the AAP report's lead, the 1999 AAP report ignored the 4% immediate complication rate and the 13% late complication rate, published in the 1993 Metcalf article.173 the task force failed to take seriously the phenomena of surgical corrections of circumcision such as that which led to Dustin Evan's Jr.'s death in October of 1998, terming them "isolated case reports" and failing to list death as a possible outcome.174 Finally, the 1999 task force completely ignored a comprehensive 1993 review of estimates for circumcision's complication rates authored by British researcher's N. Williams and L. Kapila.175 If the AAP task force had found the study's conclusion that "realistic figure [for the complication rate] is 2-10 percent"176 was flawed, it should have at least cited the study and provided reasons for not crediting it. [[21]]

A law student is not an authority on reliable medical sources. Jakew 15:33, 16 May 2006 (UTC)

You cannot deny the quality and substantiation of his arguments. Basically, cited objective facts are considered facts unless properly refuted.TipPt 17:38, 16 May 2006 (UTC)

Actually, I can easily deny the quality of his arguments, but this is not an appropriate forum to do so.

The fact remains that the AAP are a reliable source, and the fact that some law student disagrees with their assessment of the evidence is neither here nor there. He's not an authority on the matter. It's not even published in a medical journal, in which it could be judged by medical professionals.

You could just about say that, since he has some legal training (though he's not yet qualified), he able to comment on legal matters, but this is self-evidently not a legal matter. It's a matter of evidence-based medicine. Jakew 18:05, 16 May 2006 (UTC)

It is well written, accurate, and well cited. The AAP statement is not. The panel was composed of doctors (long out of medical school)not researchers. The panel was under pressure from pro and anti circ factions, as well as influenced by financial, political (re: angry parents if told that circs aren't warrented relative to the risks), and cultural forces. "Reliable" does not publish poorly cited, misquoted, negotiated text with typos!TipPt 18:34, 16 May 2006 (UTC)

Conspiracy theories do not make an source unreliable. Please read WP:RS.

As for typos and quality of writing, I can only assume you're joking. Look at the article you cite. "1993 Metcalf article.173 ***t***he task force" ('T' should be upper case) "Dustin Evan***'***s Jr.'s death" (Misplaced apostrophe - correct name is Evans, not Evan) "British researcher***'***s N. Williams and L. Kapila." (Misplaced apostrophe - should be plural, not possessive). Jakew 18:42, 16 May 2006 (UTC)

Elective non-therapeutic circumcision of children is as much a legal and ethical issue as it is a medical issue. Professional medical organizations in Australia, Canada, Great Britain, and the United States all say there is no medical indication for circumcision of healthy boys. -- DanBlackham 22:30, 16 May 2006 (UTC)

---> "The mission of the American Academy of Pediatrics is to attain optimal physical, mental and social health and well-being for all infants, children, adolescents and young adults." That is the mission of the AAP. Jakew, I have read over your writing and the research done by the cited website.

I do understand you saying that "a law student is not a reliable source", but I believe what Matthew R. Giannetti is trying to say is that the AAP did not uphold their philosophy in the past by caring for the "well-being for all infants" due to the fact that there was infant circumcision, and as Giannetti says in his conclusion that "[t]he AAP has failed to classify circumcision as experimental or cosmetic and to inform parents of the full and true nature of this procedure." Which is true--most doctors do not spend much time to the parents of what circumcision is, how it is performed, what are the risks/benefits, etc. So the retoric question must be ask: if doctors are supposed to have the "well-being for all infants" then why are the doctors permiting that infants be circumcised? —Preceding unsigned comment added by 206.148.164.27 (talk • contribs)

The obvious answer is that, having reviewed the evidence, they find that parents are best suited to determine what is in the best interests of the child (in other words, to maximise his well-being). It is quite apparent that Giannetti's opinion is that the best interests of the child is not to circumcise, but the AAP are not required to share his view. They are required to be consistent with their own assessment. And they are. Jakew 08:20, 17 May 2006 (UTC)

Obvious, but inconsistent. For parents to be best qualified, they would have to be fully informed of the risks and benefits. The complaint here is that doctors are failing to inform. Think about it. Al 12:37, 17 May 2006 (UTC)

Not quite. The complaint is that they are informing parents of their assessment of the evidence, rather than Giannetti's.

Here is another criticism of the AAP's policy statement, this time from people who are qualified to evaluate medical evidence. They argue in the opposite direction: that the AAP's policy is too anti-circ.

Neither example is evidence that the AAP are an unreliable source. Both are merely evidence that people disagree with their assessment. Jakew 13:13, 17 May 2006 (UTC)

Here's an example of AAFP quality ... "while another(11) states there are no well-controlled cohortrelated studies to document their relationship." The actual cite is different (relation is said oddly twice), cohortrelated is cohort related, and "relationship" is actually "relation" in the cite.[[22]].

