Talk:Circumcision/Archive 70

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Those raised in favour of circumcision

The last statement in the lead, "Those [arguments] raised in favour of circumcision include that it ... is best performed during the neonatal period" is certainly not an argument in favor of circumcision. It's an age-specific recommendation that belongs in another section. Wimp O'pede (talk) 01:59, 14 January 2012 (UTC)

It's an argument in favour of performing circumcision in the neonatal period. Jakew (talk) 09:24, 14 January 2012 (UTC)

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That explains why the current lead is so poorly written and disorganized. It deals with adult circumcision and neonatal circumcision without differentiating between them. If the reader is meant to assume the article is about neonatal circumcision, the argument in favor of adult circumcision that is presented in the third paragraph should explicitly claim to be an argument in favor of neonatal circumcision, rather than making that argument by innuendo, as it appears by your claim that the article is implicitly about neonatal circumcision. Wimp O'pede (talk) 16:42, 14 January 2012 (UTC)

It's an article about circumcision, which necessarily includes both infant circumcision and adult circumcision. Jakew (talk) 16:45, 14 January 2012 (UTC)

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Whether it's an oversight or a lack of scholarship, the article has no citation to indicate that any national organization of doctors has endorsed the adult studies in paragraph three (of the lead) as evidence in favor of neonatal circumcision. Wimp O'pede (talk) 17:05, 15 January 2012 (UTC)

Wimp makes a very valid point here. Please address it Jakew. Therewillbefact (talk) 08:30, 19 January 2012 (UTC)

The reason I didn't address it is that we don't need a citation for statements that aren't made. Jakew (talk) 09:31, 19 January 2012 (UTC)

The statement "Those raised in favour of circumcision include that it provides important health advantages which outweigh the risks, has no substantial effects on sexual function, has a low complication rate when carried out by an experienced physician, and is best performed during the neonatal period." goes against the medical advice of every single medical organization in every country. The fact that a doctor managed to get published, even though his advice runs contrary to the medical advice of every nation, is clearly gaming the system. It needs to be removed, or a reference placed after it that states that the surgery's risks do not outweigh the benefits, from the policy of every major nation, placed after it.Tftobin (talk) 18:16, 25 January 2012 (UTC)

The function of the paragraph is to illustrate the controversy surrounding circumcision. To do that, we give the views of those advocating it, as well as those opposing it. It seems probable that many people with at least a passing familiarity with the subject will find something in that paragraph to disagree with ("justified only by medical myths" seems frankly absurd to me, for example). But that's not a reason to remove these claims, nor to try to "correct" them. They're opinions, and are fairly clearly identified as such: since they're included to show the range of views, the only real question is whether people have actually asserted them, not whether the view is right or even if it is credible. There may, however, be a case for removing the paragraph entirely, or replacing it with a better description of controversy. Jakew (talk) 19:00, 25 January 2012 (UTC)

When one person advocates an unneeded medical procedure on another, and states that the benefits outweigh the risks, while every medical organization of every country says the opposite, it is giving credence to a decidedly non-mainstream medical point of view. What it advocates can actually be harmful or fatal. We need to alter that sentence, remove the paragraph, or provide references to more mainstream medical thought. Certainly, the least correct thing to do is to leave the paragraph the way it is. Tftobin (talk) 21:30, 25 January 2012 (UTC)

It seems a bit of a stretch to claim that it's a "non-mainstream" point of view. This CDC consultation drew the same conclusion. Furthermore, it's not correct to state that every medical organisation says otherwise: relatively few medical organisations actually comment on that particular issue, and even fewer directly contradict it. Jakew (talk) 21:42, 25 January 2012 (UTC)

American Academy of Pediatrics: "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision." http://www.nlm.nih.gov/medlineplus/circumcision.html "The American Academy of Pediatrics (AAP) does not recommend routine circumcision. "

American Medical Association, 2008: "The AMA supports the general principles of the 1999 Circumcision Policy Statement of the American Academy of Pediatrics, which reads as follows: Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision."

British Medical Association: "The general perception has been that no significant harm was caused to the child and therefore with appropriate consent it could be carried out. 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. It is essential that doctors perform male circumcision only where this is demonstrably in the best interests of the child."

Canadian Paediatric Society: "There is evidence that circumcision results in a reduction in the incidence of penile cancer and of HIV transmission. However, there is inadequate information to recommend circumcision as a public health measure to prevent these diseases."

Dutch Royal Medical Society (KNMG) "Contrary to popular belief, circumcision can cause complications – bleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications."

RACP: "After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand." Tftobin (talk) 22:16, 25 January 2012 (UTC)

None of these quotations directly address the same issue that Schoen raises. As I stated above, very few actually address this issue. Jakew (talk) 22:21, 25 January 2012 (UTC)

The KNMG quotation contradicts Schoen's assertion that the benefits outweigh the risks.

The RACP and BMA quotes do as well.

Tftobin (talk) 19:17, 26 January 2012 (UTC)

Yes, I guess you could see the KNMG quotation as contradicting Schoen's position.

The BMA quotation could be seen as such, but it suffers from cherry-picking. Elsewhere in the same document, we find "There is a spectrum of views within the BMA’s membership about whether non-therapeutic male circumcision is a beneficial, neutral or harmful procedure or whether it is superfluous, and whether it should ever be done on a child who is not capable of deciding for himself. The medical harms or benefits have not been unequivocally proven but there are clear risks of harm if the procedure is done inexpertly. The Association has no policy on these issues."[1]

The RACP quotation addresses the issue of whether the benefit-risk balance is sufficient to warrant routine infant circumcision (ie., circumcision of all newborn males). That's not the same as asking whether there is a net benefit. Presumably there would need to be not only evidence of benefit outweighing harm, but the net benefit would have to be sufficiently large to warrant such a recommendation. The RACP go on to say that "it is reasonable for parents to weigh the benefits and risks of circumcision and to make the decision whether or not to circumcise their sons."

So, rather than "every medical organization of every country says the opposite", as you originally stated, it actually seems to be "one medical organisation says the opposite". Jakew (talk) 20:09, 26 January 2012 (UTC)

And Schoen's belief, shared by almost no one else in the medical community, deserves a special spotlight in Wikipedia? Please convince me that this represents a neutral point of view, or this heads to arbitration. Tftobin (talk) 23:41, 25 January 2012 (UTC)

I would agree that this paragraph needs some editing (I do feel that it is a very appropriate topic for the lead - given the fact that circumcision is very arguably the most controversial surgery known to man). I found Tftobin's argument to be particularly valid with respect to how undue weight seems to be given to the viewpoint that circumcision "provides important health advantages which outweigh the risks". I actually could not find a citation by a single professional health organization that agrees with this sentiment in the scope of its very broad and far-reaching rhetoric. Perhaps it is trying to mention that it is beneficial particularly in high-risk areas, or on patients with specific conditions that warrant the procedure? Should this be the case, it would certainly merit some distinguishing.

Additionally, I do think that the summary of the anti-circumcision viewpoint is missing a very key component of its platform; it should integrate the viewpoint that circumcision is attributable to a number of complications and deaths every year. If there is resistance to this, I would be happy to provide a number of references showing that this is a very common contention in among anti-circumcision proponents. I am actually extremely surprised that this viewpoint is not included here. Therewillbefact (talk) 06:51, 26 January 2012 (UTC)

As noted above, a recent CDC consultation, in which multiple experts participated, also concluded that the benefits exceed the risks. That suggests that Schoen is far from a lone voice. Certainly his is a controversial position, but that's the very point of including it.