You are wrong about what most US doctors think about circs. They think it's a low risk low benefit surgery, that probably shouldn't be done given that chance of sexual or serious complications. But they take a neutral stance because of the animosity generated if they delve into the risks. Let parents decide essentially without consultation ... it's not usually that bad.TipPt 15:22, 17 May 2006 (UTC)

First of all, Tip, are you complaining about the AAP or the AAFP? The two are distinct organisations.

Secondly, what point are you actually trying to make? It isn't an exact quote. Note the absence of quotation marks. The terms 'relation' and 'relationship' have essentially the same meaning in this context.

Finally, I don't intend to debate what doctors think about circs, because it's a matter that is pure speculation and impossible to verify. So let's not waste any further time on it. Jakew 15:39, 17 May 2006 (UTC)

There are typos in both organizations statements. I just pulled one you like to use.

It was just poor english, and typos are odd in a final publication.

I know the doctor "speculation" can't be used, but that's what they tell me. Their time is valuable and talking to parents doesn't change the outcome anyway, so...TipPt 15:59, 17 May 2006 (UTC)

It's actually a republication of the original, Tip. I suspect that some typos may have been introduced. Jakew 16:07, 17 May 2006 (UTC)

Comment says the same thing twice!!

Jakew ... In the third paragraph on the introduction, you keep stating American assoc statements twice ... that say basically the same thing. "However" is also improper. Please stop.TipPt 15:03, 17 May 2006 (UTC)

Two different quotes from two different organisations. One recommends that physicians discuss benefits and risks. The other mentions the benefits and risks as part of an explanation as to why the academy is leaving the decision to parents. Jakew 15:29, 17 May 2006 (UTC)

Incidentally, I have reworded the title of this section. If you wish to say something to me personally, my talk page is the correct place for it. This article's talk page is for general discussion of the article, not personal comments. Jakew 15:42, 17 May 2006 (UTC)

See how I fixed it ... leaving content without repetition.

You generally control this Topic, so I address you directly.TipPt 15:44, 17 May 2006 (UTC)

You didn't fix it at all. You reduced two different quotes to that which they have in common. Unfortunately, in doing so, information was lost.

Nobody controls this topic. Please remember that. Jakew 15:55, 17 May 2006 (UTC)

What information was lost?TipPt 16:08, 17 May 2006 (UTC)

Please stop mangling and mashing different quotes by different organizations. Thanks. Jayjg ^(talk) 17:14, 17 May 2006 (UTC)

You know I don't mind double representation of the American view ... and it's kind of funny but it makes the intro lousy. Just plain poor writing.TipPt 15:48, 18 May 2006 (UTC)

There's a single 'American view'? How odd. I always thought that different people could have different views, even if they have the same nationality. Jakew 15:58, 18 May 2006 (UTC)

Check it out, before it's Gone...

MEDICAL ASPECTS

Neonatal circumcision has been studied using cost-benefit analyses. Largely these have computed the average net lifetime health and financial results of circumcision. The complications morbidity is compared to the potential gain in expected longevity, and the medical costs of circumcision are compared to the expected reduction in lifetime health costs.[[23]][[24]][[25]][26]][[27]] The results have mostly shown neither cost savings nor improved longevity to the practice of neonatal circumcision, and have formed the basis of public health policies. The American Academy of Pediatrics (1999) said the medical benefits of circumcision are not sufficient to recommend routine neonatal circumcision, but that it should be the decision of informed parents.[[28]] The British Medical Association states "The medical benefits previously claimed, however, have not been convincingly proven, and it is now widely accepted, including by the BMA, that this surgical procedure has medical and psychological risks.” They also state that "parental preference alone is not sufficient justification for performing a surgical procedure on a child."[[29]]

Gone, why? Al 17:20, 18 May 2006 (UTC)

Not gone, just edited somewhat. Edit summaries give reasons for various changes. Jakew 17:49, 18 May 2006 (UTC)

It's actually developing into a reasonably good partnership; Tippt introduces material that doesn't properly represent its sources, or presents it in a POV way, or is simply unsourced POV, and you pare it down to an NPOV presentation. Jayjg ^(talk) 19:10, 18 May 2006 (UTC)

Please be specific Jayjg, if you want anyone to read your comments.TipPt 17:04, 19 May 2006 (UTC)

This article is a sewer.

...and I am NOT talking about the content or point of view. The article is a confused, unreadable mess. In large part, that's due to TipPt's recent misbehavior, but certainly not entirely. Here are some of the things I suggest be done to clean the article up. I am very carefully making "value neutral" suggestions that have nothing to do with the underlying content but everything to do with the structure and organization.

• An Introduction Is Not A Dissertation

The intro to the article is approximately 63,000,141 times larger than it should be. Cut it down. Chop it off. Edit without mercy. The intro should be no more than four sentences. Anything else can go in the body of the article. If you think you have a Really Important Point that absolutely needs to be in the intro, there is a good chance that you are utterly wrong.