I'm having difficulty understanding what the underlying objections to this claim actually are. Presumably we can all agree that, in describing controversial views, we're bound to describe those which we as individuals feel are wrong or objectionable? So what is the problem? Is there concern that this might be interpreted as a statement in Wikipedia's voice, rather than documenting the existence of a controversial (and possibly wrong) opinion? If that's the case, might it not be more productive to look at how we introduce the sentences?

It is something of a red herring to ask whether professional medical associations make the same point. Are we seriously proposing to limit our discussion of controversial statements to include only those endorsed by professional medical associations? That would seem counterproductive, as policy statements tend to be conservative. To illustrate controversy, we need to include the views of those trying to change things: "advocates" and "opponents".

Finally, a lot of work has gone into making this paragraph as neutral as possible. In particular, we've been careful to give each opposing viewpoint a similar amount of weight: the same number of points, roughly the same number of words, and the same number of citations (one). If you wish to change the opponents' citation to one that includes references to deaths, I'm not opposed in principle, but please bear these points in mind, and please present proposed changes for discussion. Jakew (talk) 10:23, 26 January 2012 (UTC)

While we're addressing this paragraph, I also believe that the "is justified only by medical myths" segment is not an accurate representation of the anti-circumcision movement. An argument with more credence among professionals on that end is the belief that studies garnered from sub-saharan Africa should not be used as a basis for recommending circumcisions in areas that are not in high risk of HIV transmission. You can see this argument being made here, for instance. If requested, I can provide more references that dovetail with this resource in opinion. Therewillbefact (talk) 07:16, 26 January 2012 (UTC)

Haven't we already discussed HIV at length? I think that particular issue is so exhausted that it needs to spend several years recovering at a retreat in the Swiss Alps. Jakew (talk) 10:23, 26 January 2012 (UTC)

If indeed the CDC agreed with Schoen, this is a surprise. Their view has had no effect on any other major medical association. If we tallied up all the medical organizations of countries who stated that any benefits are not worth the surgical risk, the point of view that the benefits are worth the risks would be in the extreme minority. This amounts to free advertising for an extreme minority view. It is also not an accurate representation of the views held by most proponents of circumcision. Tftobin (talk) 12:33, 26 January 2012 (UTC)

As noted above, this focus on the views of medical associations is something of a red herring given that we're discussing a debate in which participants largely try to change health policy. However, Schoen's view (and the consensus of the CDC's consultation) seems quite consistent with the American Urological Association's recommendation "that circumcision should be presented as an option for health benefits"[2]

Your second point is rather bizarre, and I wonder if I've misunderstood. Are you suggesting that most proponents of circumcision do not believe that the advantages of circumcision outweigh the risks? That would seem a little contradictory to me: why would someone advocate something unless they thought it worthwhile? Jakew (talk) 13:09, 26 January 2012 (UTC)

Since I was instrumental in crafting the "Controversy" paragraph I will say that many hours of debate went into it for weeks from both sides. The object was to list reasons and perspectives from both sides and weight them against each other accordingly. I'm not opposed to possible changes but if we make changes to one side we need to reflect changes on the other to address NPOV concerns. I feel its important address this in the lead and follow it up more thoroughly in its own section. Garycompugeek (talk) 15:57, 26 January 2012 (UTC)

The CDC article referenced contains no recommendation of circumcision, and no statement that the benefits outweigh the risks. This effectively reduces the medical source who states the pro-circumcision theme of 'the benefits outweigh the risks' to one source, Dr. Schoen. Most people advocate for circumcision for religious reasons. Most of those who aren't advocating for religious reasons most often do it to fit in with a perceived cultural norm. Any medical benefit is tangential to these two very large groups. Tftobin (talk) 16:35, 26 January 2012 (UTC)

Please don't waste other editors' time by making false claims. Go to the CDC article I cited above. Scroll down to the "Figure". Click to open (you'll open this image). Scroll to the section "Proposals for newborns". Examine proposal P1, which states "Medical benefits outweigh risks for infant MC, and there are many practical advantages of doing it in the newborn period." Jakew (talk) 16:42, 26 January 2012 (UTC)

I will thank you not to treat me like an idiot, lecturing me about wasting other editors' time by making false claims. How does this fit with presumption of good faith? I believe you are in violation. The section you pointed me to was a recommendation brought to the CDC by paid consultants. The CDC never embraced their recommendations in the rest of the article. The footnotes include "The findings and conclusions in this article are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention (CDC)." Tftobin (talk) 17:06, 26 January 2012 (UTC)

You stated that the article "contains [...] no statement that the benefits outweigh the risks", which, as I've shown, is false. I'm not suggesting that you were acting in bad faith, but you clearly hadn't read the article thoroughly, otherwise you wouldn't have made such a claim. Regarding the article, the entire article documents an expert consultation, which is why I've referred to it as a "CDC consultation" above. Jakew (talk) 17:23, 26 January 2012 (UTC)

The fact remains, that the CDC did not support the view that the benefits outweigh the risk, a group of external consultants whom they paid suggested it, and the CDC didn't express any opinion either way. This is not tacit support by the CDC. We are down to the opinion of one doctor who has written at least 2 books on circumcision. This does not lend credence to your assertion that 'It seems a bit of a stretch to claim that it's a "non-mainstream" point of view.' Tftobin (talk) 18:22, 26 January 2012 (UTC)

I didn't say that the CDC had endorsed the proposal, Tftobin, just that it was an outcome of the expert consultation. And such outcomes do not materialise out of thin air: a proposal would have to be proposed by at least one person and endorsed by a majority of the other invited experts, so your claim that "we are down to the opinion of one man" is mystifying. Furthermore, multiple authors have made comparable assertions. Here are a selection: [3] [4] [5] [6] [7] [8] [9] [10] [11] [12] [13] [14] [15] [16]

Also, while they're irrelevant to the conversation at hand, I believe you're mistaken in your claims about Schoen. To my knowledge he has written 2 books on circumcision, and was not invited to leave the task force. Please note that, per WP:BLP, it is especially important to check ones facts when making claims about living people. Jakew (talk) 19:17, 26 January 2012 (UTC)

My apologies. I had heard him say in an interview that he had written 23 books. The 10 figure came from amazon.com, entering his name, but only 2 books on circumcision were written by him, the rest by someone else. Such are the quirks of an amazon search. Point taken. The concern remains. If it is true that the benefits outweigh the risks, why has no nation changed its policy? Hence, it is still far out of the mainstream, any way you want to look at it. Tftobin (talk) 20:14, 26 January 2012 (UTC)

This really isn't the place to argue about whether Schoen's assertion is actually true, and I'm concerned that if we start that particular debate it will never end. The questions we're concerned with is whether it is verifiable, and whether it belongs. Since no one is questioning whether Schoen actually made the statement, verifiability is a non-issue, so we're left with the question of whether the material belongs in the article.

My view is that it's not very practical to illustrate a controversy by including only completely mainstream viewpoints. Mainstream viewpoints tend to be very similar but with minor differences. Schoen's viewpoint isn't mainstream. Neither is that of Milos and Macris. Both sets of authors are trying to change mainstream thought, and because of that they help to illustrate the controversy. That said, I'm quite prepared to believe that choosing illustrative viewpoints isn't the best way to document the controversy, and I'm in the process of looking at alternatives. Jakew (talk) 20:38, 26 January 2012 (UTC)

No one is suggesting that you replace the entry with Milos and Macris. Schoen's view simply does not represent the reason why most people advocate for circumcision. Quoting him does a disservice to people who choose for religious or cultural reasons. Those people are in the vast majority. Tftobin (talk) 20:46, 26 January 2012 (UTC)

Milos and Macris are already cited, in the adjacent sentence.

It is certainly true that religion is the reason why most circumcisions are performed, but I am not convinced that religious reasons are given by most advocates. It doesn't make a lot of sense: Jews and Muslims generally are circumcised already, and circumcise their sons as standard practice, so there is little point in promoting it to other Jews or Muslims. And generally speaking, Jews don't care whether non-Jews are circumcised, and Muslims don't care whether non-Muslims are circumcised, so they've little reason to promote it to people of other faiths. What evidence do you have that "most people" advocate for circumcision on religious or cultural grounds? Jakew (talk) 21:04, 26 January 2012 (UTC)

None whatsoever. Simple logic tells me that if in the US 80% of adult men are circumcised, and the two main medical societies are essentially neutral on the subject, then there is a reason, be it cultural or religious. The cultural reasons hold true for South Korea, since it is not a matter of religion there. The anecdotal reasons I hear every day are, to look like his father, and because they are afraid of teasing in the locker room. I am utterly convinced that this is why most of the circumcisions in the US take place, because I've heard it year after year. Medical evidence that this is so, none at all. Tftobin (talk) 21:32, 26 January 2012 (UTC)

Are you talking about the reasons why circumcisions are performed, or the reasons given by those trying to persuade others to circumcise their sons? Jakew (talk) 22:13, 26 January 2012 (UTC)

What I am talking about, is if that statement remains the way it is, I plan to cite the medical policies of the UK, US, Canada, New Zealand, Australia, and the Netherlands, at a minimum, to balance it out. Tftobin (talk) 11:23, 27 January 2012 (UTC)

We already include this: "According to the Royal Dutch Medical Association (2010), no professional association of physicians currently recommends routine circumcision." Jakew (talk) 11:25, 27 January 2012 (UTC)

I reverted your addition, Tftobin, because it violates Wikipedia's policy against original research. To make such a claim, you would have to cite a source that explicitly contrasts Schoen's opinion with that of the AAP, BMA, and RACP, and draws that conclusion. Your own opinion that these policies contradict Schoen's claim is not sufficient. (Even if you had such a source, it would be problematic from an NPOV perspective, because citing criticism of Schoen without also citing criticism of Milos and Macris would be rather one-sided.) Jakew (talk) 16:03, 27 January 2012 (UTC)

I don't see your Schoen source contrasted with the policy of any national medical organization. Why two sets of rules? ::::::Tftobin (talk) 16:24, 27 January 2012 (UTC)

Your edit contrasted Schoen's view with that of several policies: "The statement that the health advantages outweigh the risks runs counter to the medical advice of the AAP in the United States, the BMA in the UK, and the RACP in Australia and New Zealand." I don't understand what you mean about "two sets of rules". Jakew (talk) 16:29, 27 January 2012 (UTC)

Why would my sources have to directly address Dr. Schoen's point of view, when the Schoen you cite does not address the fact that there is no medical organization of any country, which endorses Schoen's assertion that the benefits outweigh the risk? Seems awfully one sided. Tftobin (talk) 16:36, 27 January 2012 (UTC)

Any statement we make has to be fully supported by the cited source (please see WP:V and WP:NOR for details, but that's the essential point).

The sentence describing Schoen's views ("Those raised in favour of circumcision include that it provides important health advantages which outweigh the risks, has no substantial effects on sexual function, has a low complication rate when carried out by an experienced physician, and is best performed during the neonatal period") doesn't mention any medical organisations, so it doesn't matter whether he referred to any or not.

The sentence you propose to add ("The statement that the health advantages outweigh the risks runs counter to the medical advice of the AAP in the United States, the BMA in the UK, and the RACP in Australia and New Zealand.") explicitly contrasts Schoen's claim that the health advantages outweigh the risks with the medical advice of three bodies. But none of the three sources actually refer to Schoen's claim, nor do they make such a comparison. The comparison is your own original interpretation, and that's the problem. Jakew (talk) 16:50, 27 January 2012 (UTC)

Please don't lecture me, Jake. The comparison was simply on the basis of 'either the benefits outweigh the risks', or 'the risks outweigh the benefits. It's as simple as that. I deeply appreciate your changes to the controversy section, from the bottom of my heart. Diminishing the polarization makes this better for everyone.

Tftobin (talk) 21:17, 27 January 2012 (UTC)

Tftobin, your signature should immediately follow your text. If you continue to put it on the next line, it will revert to the left margin, thus becoming totally detached from your comment, as is happening with all your comments up to now. Please consider this when commenting in the future. Thanks! Jayjg ^(talk) 01:36, 29 January 2012 (UTC)

Rewrite of controversies paragraph

I've rewritten the 'controversies' paragraph based on secondary sources. It now reads:

• There is controversy regarding circumcision. Specific controversies have included the health benefits and risks of the procedure, ethical and legal considerations, and the application of human rights principles to the practice.

Jakew (talk) 19:00, 27 January 2012 (UTC)

Huh. So you rewrote it to cite review articles, and thus comply with WP:MEDRS, and to also actually summarize the article content, per WP:LEDE? Jayjg ^(talk) 20:36, 27 January 2012 (UTC)

I strongly oppose this edit - it is more ambiguous, and makes no mention of what the opposing viewpoints are in particular. Being that this is arguably the most controversial surgery known to man, there is a lot of merit to summarizing what the POVs are in the lead. What was the reason for making this change exactly, and why didn't you solicit the opinions of other editors in the talk page before making the edit? This was content that editors have argued over integrating in the talk page for months, and you've just significantly changed it without input from any other editors on a whim. As already pointed out by Doc James under Talk:Circumcision#Controversy, there is a good reason behind why we were summarizing the POVs surrounding the controversies. Therewillbefact (talk) 21:03, 28 January 2012 (UTC)

The edit was made as part of the general aim to improve sourcing by replacing primary with secondary sources. Since both of the original articles (Milos & Schoen) were used as examples of opposing viewpoints, they were primary sources in the context of a controversy. Wikipedia prefers secondary sources — in this case, those that explicitly describe and document controversies. The fact that the edit eliminated Tftobin's concerns was a happy bonus. Jakew (talk) 21:21, 28 January 2012 (UTC)

I can't imagine it would have been that difficult to find secondary sources that dovetailed with the content in the paragraph. I would have been more than happy to help locate a few. And again, why didn't Jakew check with the editors in this talk page regarding the merits of this significant edit? He omitted over 15% of the text that was in the lead here - the word count dropped from 326 to 277.