• Culture and Religions: When Laundry Lists Attack!

The whole culture and religions section is out of control. Paring it down to a reasonable size is probably impossible at this point, so split it off into its own article. Then nuke it from this 55k monstrosity of an article.

• Medical Analysis

Holy Prostate Cancer, Batman, we have another article on this topic that is 66k long and we still feel the need to have this thing dominating the entire middle section of the article? Turn this entire section into a single paragraph. One. Each alleged benefit or risk of circumcision gets a sentence, with one cite, and if people care to learn more they can read the Medical analysis of circumcision article, presumably after giving up their dreams of reading War and Peace.

• History

See "medical analysis". Same logic. Same proposed solution.

• Everything else

The ethics and prevalence sections seem ok, or at least not utterly out of control in the way the above-named sections are. The "See also" section is a bit muddied -- surely we have a style guide on making that a bit more useful. My instinct says its silly to say "see also" if you've linked to the "also" in the text -- use "See also" for relevant bits that for one reason or another you didn't link it.

That's all I have for now. Comments? Nandesuka 00:54, 19 May 2006 (UTC)

The article is inaccurate without a pertinent introduction, which is not too long. You have removed valuable content, again without justification. If you hack still it down, leave all critical cited points.

I doubt anyone can fix this Topic, judging by the behavior we ALL seem to use here ... It is quite unstable, so I have come to see Jakew's point of references (with respect to rewriting the whole thing).

It's best to leave it alone, making incremental changes. That is especially true given Nandesuka's recent actions. Who can be trusted to accurately condense and organize? So, far nobody.TipPt 03:40, 19 May 2006 (UTC)

Nandesuka ... you should try to edit other's work, not revert to yours again. I have learned that lesson...TipPt 03:37, 19 May 2006 (UTC)

I think most of what you say makes sense, Nandesuka. I particularly agree about the introduction, which is far too long-winded. We have already got a circumcision in the Bible article, and I'd suggest moving that to something like "cultural and religious aspects of circumcision", and merging what we have here into that. Jakew 11:16, 19 May 2006 (UTC)

Maybe the article needs to be split more (rather then merged)? --BerserkerBen 15:01, 19 May 2006 (UTC)

Parental reasons for neonatal circumcision, and "informed" parents

Below are two versions of the second (intro) paragraph.

First, here's what seems to be OK, except that "cultural ritual" (NOT "reasons" ... that's not the cite Nandesuka), "health" and "hygiene" must be in quotes because they are drawn directly from the survey questionares:

The practice of circumcision predates recorded human history, with depictions found in stone-age cave drawings and Egyptian tombs. The origins of the practice include ritual sacrifice, offering, or sign of submission to a deity, a rite of passage to adulthood, a mark of defeat or slavery, or an attempt to alter esthetics or sexuality. Circumcision and frenectomy remain the most common surgical procedures performed on young males, predominately members of the Muslim and Jewish faiths, but also the majority of Americans, South Koreans and Filipinos.

Here is a proposed second part of that paragraph:

The American Medical Association Council on Scientific Affairs finds "parental decision-making is based on social or cultural expectations, rather than medical concerns."[30] Surveys of American parents indicate that parental decisions regarding circumcision are made on the basis of "cultural ritual," [31] religious beliefs, and "health" and "hygiene" reasons.[32] [33]. In general, "many parents' decisions about circumcision are preconceived," “the presentation of medical information on the potential advantages and disadvantages of circumcision had little influence on parents' decisions," and in one study, "nearly half of those physicians performing circumcisions did not discuss the potential medical risks and benefits of elective circumcision prior to delivery of the infant son."[34] In two studies, strong parental cultural expectations clash with deliberate informed consent, and “a significant number of parents in the studies mentioned expressed animosity toward the care provider.” Discord arises from the implication that parental desire to circumcise involves “undue risks” and and provides “limited medical benefit” to their child.

The second is what Nandesuka prefers (but is not accurate):

American surveys indicate that parental decisions regarding circumcision are made on the basis of cultural reasons, [35] religious beliefs, and health and hygiene reasons.[36] [37]

Which do you all prefer, and why?TipPt 03:21, 19 May 2006 (UTC)

I will say this as bluntly as I can: no matter what the topic — circumcision, knitting, flying kites, cute fluffy little kittens — putting a paragraph that long, and that detailed, in the introduction to the article is nothing short of ludicrous. Nandesuka 03:27, 19 May 2006 (UTC)

Idealy, the introduction paragraphs would be shorter, but linked to related articles within the Topic. Unfortunately, much of that stuff is junk. Regardless, the reader benefits from summary of historical context and current practice in the intro.TipPt 03:33, 19 May 2006 (UTC)

PS ... I'm going fishing, so have fun next week.TipPt 03:38, 19 May 2006 (UTC)

The solution to "the related articles are junk" is "fix the related articles" not "stuff up the introductory paragraphs to this article with several thousand sentences on disjoint, barely related factoids." Nandesuka 03:55, 19 May 2006 (UTC)

It's somewhat long, and I'd love to see good editing. But is flows fairly well, is easy to read and understand.TipPt

I disagree in the most strenuous terms possible. It flows poorly. It is hard to read. It is hard to understand. It fails our readers on all possible axes. Nandesuka 04:11, 19 May 2006 (UTC)

Furthermore, it repeats that which is already stated further on in the article. Complex, citation-heavy information (especially that which is US-centric) does not belong in the introduction. Keep it simple. Jakew 11:19, 19 May 2006 (UTC)

Nandes ... what grade level do you target?