Perhaps it is worthy of mention that other controversial entries on Wikipedia still explicitly summarize opposing viewpoints in their leads, see ADHD for an example. The paragraph is now almost a third of its original size (word count was 84, it is now 31). Now there is almost twice as much weight in the lead on how circumcision hedges against HIV prevention in high-risk areas (word count of 59) than on controversy surrounding circumcision (wc of 31). Therewillbefact (talk) 22:37, 28 January 2012 (UTC)

I also oppose this edit, in its current form. Perhaps all that is needed is an expansion, but as it stands now, it is extremely vague, and doesn't give the reader any useful information. The wording "Specific controversies" is an overstatement given how the paragraph is currently written - no specific controversies are mentioned, only areas in which there are controversy. WP:LEAD states that 'the lead should not "tease" the reader by hinting at—but not explaining—important facts that will appear later in the article,' and the recent edit omits important facts (the specific details of the controversy) that were present in the old lead. kyledueck (talk) 22:12, 28 January 2012 (UTC)

Therewillbefact, since you insist that you "can't imagine it would have been that difficult to find secondary sources that dovetailed with the content in the paragraph", please present those review articles here. Kyledueck, what text do you think it would be appropriate to add? Jayjg ^(talk) 01:34, 29 January 2012 (UTC)

I also disagree with removal of the quote and think it should be changed back to its prior form. Milos and Schoen is a valid secondary source, they analyzed other papers and came to their conclusion. Gollaher 2000 also describes it as controversial. Gsonnenf (talk) 05:09, 29 January 2012 (UTC)

Jayjg, while I agree that this paragraph might have benefited from some revising, I'm not sure if it's appropriate protocol for Jakew to reduce an important lead paragraph to a third of its original size without any other editor input. But since you requested it, I'll try to explain why the controversy surrounding circumcision is not acknowledged in enough detail with this most recent edit:

We already know that a controversy exists over whether circumcision is an appropriate procedure for the health conditions that are thoroughly laid out for readers in the second paragraph ("balanitis xerotica obliterans, phimosis, balanitis, posthitis, balanoposthitis and urinary tract infections"). That sentence alone actually makes up almost a tenth of the lead, which is also about the same size as the entire controversy paragraph, since Jakew's recent revision... No mention of a controversy exists with respect to how health professionala have argued against circumcision being an appropriate procedure for many of these conditions, such as phimosis and balanitis xerotica obliterans. Have a gander at these sources: 1, 2, 3, 4, 5, 6, 7, 8. The controversy paragraph is far too brief and watered-down right now, given the number of instances this topic is addressed by secondary sources when phimosis or balanitis is mentioned. It is not even mentioned in the lead that deaths have been attributed to circumcisions. Regarding the existence of circumcision-related deaths, please see: 1, 2, 3, 4, 5, 6, 7. This is likely the most ardent talking point among anti-circumcision proponents.

Consider this text from 2011, which acknowledges an "ongoing controversy over the relative merits of randomized controlled trials (RCTs) and non-randomized observational studies in assessing efficacy and guiding policy." This dispute - whether circumcision might not be HIV-preventative - actually isn't found or alluded to anywhere in the lead, despite other pubmed-indexed sources such as this one, also from 2011, which states that "male circumcision is being highly debated because of ethical, law and scientific issues and the different roles of this procedure: therapeutic, prophylactic (but there is no universal consensus) and ritualistic role" and additionally acknowledges that circumcision trends have decreased worldwide due to "the improvement of hygienical conditions and, above all, the lack of unanimous consent on the real usefulness of protective circumcision". The closest thing to this in the lead is "specific controversies have included the health benefits and risks of the procedure". And that's it. It's actually pretty jaw-dropping that almost a quarter of the lead describes how "strong" evidence exists with respect to circumcision as HIV-preventative in high-risk areas, with numbers and verdicts to boot ("reduces the risk of HIV infection in heterosexual men by 38-66%" ... "studies have concluded it is cost effective"), but there is no mention of the ample sources that feature viewpoints that run contrary to this narrative on a global scale. There's not even an attempt to distinguish how these results have been different for men who do not reside in high risk areas. Perhaps see this text, which states how proposals to integrate circumcision campaigns in Australia to hedge against HIV "ignore[d] doubts about the robustness of the evidence from the African random-controlled trials as to the protective effect of circumcision and the practical value of circumcision as a means of HIV control". Are these enough secondary sources to show how health professionals have explicitly questioned the merits of circumcision as a preventative procedure?

When circumcision is mentioned in popular media, it is often accommodated by mention of a controversy, and a description of the opposing viewpoints in detail. Try searching for "circumcision" under the news filter in Google News. My second result was "Circumcision stirs debate‎" (STLtoday.com - 2 days ago). My third result is "Progressive Rabbis On Creating A Jewish Covenant Without Circumcision" (Salem-News.Com - 1 day ago), fourth is "Congress and States Prepare for another Circumcision Battle" ( PR Web - 4 days ago). In the first two pages I also saw links to "Toddler's tragic death after circumcision" (Times LIVE - Jan 21, 2012), Ethiopian Jews confront psychological trauma (Jerusalem Post - 2 hours ago), Baby dies after being circumcised (Daily Monitor - 5 days ago), Put it in Print (PiiP): Penis rights‎ (Boise State University The Arbiter Online - 2 days ago). All this was found in the first 20 links that were listed off. I am not advocating that we cite these these sources in the entry, but this should put how far-reaching and pervasive the controversy is into perspective. Consider this source which makes the following claim:

Although many 19th-century misconceptions about the foreskin have been dispelled since it was shown that infantile phimosis was not an abnormality, the ideas that ritual or religious circumcision arose as a hygiene measure, and that circumcision makes no difference to sexual response, have persisted. The first idea should be dismissed as a myth and the second has been seriously questioned by modern research.

My point is that the controversy surrounding circumcision is much more detailed and far more prevalent than one would believe after reading this summary. When circumcision is mentioned in media sources, controversies and opposing viewpoints are very often mentioned. Even if we only stuck to secondary sources, there is still a lot of content to work with. This is why there is merit to providing more detailed information surrounding the controversy, given its weight when most people read about circumcision. I'm having a hard time believing I have to actually argue this. Perhaps putting the paragraph higher in the lead is warranted as well. A year ago the controversy paragraph was the second paragraph of the lead, for what it's worth. Therewillbefact (talk) 06:16, 29 January 2012 (UTC)

Therewillbefact, very few of the articles you cite appear to be secondary sources that discuss a controversy. Rather, they seem to be primary sources expressing viewpoints, from which you infer a controversy. The exceptions seem to be this source, which you've misinterpreted (it refers as background to the general controversy surrounding the relative merits of RCTs and observational studies, not one specifically related to circumcision), and the first of the news articles, which is not suitable as a source. Jakew (talk) 09:31, 29 January 2012 (UTC) (edited 11:15, 29 January 2012 (UTC))

Therewillbefact, that is an awesome compilation of evidence that demonstrates the controversy. No doubt many jaws drop open when people read this article. Controversy is the essential fact of circumcision in modern times. Hard to believe wikipedia would whitewash it.Chevara (talk) 17:42, 29 January 2012 (UTC)

Therewillbefact, as Jakew points out, you are bringing in what are essentially primary sources vis-à-vis circumcision controversy - to understand the issue here, please review both WP:PRIMARY and WP:SYNTH. You need to find sources that explicitly discuss controversy around circumcision; you cannot simply infer there is such a controversy.