It does not repeat specific relevant content, cites, and quotes. It USED to be highly US-centric ... then I added the BMA, (and soon the Canadian.)TipPt 17:20, 19 May 2006 (UTC)

"Summarize briefly first, then go into depth later" is not targeted at any specific grade level. It's just good style. Nandesuka 17:50, 19 May 2006 (UTC)

POV

So, I put back the POV tag after Nandesuka removed so much material in a non-neutral manner. You know, it's not a horrible thing for the article to reflect all relevant POV's. Al 03:57, 19 May 2006 (UTC)

Actually, the material I removed was without reference to its point of view. Can you please specify what, exactly, in the article fails to conform with the NPOV policy? That would be a big help. Nandesuka 04:02, 19 May 2006 (UTC)

The whole point of Wiki is to inform the reader; your intro does a very poor job, and unfortunately critical content is missing from related articles. Please submit proposed articles before you delete valuable content from the intro.TipPt 04:09, 19 May 2006 (UT

We inform our readers by providing well-written articles. Well-written articles do not barrage the reader with a slew of barely-connected factoids and footnotes in the first three paragraphs. If you are unhappy with the related articles, the solution is to fix them. The solution is categorically not to turn the introduction to this article into a pile of dense, unreadable, heavily-footnoted garbage. Nandesuka 04:11, 19 May 2006 (UTC)

It is important to keep a cool head, especially when responding to comments against you or your edits. Personal attacks and disruptive comments only escalate a situation; please keep calm and remember that action can be taken against other parties if necessary. Attacking another user back can only satisfy trolls or anger contributors and leads to general bad feeling. Please try to remain civil with your comments. Thanks!

Calling someone's work "garbage" is hardly civil. All you needed to say is that you didn't find his version to be as clear as the one you endorse. Al 04:28, 19 May 2006 (UTC)

First of all, it's not any one person's version. TipPt didn't write that introduction all by himself. Its garbage nature is the fault of many editors, and the constant back-and-forth over various issues. I have no doubt that I contributed to the mess also.

Second, I think it is important not to understate the seriousness of the problem. I use the word "garbage" because that introduction is garbage. As an introduction, it has absolutely no redeeming qualities whatsoever. It is a nightmare. It is unreadable. By any reasonably objective standard, it is garbage, and It's important that we as editors recognize it, so that we can fix the problem.

Your points about civility, howver, I am sure are well-intentioned. I will make sure to emphasize, when we discuss this issue, that it is the hugely long version of the introduction (which I, as an editor, am equally responsible for), and not any specific editor's work that is garbage. Nandesuka 11:11, 19 May 2006 (UTC)

It may well be that your incivility was unintentional, but it is still incivility. Likewise, saying "you endorse garbage" is not a huge improvement over "you wrote garbage". The solution is to focus on what you dislike, without using dismissive terminology. Words like "garbage" have little place in edit summaries and article Discussions.

Now, if you have specific complaints, let's focus on those. Al 12:32, 19 May 2006 (UTC)

Alienus, I can't agree with your assessment. Civility means being civil to others, not towards the content of articles. Anyone who takes offense at criticism of an article that they have edited is missing the point of WP:OWN, in my view.

Frankly, I think it's pointless and unproductive to talk about who is at fault for the article's problems. Jakew 13:25, 19 May 2006 (UTC)

As I said, if you have specific complaints, let's focus on that. It would be an improvement over negative generalizations. Al 15:07, 19 May 2006 (UTC)

Talk:Circumcision#This_article_is_a_sewer lists a large number of problems and proposed action items. You might want to read it before you comment further. Incidentally, as long as we're asking for specifics, can you please identify which text you believe fails to conform to NPOV? Please remember that is an abuse of the {{POV}} template to tendentiously apply it to articles without cause. Nandesuka 15:14, 19 May 2006 (UTC)

TipTp already answered this, but I'll clarify. The biggest problem isn't with the phrasing of what's in the article, but with the absence of information that might put circumcision in a more negative light. For example, in removing the quote-heaviness from the intro, you removed a lot of quotes that are now no longer to be found in the article, thus slanting it. This is part of a long-term problem, now being dealt with in an RfM, in which material of this sort has a tendency to be removed. Oh, and need I remind you to WP:AGF about that tag? Al 15:23, 19 May 2006 (UTC)

What specifically do you believe was removed from the introduction that isn't available elsewhere in the article? I, frankly, don't see anything. You're being too vague. Nandesuka 15:35, 19 May 2006 (UTC)

Why don't you read the full version intro, and try to find more than one (there's one left in your slashed version) of the textbook citations? How about trying to find this study quote: Discord arises from the implication that parental desire to circumcise involves “undue risks” and and provides “limited medical benefit” to their child. How about the AMA Council statements? How about the concept and application of cultural ritual? How about the BMA saying (note that was written in 2003)?

"medical benefits previously claimed, however, have not been convincingly proven."

Good luck next week trying to write all the new articles, reorganize the topic outline, and have it STABLE.TipPt 16:20, 19 May 2006 (UTC)

I think a better question is this: why do we need to have information about how US parents reacted twenty years ago to then-current information in the introduction? Why do we need to have conflicting and contradictory views from medical organisations in the introduction?

I see no reason why these should not be included in the appropriate sections, but the purpose of an introduction is to introduce the subject, for goodness' sake! It's for simple, uncontroversial facts. Going into mind-boggling detail makes it worse, not better. Jakew 16:47, 19 May 2006 (UTC)

The AMA Council statement was made in 1999, with a review of the lit at that time. It's not dated.

We are seeking neutrality in the Topic, which currently (assuming Nend's slash is in right now).

Conflicting and contradictory ASSOC statements inform the reader. The US ASSOC take a relatively pro-circ stance, thus it is proper to include global ASSOC statements.

What I saw going on was a shift toward neutrality in the intro, which is most easily thwarted by Nend's slash. The reader looses.TipPt 17:01, 19 May 2006 (UTC)

It's funny Jakew, I went searching for diverse ASSOC quotes because YOU were insisting on two US ASSOC quotes in the third paragraph ... saying essentially the SAME THING!!TipPt 17:11, 19 May 2006 (UTC)

When I first started working on this topic, someone (not in this discussion) listed the pro-circ participants ... that list has proven true.TipPt 17:15, 19 May 2006 (UTC)

Just so everyone knows what Nandesuka deleted from the Introduction

I know it needs condensing, but the content is critical to current practice.

Circumcision is the removal of some or all of the foreskin (prepuce) from the penis. The frenulum may also be removed at the same time, in a procedure called frenectomy. The word "circumcision" comes from Latin circum (meaning "around") and caedere (meaning "to cut"). Female circumcision is a term applied to a variety of procedures performed on the female genitalia. Except where specified, "circumcision" in this article should be understood as "male circumcision".

The practice of circumcision predates recorded human history, with depictions found in stone-age cave drawings and Egyptian tombs. The origins of the practice include ritual sacrifice, offering, or sign of submission to a deity, a rite of passage to adulthood, a mark of defeat or slavery, or an attempt to alter esthetics or sexuality. Circumcision and frenectomy remain the most common surgical procedures performed on young males, predominately members of the Muslim and Jewish faiths, but also the majority of Americans, South Koreans and Filipinos. The American Medical Association Council on Scientific Affairs finds "parental decision-making is based on social or cultural expectations, rather than medical concerns."[38] Surveys of American parents indicate that parental decisions regarding circumcision are made on the basis of "cultural ritual," [39] religious beliefs, and "health" and "hygiene" reasons.[40] [41]. In general, "many parents' decisions about circumcision are preconceived," the presentation of medical information on the potential advantages and disadvantages of circumcision had little influence on parents' decisions," and in one study, "nearly half of those physicians performing circumcisions did not discuss the potential medical risks and benefits of elective circumcision prior to delivery of the infant son."[42] In two studies, strong parental cultural expectations clash with deliberate informed consent, and “a significant number of parents in the studies mentioned expressed animosity toward the care provider.” Discord arises from the implication that parental desire to circumcise involves “undue risks” and and provides “limited medical benefit” to their child.

Non-therapeutic infant circumcision has become controversial in recent decades. National medical associations in the United States, Canada, and Australia do not recommend routine infant circumcision.[43] The American Academy of Family Physicians recommends that "physicians discuss the potential harms and benefits of circumcision with all parents or legal guardians considering this procedure for their newborn son."[44] The British Medical Association states "The medical benefits previously claimed, however, have not been convincingly proven, and it is now widely accepted, including by the BMA, that this surgical procedure has medical and psychological risks.” They also state that "parental preference alone is not sufficient justification for performing a surgical procedure on a child."[45] The American Academy of Pediatrics states "In the case of circumcision, in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. ... It is legitimate for parents to take into account cultural, religious, and ethnic traditions, in addition to the medical factors, when making this decision."[46]

At least there's a good RfC in the works...

With great documentation ... that will attract attention.

The only hope is for others to view the issues and bring new consensus. Otherwise the Topic will continue (forever) to be unstable and lousy.