Chevara, please review WP:NOTAFORUM. Jayjg ^(talk) 18:04, 29 January 2012 (UTC)

I do not think it is acceptable to dwarf an important paragraph to a third of its size without any input from other editors. This edit shrank controversy coverage from 25% to only about 10% of the lead, so it is a significant change to the narrative of the lead. If we keep this paragraph at this size, we are placing an undue amount of weight on the rest of the content - such as the description which states that strong evidence describes circumcision as HIV-preventative (which now makes up roughly 25% of the lead). Roughly the same amount of weight is now being given to the entire controversy paragraph in the lead as the comprehensive description of conditions circumcision is used for (balanitis, phimosis, etc). All this without any mention with respect to the abundancy of opposing viewpoints regarding circumcision as appropriate for those conditions (see the second paragraph in my last comment). Controversies and opposing viewpoints are very often highlighted when circumcision is mentioned in broadband mediums, and it is only covered in the last paragraph of the lead and makes up only a tenth of the lead now (it was a quarter of the lead content until Jakew's edit). Actually, neither Jakew nor Jayjg have addressed this yet, so I will restate it again here. Therewillbefact (talk) 00:47, 30 January 2012 (UTC)

Do you have a reliable secondary source stating that the use of circumcision to treat phimosis, etc., is controversial, Therewillbefact? If so, I'm quite happy to add it to the controversies paragraph. Jakew (talk) 10:37, 30 January 2012 (UTC)

I keep mentioning this, but neither you nor Jayjg have bothered to address it, so I'll state it again in bold: We shrank the coverage of controversy in the lead from almost 25% to roughly 10%. We need an explanation regarding this drastic reduction of the weight of controversy in the lead. — Preceding unsigned comment added by Therewillbefact (talk • contribs) 17:28, 30 January 2012 (UTC)

I agree that the paragraph is shorter; I don't know whether that's a good thing or a bad thing, as I haven't attempted to judge the weight given to controversy in secondary sources. I think a more pressing question is, do we summarise the available secondary sources on the matter? Jakew (talk) 18:15, 30 January 2012 (UTC)

I think there is a lot of merit to doing so. Therewillbefact (talk) 18:37, 30 January 2012 (UTC)

But please solicit the input of other editors in this talk page before making a substantial edit to the lead next time... Therewillbefact (talk) 18:57, 30 January 2012 (UTC)

To begin with, from what I see the last two paragraphs of the lede are both about "controversy", so by my count 21% of the lede is currently devoted to "controversy". More fundamentally, though, it seems to me that far too much attention is being given to purely mechanistic analyses of the article's lede. Beejaypii spent literally weeks arguing that the lede devoted too much attention to HIV, because 25% of it (since significantly reduced) was on that topic, and insisting that we must devote a mathematically equal number of words to every subject discussed in the article. Now you are arguing that there is a problem because "only" 10% is devoted to "controversy". As I've noted before, what is actually important is that the lede accurately summarize the most important points of the article, in concise, well-written, clear prose. Arguments about 10% vs. 20% miss the point entirely. Jayjg ^(talk) 19:14, 30 January 2012 (UTC)

Only the last paragraph acknowledges a controversy, Jayjg. Additionally about 25% of the lead is still dedicated to HIV, so your argument that the section on HIV has "since significantly reduced" doesn't carry a lot of weight here. Please get your facts straight next time you try to put content weight into perspective for us. Therewillbefact (talk) 19:34, 30 January 2012 (UTC)

Jayjg is referring to this edit, which drastically shortened the paragraph. As a word of advice, when advising others to get their facts straight, it's generally a good idea to have one's facts straight. Jakew (talk) 19:55, 30 January 2012 (UTC)

Therewillbefact, the second-last paragraph states that medical associations don't recommend routine circumcisions, and notes discussions about its ethics. Are you seriously stating that a discussion about the ethics of a procedure is not a "controversy"? That would be very odd indeed, considering that the last paragraph specifically describes such ethical considerations as "controversy" (as a side note, the two statements are repetitive, and should be combined). Moreover, the HIV section in the lede was indeed "significantly reduced", and is now 63 words, close to half the 117 words it was a month ago; the fact that the entire lede itself was subsequently shortened, thus modifying all the "percentages", does not change that fact. Please note Jakew's comment immediately above about getting facts straight. And finally, you have failed to respond to the main point, so I'll just summarize and highlight it: ...far too much attention is being given to purely mechanistic analyses of the article's lede... what is actually important is that the lede accurately summarize the most important points of the article, in concise, well-written, clear prose. Arguments about 10% vs. 20% miss the point entirely. Jayjg ^(talk) 20:07, 30 January 2012 (UTC)

I would appreciate it if you both refrained from putting words in my mouth going forward. Jayjg said HIV-related content once consisted of 25% of the lead, and also mentioned that this percentage has drastically reduced since. Allow me to quote it: "Beejaypii spent literally weeks arguing that the lede devoted too much attention to HIV, because 25% of it (since significantly reduced) was on that topic (...)" Did Jayjg not just say here that 25% of the lead was previously devoted to HIV, and has "significantly reduced" since? Now what I was saying is that HIV coverage still consists of roughly 25% of the lead. The previous coverage of HIV content in the lead was actually closer to 30%, for what it's worth, and is now about a quarter. Jakew, the next time you ask someone who informs someone to get their facts straight, I politely ask that you've also done the same.

Jayjg, if you've read my comments you would understand that I have addressed your point on a number of occasions so far... My whole argument regarding this edit is that there is not enough substance regarding the commonly-held viewpoints surrounding the controversy in the lead. There is no mention of pain, death, or the opposing viewpoints surrounding the merits of circumcision as an appropriate procedure to prevent HIV in developed nations, or as an appropriate hedge against the health conditions which are already comprehensively provided in the lead, for that matter. Additionally, the second-last paragraph does not explicitly make a mention of a controversy. I will agree with you that it is implicit. If you reread my comment you'll see that I typed "only the last paragraph acknowledges a controversy".

If "controversy" is too ambiguous or misleading a word for either of you, I would be more than happy to address that rhetoric. Perhaps we can mention that opposing viewpoints exist among health professionals over whether circumcision is the most appropriate treatment for the comprehensive conditions that are listed off in the 2nd paragraph. We have an ample number of pubmed-indexed sources that make this claim. They do not explicitly mention a controversy, but they do mention that there are alternatives which they view as more appropriate, such as this source which claims "circumcision should not be considered as a routine part of penile surgery unless a significant phimosis is present or revisional surgery is contemplated" or this source which mentions "topical treatment of phimosis can reduce costs by 27.3% in comparison with circumcision. Therefore, topical treatment of phimosis should be considered prior to the decision to perform surgery". Or consider this source which states "the standard practice for preputial disorders remains circumcision. However, prepuce preservation is often technically feasible without compromising treatment. Preservative surgery combined with reconstruction may lead to better patient satisfaction and quality of life." I understand that the lead mentions that circumcision is one of a few treatments for these conditions. But if we are going to dedicate 10% of the lead to it, why not briefly mention that health professionals have suggested (on more than one occasion) that there are more appropriate treatments for many cases of these conditions? Therewillbefact (talk) 03:52, 31 January 2012 (UTC)

I've already adddressed your sources re treatment, in the #Merit to acknowledging a world-wide decrease of circumcision rates section (see comment dated 09:38, 24 January 2012). I'll therefore be brief. This and this are primary sources, and thus unsuitable. This is a secondary source, but it doesn't seem to dispute the use of circumcision. It does acknowledge the existence of (and, though it's hard to tell from the phrasing, may even prefer) alternative treatments for some conditions, but that's rather tangential to the subject of this article. It's important to realise that the subject of this article is circumcision, not the treatment options for various conditions affecting the foreskin, and we need to stay on-topic. If there is a controversy surrounding the use of circumcision itself as treatment, that's on-topic. As I said previously, if you can find a reliable secondary source documenting such a controversy, I've no objection to adding it. Jakew (talk) 09:24, 31 January 2012 (UTC)

If we are going to devote 10% of the lead to the comprehensive list of conditions circumcision is said to treat, I think it stands to reason that we can briefly mention the source I provided, which states that alternatives "may lead to better patient satisfaction and quality of life" (this was clearly referring to preservative surgery combined with reconstruction instead of circumcision). Is it not proper protocol to find a reputable secondary source, and state what it says in the entry without without editor interpretation of said text? That is all I'm trying to do here. Therewillbefact (talk) 02:58, 1 February 2012 (UTC)

It's entirely appropriate to state what secondary sources say about the subject, but not what they say about other subjects. If this article were entitled "treatments for foreskin conditions other than circumcision" then it would be on-topic. Jakew (talk) 09:05, 1 February 2012 (UTC)

As has been mentioned before, "proper protocol" is to a) write appropriate text in the Medical analysis of circumcision article, based on what reliable secondary sources say about that subject, b) if appropriate, summarize that material here, using high-level review articles, and c) if the information is highly notable, summarize that information in the lede. "Improper protocol" would be to ignore the article itself, add material to the lede based on personal viewpoints about the procedure, and then attempt to find secondary sources to support that POV. Jayjg ^(talk) 21:25, 1 February 2012 (UTC)

Given that we are devoting 10% of the lead is to the comprehensive list of conditions that circumcision has been used for, I think it would be fair to draw attention to the disagreement among health professionals with respect to how appropriate circumcision is as a procedure for said conditions. We do not have to use words such as "controversy", we could rather summarize the source(s) after the detailed list of conditions in that paragraph in a sentence. Therewillbefact (talk) 06:18, 3 February 2012 (UTC)

See my previous response. Jakew (talk) 09:24, 3 February 2012 (UTC)

If you can expend the energy to say, "See my previous response", you can take the energy to truly address what he's saying in the paragraph.

Don't phone it in, talk to the man. He put some thought into it. Tftobin (talk) 00:33, 4 February 2012 (UTC)

Since Therewillbefact said essentially the same thing above (dated 02:58, 1 February 2012), and I've already responded to it, I see little point in repeating myself. Jakew (talk) 09:45, 4 February 2012 (UTC)

how about controversy include the brit shalom movement Robert B19 (talk) 23:12, 7 February 2012 (UTC)

What reliable secondary sources document such a controversy, Robert? Jakew (talk) 09:17, 8 February 2012 (UTC)

This change is not approved by the majority of users. This change obviously did not meet the criteria of consensus and should be reverted.Gsonnenf (talk) 06:27, 8 February 2012 (UTC)

[ Comment by Jayjg moved to "POV tag". Thank you. ]Gsonnenf (talk) 22:27, 8 February 2012 (UTC)

I found some pretty interesting stuff for the controversy section. May 21, 2001 issue of New York "With circumcision rates dropping in America, some squeamish Jews are trying out a bloodless Bris. " http://nymag.com/nymetro/news/culture/features/4692/ The Case for Brit without Milah Policy Statement "For the record, the author of these pages is firmly opposed to all infant circumcision, the Jewish variety no more or less than any other, and has no issue with any other aspect of Judaism. The Jewish traditions of rationality and compassion will ultimately prevail over physical circumcision." http://www.circumstitions.com/Jewish.html "Welcome to the web-based multimedia project that's putting real faces and voices to the current Jewish movement opposing circumcision. This dynamic site is being created by, for and about Jews who are united in the belief that cutting children's genitals is unnecessary and harmful. As our name implies, an increasing number of Jewish people are moving in a more ethical, more humanitarian and more Jewish direction: beyond the bris." http://www.beyondthebris.com/ "The State of the Foreskin in Israel - More Israeli Jews Keep Their Son's Intact for Moral and Ethical Reasons - Israeli's Rejecting the Brit Milah or Bris" http://abchomeopathy.com/forum2.php/233025/ Robert B19 (talk) 02:31, 11 February 2012 (UTC)

Only the first of those is a remotely reliable source, and it doesn't assert that there's a controversy. Jakew (talk) 09:00, 11 February 2012 (UTC)

POV tag

At 07:19, January 20, 2012, Gsonnenf (talk · contribs) added a {{POV}} tag to the article. No reason was given in the edit summary, and no explanation for it was subsequently provided at this talk page. Approximately 8 days later at 17:15, January 28, 2012, citing the continued absence of an explanation, I removed this tag, citing WP:DRIVEBY. Within 2 hours, Gsonnenf restored the tag, claiming "The entire talk page is covered with NPOV discussion. Leave this."

Per DRIVEBY: "The editor who adds the tag must address the issues on the talk page, pointing to specific issues that are actionable within the content policies, namely Wikipedia:Neutral point of view, Wikipedia:Verifiability, Wikipedia:No original research and Wikipedia:Biographies of living persons. Simply being of the opinion that a page is not neutral is not sufficient to justify the addition of the tag. Tags should be added as a last resort." [emphasis in original]

As of this moment, Gsonnenf still has not provided an explanation for the tag on this talk page, let alone identifying specific, actionable issues, as required. Furthermore, please note that talk pages almost always contain at least one discussion that references NPOV; tags are a last resort, and are intended to be a short-term, temporary measure. They are not intended to be used as a protest, nor as a means of holding an article hostage until a desired outcome is obtained. Jakew (talk) 19:19, 28 January 2012 (UTC)

This page has been assessed as [not NPOVed], which we haven't explicitly addressed yet in this talk page. Therewillbefact (talk) 21:21, 28 January 2012 (UTC)

Since that assessment was that of one person, and applied to the version of the article as of "09:27, December 26, 2006‎" (more than five years ago), what possible relevance could it have today? Jakew (talk) 22:23, 28 January 2012 (UTC)

None, obviously. Jayjg ^(talk) 01:21, 29 January 2012 (UTC)

The entire article is biased in favor of circumcision. That "cost-effective" argument is right off a factory assembly line. Chevara (talk) 22:29, 28 January 2012 (UTC)

No policy-based reasons for the tag have been expressed. Tags are only relevant and valid if they have policy-based reasons for their placement. Without them these tags must be removed. Jayjg ^(talk) 01:21, 29 January 2012 (UTC)

wp:driveby is simply an opinion, it is not a policy, guideline or supplement (such as WP:SYNTHNOT) to policy. The observation of the constant arguments about what secondary sources to include and the discussion on the removal of valid phrasing to be replaced by phrasing that is more pro-circ is enough to fit the spirit of the tag. But since you insist on Wikipedia:Wikilawyering I will post that many authors believe this page violates WP:NPOV. Please see the talk pages and archive 69 where therewillbefact, Tftobin, gsonnenf, Robert B19, Chevara, Wimp O'pede, Carlossuarez46, Garycompugeek and Beejaypii dispute the neutrality of the edits made by jakew and jayjg. In these discussions the majority author group disagree with the wiki violations that are asserted and feel these are removed without consensus to push a certain POV. Gsonnenf (talk) 05:49, 29 January 2012 (UTC)