One might look at the talk between Jakew and I regarding listing medical beneifits (in great detail) TWICE ... at Jakew's insistance. Broken promises. Double representation of US assoc statements. Improper deletion of BMA statments (relating to the double US). Now this slash, leaving the reader without access to critical information.TipPt 17:28, 19 May 2006 (UTC)

Good luck trying to incorporate all the intro (slashed) material properly. Until that is done, removing material is biased.TipPt 17:31, 19 May 2006 (UTC)

If you can find an appropriate place in the body of the article to put such material, without duplicating or repeating material that is already there, I encourage you to do so. Making the introduction be clumsy and overweight, however, is not an acceptable alternative. Nandesuka 18:00, 19 May 2006 (UTC)

Indeed. It would help if TipPt would try to think of the reader, rather than the message he feels impelled to impart. Jayjg ^(talk) 20:52, 19 May 2006 (UTC)

3rd picture

What purpose does the 3rd picture serve? We already have one of a clipped, unclipped, erect, not erect penis! What new information does the 3rd picture provide? Honestly I wonder if some people out of drooling perverted exhibitionism post nude pictures of them selves here, great way to chat with people on the internet: “Ya my dicks on wikipedia!” --BerserkerBen 05:58, 20 May 2006 (UTC)

Hmm. While I don't really care one way or the other, I don't necessarily think it's safe to assume the picture was added for the reasons you suspect. The article on toplessness, for instance, has multiple pictures of both men and women with bare chests. As a matter of fact, I'm very surprised that we haven't had someone in here yet accusing us of racism for only having pictures of white penises. Eventually we will, and they won't be happy until we have seven pairs of pics representing every possible color they come in... sigh. Can't please everyone. :P Kasreyn 10:45, 22 May 2006 (UTC)

The race problem can be fixed with black and white images. I would like to move the pictures to a section that describes the physical aesthetic aspects of circumcision.--BerserkerBen 00:35, 23 May 2006 (UTC)

The counter-argument is, why black and white? Why not Hispanic and white? We don't want Wikipedia to get into the situation where we judge something's inclusion based on the percentage of that ethnicity in the populace. And then even if we do pander to the race issue, we're never going to make everyone happy, and we'll upset people who will claim "my god, look at that! the article has ten different pictures of penises! you guys are NUTS!" :P Kasreyn 09:06, 23 May 2006 (UTC)

Maybe I misread, but I thought he meant "black and white" as in "black and white film, the opposite of color film," the idea being that that would make it not-obvious what the background of the penis-owner is. But I dunno. Nandesuka 12:24, 23 May 2006 (UTC)

Yep, black and white as in grayscale, lets try it. --BerserkerBen 18:33, 23 May 2006 (UTC)

Wouldn't it be better to cross that bridge when you come to it? If someone makes a reasonable objection to there only being a caucasian penis used as an example, then it would make sense to worry about that. --Alex uk 86 20:47, 23 May 2006 (UTC)

How do you envision crossing that bridge when we come to it? Someone complains that there are only images of caucasian penises, so the solution is. . . change them to greyscale! The original objector might rightly object that we then just have images of greyscale caucasian penises. If we convert them into greyscale now, and that really does help obscure skin color, then we might avoid complaints that couldn't be dealt with by just converting to greyscale. ^L_Wizard @ 00:07, 24 May 2006 (UTC)

Agreed. It's a waste of time to try to prepare for future complaints. We have no way of knowing what sort of person will come here, or in what way they might be offended, until they say so. Kasreyn 23:53, 23 May 2006 (UTC)

Ohh. Wow, I'm an idiot. -_-;; Kasreyn 23:52, 23 May 2006 (UTC)

I completely disagree with converting the images to grayscale. Yet again, we are back to worrying about offending people. If you want the article to have more than just caucasian penises, go ahead and get some CC licensed pictures and we can increase our ethnic diversity. As to the grayscale conversion, if we aren't going to remove the pictures to avoid offending people, why would we reduce their quality? Why not replace them with animated GIF sketches done in paint that switch between all of the colors? Where do we stop? We don't do these things because we don't compromise the quality of the article to avoid offending those who are easily offended. Christopher 02:55, 24 May 2006 (UTC)

What makes you think that the photos are "caucasian"? The one that was recently replaced by the current photo number 2 (and which I for my part considered demonstrated more clearly the structure of an uncircumcised penis) was that of a Chinese man. Curiously, it appears to have been replaced on the grounds that it was somehow less attractive than the photo of the rather inflamed and orange-coloured circumcised penis. Masalai 12:54, 24 May 2006 (UTC)

lol. i don't like the look of the circ'd penis either (no offence to the own of that penis), but its a fair example of a circ'd penis. Likewise the uncirced is a fair example of an uncirced. Anyway, to the point, i don't think its racist or unreasonable to leave both pictures as they are and save ourselves the effort, i agree that maybe changing them might stop someone objecting about racism, but i'm sure they were not put there with racist intent and they sure as hell will find something to object about if they really want to! (perhaps even this discussion?!?)--Alex uk 86 16:16, 24 May 2006 (UTC)