Disagreement is not evidence to support a POV tag, and it is standard practice to remove such tags unless evidence is given that a significant POV problem exists. It is common for a group of editors to not like the content of an article on a contentious topic, but that does not mean there is a POV issue. Referring to commentary elsewhere is not adequate, nor is counting the number of editors who think there is a POV issue. The POV tag should be removed if there is no succinct and precise indication of why it should be there. Consider, for example, that there are probably a hundred editors who would like to put a POV tag on evolution. Johnuniq (talk) 06:47, 29 January 2012 (UTC)

The pro-circumcision argument for "cost-effectiveness" in the lead throws the neutrality of the entire article off-balance. There are a number of problems with the article, too many to clear up in one day. Is anyone arguing that the article is slanted against circumcision?Chevara (talk) 17:35, 29 January 2012 (UTC)

Regarding whether there should be a tag, the views of Wimp O'Pede, a banned sockpuppet, are not relevant. Also, when it comes to broad policy and the proper use of tags, the views of Therewillbefact, tftobin, Robert B19 and Chevara, four editors who essentially joined Wikipedia this month, edit exclusively from an anti-circumcision POV, edit essentially one article (this one), and have a combined total of 9 article edits among them, carry little weight. In addition, Carlossuarez46 hasn't stated the article should be tagged. Finally, there's no "pro-circumcision argument for "cost-effectiveness" in the lead". "Perma-tagging" an article because one cannot insert policy-violating POV is an old tactic, and this article has been a particular target for it, but it's WP:DISRUPTive, so you'll have to come up with an actual and specific policy issue, because this won't be tolerated for much longer. Jayjg ^(talk) 17:55, 29 January 2012 (UTC)

Jayjg, I have successfully posted exactly zero articles. I don't believe you can accurately assess what my long term point of view is. Your hostility and prejudice comes through loud and clear. It's coming close to harassment.Tftobin (talk) 17:50, 1 February 2012 (UTC)

I've removed the tag, as it's now more than 2 days after I posted my original message, and there's still no sign of an explanation including specific actionable points. Jakew (talk) 09:30, 31 January 2012 (UTC)

I advise that we continue with the {{POV}} tag. Editors have indicated specific actionable points that have been met with denial by other editors. That is not a resolution. Chevara (talk) 16:29, 31 January 2012 (UTC)

To repeat, "perma-tagging" an article because one cannot insert policy-violating POV is an old tactic, and this article has been a particular target for it, but it's WP:DISRUPTive, so you'll have to come up with an actual and specific policy issue, because this won't be tolerated for much longer. Jayjg ^(talk) 17:32, 31 January 2012 (UTC)

Furthermore, the fact that "actionable points" were listed does not make the points violations of POV. The article needs to give weight to points-of-view in accordance with the accepted literature that exists outside of wikipedia. People with strong beliefs on one side or the other will always have "actionable points" they wish to see addressed in the article to make it jibe more closely with their own opinions. For there to be a need for the tag, a cogent argument indicating how there exists a POV issue according to Wikipedia policies & guidelines must be made. Without this, the tag is at best incorrect, at worst an example of disruptive editing. -- Avi (talk) 18:02, 31 January 2012 (UTC)

Which editors have identified which specific actionable points? Could you provide diffs? Jakew (talk) 18:13, 31 January 2012 (UTC)

worth repeating, "If an editor thinks he is truly neutral, and has no POV, he is not only violating WP:NPOV (which clearly states that all editors have a POV: "All editors and all sources have biases"), but he is likely to refuse to ever compromise over content ("because he is not biased, on the contrary, he is completely neutral, right and represents the truth"). One cannot reason with such a user (one can try, but one will always fail). Let's call such users "true believers" for the purpose of further discussion. There are also editors, known as "POV pushers", who likely realize they have some POV, but believe it is the "correct" one. For this discussion, there is little difference between the "POV pushers" and the "true believers", as their actions and consequences are little different (besides, few "POV pushers" will admit they have a POV, so in effect they claim to be "true believers" anyway)." http://en.wikipedia.org/wiki/User:Piotrus/Morsels_of_wikiwisdom#On_the_importance_of_wikipolitics — Preceding unsigned comment added by 198.189.145.4 (talk) 18:18, 31 January 2012 (UTC)

Is your post about article content or about editors? Clearly the latter. Please login when editing, and please review WP:NPA. Jayjg ^(talk) 19:28, 31 January 2012 (UTC)

Just as an aside, there really is no need to log in to edit here—we welcome anonymous editing—unless the lack of a log-in is meant to mislead the editing community (e.g. attempt to demonstrate more support for a position than is held by the actual number of editors) or other forms disruptive editing (e.g. evade sanctions or protective measures). The quotation brought is certainly applicable; however, I think we may differ as to which editors approach this article within the guidelines and which are the "true believers" who wish their POV given undue weight notwithstanding the verifiable literature, existing studies, and neutral prose. -- Avi (talk) 20:14, 31 January 2012 (UTC)

If I were to speculate, I would guess that people who hang out at "intactivist" fora, and who come here as a result of encouragement to do so in those fora, would be far more likely to be "true believers" promoting a POV than regular Wikipedia editors who are here because they support Wikipedia, and who have edited thousands of different articles besides this one. And given the persistent sockpuppeting on this article, the "unless" you mention is a significant concern here. Jayjg ^(talk) 21:15, 1 February 2012 (UTC)

I cannot disagree with your assessment, unfortunately. Statistically speaking, the majority of anon editors here have been sock/meatpuppet warriors. -- Avi (talk) 21:39, 1 February 2012 (UTC)

Jayjg, your speculation is about as likely as speculation that a group of circumcision fetishists are colluding to slant this very entry in a decidedly pro-circumcision direction, with each article they post and the way their behavior buttresses each other. Tftobin (talk) 01:35, 3 February 2012 (UTC)

...except that the "intactivist" fora exist, the posts about this article are easily found on them, editors here have admitted posting them and coming here because of it, and this article has indeed been plagued by sockpuppets. Jayjg ^(talk) 01:50, 3 February 2012 (UTC)

You might want to take a hard look around you. Circumcision fetish fora exist, and have members, and those members have been known to post. Just saying. It may not be as one sided as some would like to think. You might want to check a little, before casting any stones. Tftobin (talk) 13:05, 3 February 2012 (UTC)

Perhaps they do exist, I wouldn't know. However, they don't really seem relevant to what happens in this article. Whenever new editors show up at this article, they inevitably edit from an strongly anti-circumcision viewpoint, so the scenario you suggest contradicts the reality of this article. And when I "take a hard look around me" and "check a little", I find literally thousands of posts on various fora made by various anti-circumcision activists, maligning one specific editor here - saying (as one random example) conspiratorial things like "He trolls the internet late at night, looking for vulnerable parents to influence, to surgically alter their kids, while pretending to be neutral. This is a technique he picked up from feigning a neutral point of view with Wikipedia, all the while slanting it to a pro-circumcision position, but not enough so that those protest against his manipulations have arbitrators come down on their side. He collaborates with other circumcisers worldwide." These are the kinds of comments that indicate a profound misunderstanding of both this article and how Wikipedia works, and seem more like personal vendetta than anything else. Jayjg ^(talk) 16:31, 3 February 2012 (UTC)