Well the cut one does looks smaller I would say that’s a subtle put down. What bothers me though is how someone managed to censor it! It like someone purposely mocking my tag! --BerserkerBen 18:19, 24 May 2006 (UTC)

I've just reverted it, i'll put a comment on that images discussion in a sec. (oo, look at me all wikified - assuming its the right thing to do)Alex uk 86 22:04, 24 May 2006 (UTC)

Exactly how was it done and who did it? Oh I see never mind my bad.--BerserkerBen 22:24, 24 May 2006 (UTC)

Masalai, I don't think that's inflammation you're seeing. That reddish ring around the penis, well below the glans, is simply a circumcision scar. Some circumcision scars are broader than others, depending on how neat a job was done. The orange aspect is simply poor color balance in the image, which may be due to poor original lighting. If it really bothers you, some photoshopping could provide it a more natural appearance. Kasreyn 23:03, 24 May 2006 (UTC)

Circ Advocacy merge per tag

In a word, preposterous. This article is already huge. It's longer than is considered preferable by article size. Merging it with Circumcision advocacy is unneccessary. I'd say both issues are notable enough to deserve seperate articles. I don't see how making this article any larger will help. Kasreyn 00:52, 25 May 2006 (UTC)

I strongly agree. If anything, maybe we should be looking at splitting a few things off?!? Circumcision advocacy is an article in its own right, and there is already a link to it in the "see also" section--Alex uk 86 12:27, 25 May 2006 (UTC)

First picture's licence

The first picture claims (in its Licensing section) to be a Wikipedia screenshot, which it clearly is not. I'm not sure of the procedure for further investigation, but I thought I'd let someone over here know about it at least. /blahedo (t) 01:06, 25 May 2006 (UTC)

I have fixed the licensing problem (It was a copy of a GFDL license and so retains that license)--Clawed 02:59, 25 May 2006 (UTC)

Suicide bombing vs Circumcision

Someone should point out as a disadvantage of circumcision that circumcised men are more likely to turn into suicide bombers than "un"circumcised men.Cuzandor 02:48, 25 May 2006 (UTC)

On the off chance that you're being sincere, see Correlation implies causation (logical fallacy). Rhobite 02:57, 25 May 2006 (UTC)

Then that "reduces HIV infection risk" is a logical fallacy too? Because they don't know how could circumcision reduce HIV infection either.

Well there are theories on that (see article), of course it’s a moot point because reduced chances of infection is not good protection, lets say circumcision cuts your chances in 1/2 or 1/3, but a condom cuts it to 1/40, I think I would go with the condom.--BerserkerBen 18:32, 25 May 2006 (UTC)

Also, circumcised people are more likely to drive SUVs, eat mac donald's, invade other circumcised people's countries et cetera, I conclude that circumcision causes violence Cuzandor 03:12, 25 May 2006 (UTC)

What I'm trying to say is that all those "are more likely" statements are kind of invalid. Cuzandor 03:20, 25 May 2006 (UTC)

Then how about saying it outright without trying to be so cute about it? Which "are more likely" statements in the article, in particular, do you feel are invalid, and why? Cut to the chase. Kasreyn 05:12, 25 May 2006 (UTC)

He doesn't think that we should mention the studies which suggest that circumcised men have a reduced risk of being infected with HIV. As long as these studies are mentioned in a NPOV manner, it's fine to mention them in this article. The way scientists demonstrate causation is through controlled tests, and it sounds like the latest study was randomized and controlled well enough to eliminate social factors as variables. Rhobite 14:17, 25 May 2006 (UTC)

But they are inconclusive studies. This is an encyclopedia, this must contain conclusions only ( I think ). 201.23.64.2 17:05, 25 May 2006 (UTC)

Almost Nothing can be concluded without doubt, the information is worthy of remaining on the article, though again the protection it provides (if any) is minimal, the risk of infection are bad even if you are circumcised, if you want well verified protection, cut or not, your going to have to were a condom.--BerserkerBen 18:32, 25 May 2006 (UTC)

What do you mean by "inconclusive"? The study seems to contain a conclusion. And how would an "inconclusive" study be equivalent to your suicide bomber example? Rhobite 18:58, 25 May 2006 (UTC)

What is "conclusion"? Science is a process, not a destination. Kasreyn 22:30, 25 May 2006 (UTC)

I studied male suicide bombers and found out that almost 99% of them were circumcised. I can't explain how this happen, but I can make up an hypothesis. The same happens with the HIV infection risk reduction rate, therefore my statement that circumcision increases the likelyhood of the "patient" to become a suicide bomber should be added to the article too.201.23.64.2 23:57, 25 May 2006 (UTC)

Find a reliable source that reaches the conclusion that circumcision causes, or might cause, suicide bombing, and you can include it in the article. In the meantime, please review our policies on no original research. Have a nice day. Nandesuka 01:07, 26 May 2006 (UTC)

Clearly you don't understand the purpose of experimental controls. Rhobite 01:20, 26 May 2006 (UTC)

This is a well-known logical fallacy. Correlation does not equal causation. Sorry, try again. Kasreyn 04:40, 26 May 2006 (UTC)

That's precisely the point. The fact that circumcision is (negatively) correlated with AIDS does not imply that circumcision has any causative influence on contraction of AIDS. The article contains "a well-known logical fallacy." Isn't that a bit concerning? ^L_Wizard @ 07:19, 26 May 2006 (UTC)

Two points: firstly, we accurately represent the conclusions in the papers that we cite. Secondly, the most recent study is a randomised controlled trial - a scientific experiment to see whether circumcision worked, and it did. Jakew 08:49, 26 May 2006 (UTC)

I wouldn't know about that, LW. I haven't studied the case in point, so it would be a mistake for me to speak on something I'm ignorant about. I wasn't aware anon 201.etc was making a comparison to an existing claim in the article. In that case, his insistence on including nonsense is merely unneccessary disruption of the talk page to prove a point. Kasreyn 12:23, 26 May 2006 (UTC)

On reading of the relevant section, LW, I really don't get why you're worried. The article takes great pains to point out how controversial this research is. However, if true, it would certainly be notable. Note that the fallacy only refers to when correlation is assumed, without any other evidence, to equal causation. Obviously, sometimes correlation really does come about in this way. Objects on earth's day side are much warmer than objects on earth's night side. It would be a fallacy to use merely this datum to conclude that warmth derives from the sun, even though it's true. Kasreyn 12:28, 26 May 2006 (UTC)

OK I give up, now I see that "scientists" are too proud to admit they are wrong Cuzandor 16:34, 26 May 2006 (UTC)

Science is defined by its willingness to disprove theories. Saying that scientists never admit they are wrong displays a complete lack of understanding of the practice of science. Rhobite 19:25, 26 May 2006 (UTC)

See, that's what I'm talking about. If you are a scientist and know you are wrong, don't admit it; invent some kind of riddle or word play! The fact is that "random trials" are unreliable. Cuzandor 02:22, 31 May 2006 (UTC)

What is wrong with random trials? You are aware of observational bias, right? My understanding is that randomization in studies is necessary to prevent observational and other kinds of bias in the judging of results. In general, if you have a point to make, how about you make it instead of accusing Rhobite of lying? If you have a case to make against a particular study cited in this article, stop pussyfooting around and make your case clearly. Kasreyn 16:21, 31 May 2006 (UTC)

They are wrong because they are random. I don't understand how randomness can make anything "unbiased". I belive it makes the result random as well. If circumcision prevents HIV, why there are a lot of people with HIV in USA? 201.23.64.2

I don't know why I'm trying to "argue". Lwizard already said what I tryed to say before. Ah I understand, it's there because it's "NPOV", it's "science", NPOVness and Scienceness nullifies fallacyness. 201.23.64.2 19:32, 1 June 2006 (UTC)

Court rulings

The following unsourced claims were recently inserted:

However, courts have ruled that the right of a parent to give valid, legal consent for a minor is limited to medical treatment. Other courts have also ruled that the removal of normal, healthy tissue does not constitute treatment.

Both claims are vague and dubious, and the wording POV. Could someone please provide actual citations for these claims? Jayjg ^(talk) 17:37, 25 May 2006 (UTC)

POV template

I have removed the POV template again because no one has identified any specific problems with the text in the page (claiming that other editors are biased is not the same as identifying what text in the article fails to conform to WP:NPOV. Please remember that placing templates like this on an article without identifying why you are doing so is vandalism. Feel free to use the space below to discuss the specific objections you have to the text of the article. Nandesuka 11:28, 27 May 2006 (UTC)

Your repeated edit-warring to remove the POV tag is a sign of bad faith. You know that all of the circumcision articles are controversial, with some content considered POV by some people. Al 18:23, 27 May 2006 (UTC)

I daresay there is not a single article on Wikipedia whose content is not "considered POV by some people." That's not what the {{pov}} template is for. If there are specific passages and terms that you care to identify, then it is appropriate to add the tag and identify them. The template is categorically not meant to simply indicate "this article disagrees with my point of view," and using it in such a way is abuse. Nandesuka 18:55, 27 May 2006 (UTC)

Indeed. It is supposed to be a temporary tag, for the purpose of getting specific problems fixed. That's impossible if the problems aren't specified. Jakew 19:08, 27 May 2006 (UTC)

The hardest problem is to pick just ONE issue. For now, I'll let it sit, while we deal with the RfM. I suspect that the recommendations that come out of that process will impact this article, as well. Al 01:14, 28 May 2006 (UTC)