If it's not relevant, why did you bring it up? How is what you posted relevant to this discussion? Am I saying it in here? Now, do you want to tell me there's no truth in it? Why are you bringing an outside discussion into Wikipedia? Seems a bit like stalking to me. I wonder how others in the Wikipedia structure would feel about it? Or is someone curious enough to find out? Tftobin (talk) 00:42, 4 February 2012 (UTC)

You are the one who brought up these hypothetical "Circumcision fetish fora", not me. I'm pointing out they're not relevant to this article, since it's not constantly inundated with new pro-circumcision editors and socks - that in fact, the problem here is exactly the opposite. Jayjg ^(talk) 01:44, 5 February 2012 (UTC)

I brought it up after you brought up the speculative "I would guess that people who hang out at "intactivist" fora, and who come here as a result of encouragement to do so in those fora". If this is the welcome mat you typically put out, I totally understand why people don't contribute. Are you always this hostile? Why is it that Jake and I can converse here in a civil manner with relative ease? You win, Jayjg. I won't be back. If Wikipedia was serious about wanting the general public to contribute, it would allow you to assault incoming potential contributors enough to drive them out immediately. It shouldn't require an asbestos suit. Enjoy your private party. Tftobin (talk) 15:57, 5 February 2012 (UTC)

I'm sorry you feel that way - although I must say, what happens on this talk page is not one-hundredth as hostile and vitriolic as the stuff I've seen over the past few days looking through various anti-circumcision fora and postings (random example provided in my posting above of 16:31, 3 February 2012). Jakew is extraordinarily patient. Jayjg ^(talk) 22:43, 5 February 2012 (UTC)

All this makes me feel very unwelcome here. Robert B19 (talk) 21:05, 3 February 2012 (UTC)

Wikipedia welcomes all people who are willing to edit in accord with its policies. Having to edit in accord with Wikipedia's policies makes some people feel very unwelcome. Jayjg ^(talk) 21:22, 3 February 2012 (UTC)

It isn't playing by the rules which bothers some. It's the impression some give, of lording power over others. Like they own Wikipedia, and others are trespassing. Like it is not better to have a wide range of information and viewpoints. Tftobin (talk) 00:42, 4 February 2012 (UTC)

Wikipedia is only interested in "a wide range of information and viewpoints" when those come from reliable secondary sources. The circumcision article is actually quite good in that regard. Jayjg ^(talk) 01:44, 5 February 2012 (UTC)

This makes me sad to here. I implore the veteran editors who watch and edit this page to make extra effort to assume good faith and ty not alienate new editors regardless of their WP:POV. A kind word goes much further than the stick and if we explain rules and policies in a kind manner new editors are less likely to take it so personally if you disagree with their viewpoint. Just remember a new editor could leave this page and created hundreds of new article's vastly improving the encyclopedia....or not. Garycompugeek (talk) 21:37, 3 February 2012 (UTC)

Jayjg, you mentioned the "literally thousands of posts on various fora made by various anti-circumcision activists" In your opinion, do they offer any evidence that is currently not in the article?Chevara (talk) 18:32, 4 February 2012 (UTC)

I can't vouch for everything they say, but based on a small random sample they mostly seem to contain a) personal opinion, often of a quasi-religious "good vs. evil" nature; b) personal attacks; and c) highly selective (and often misinterpreted) use of primary or non-scientific sources. Jayjg ^(talk) 01:44, 5 February 2012 (UTC)

Jayjg, in your opinion, are there people in favor of circumcision who hold their viewpoint with equal passion? Chevara (talk) 16:40, 5 February 2012 (UTC)

What do you mean by "passion"? Do you mean are their people whose opinion on circumcision is quasi- or fully- religious on both sides of the fence? Then the answer is certainly. Is your question, are theyr people in favor of circumcision who resort to personal attacks and selective and often misrepresentative quotations on Wikipedia? The answer to that, in my opinion, is perhaps, but certainly an order of magnitude less than those from the anti-circumcision side. At least according to my, admittedly faulty, memory. -- Avi (talk) 16:46, 5 February 2012 (UTC)

There is obviously no consensus that this article is NPOV. JakeW, 2 days is not sufficient to gain consensus on an issue that is clearly present. I am re-adding the tag. Many contributors have careers where in they cannot spend 24 hours a day defending an article. None the less, many are very experienced in writing articles and interpreting laws and regulation, including wikipedia policy. Please do not weight your view point above theirs simply because you feel your more experienced or because you have more contributions to an article or talk page.Gsonnenf (talk) 05:53, 8 February 2012 (UTC)

Gsonnenf, it is now eleven days since I pointed to the lack of an explanation for the tag including "specific issues that are actionable within the content policies". Such an explanation has still not been provided. And since we don't know what the specific issues actually are, it is a logical impossibility for us to obtain consensus over whether they have been resolved, and indeed whether they are valid problems. The tag has again been removed. May I suggest that, if you require more time to formulate an explanation, you take as long as you wish, and add the tag once you have prepared that explanation. Jakew (talk) 09:15, 8 February 2012 (UTC)

Jake you removed the tag after 2 days. Please be advised that wp:driveby is not a policy. It is simply an article. Pointing to the recent disagreements on changed content on this talk page, that you are involved in, is sufficient. These are actionable and will be discussed in there relevant heading as to keep the discussion coherent.Gsonnenf (talk) 09:59, 8 February 2012 (UTC)

DRIVEBY may not be policy, but it is widely recognised as good practice. But perhaps you'd care to consider the instructions shown at {{POV}}? "The editor placing this template in an article should promptly begin a discussion on the article's talk page. In the absence of any discussion, or if the discussion has become dormant, then this tag may be removed by any editor. [...] Please also explain on the article's talk page why you are adding this tag, identifying specific issues that are actionable within Wikipedia's content policies." (In fairness, I should point out that the last sentence was not present when you initially tagged the article. To date, however, you haven't begun any discussion about the tag.) It is not sufficient to vaguely refer to recent disagreements. As a reminder, tags are supposed to be temporary, and should be removed once the issues have been addressed; this implies that the issues must, as a minimum, be identified. Jakew (talk) 10:23, 8 February 2012 (UTC)

Guidelines are non-policy, but good practice. wp:driveby is not a guideline it is an article. Please read the {POV} tag for a description of when to remove.

This template is not meant to be a permanent resident on any article. Remove this template whenever:

No discussion about neutrality issues was started on this article's talk page.

Discussion about neutrality issues is dormant.

There is consensus in the discussion that the problems have been resolved.

These have not been met. You are in neutrality discussions on this talk page. They are not dormant. There is no consensus to remove the tag.Gsonnenf (talk) 12:24, 8 February 2012 (UTC)

Please could you point to the neutrality discussion which you promptly began when placing the tag? I could not find one. The only discussion about the tag is this one, which a) you didn't begin, and which b) doesn't identify specific issues anyway. Jakew (talk) 12:32, 8 February 2012 (UTC)

The POV tag content says nothing about "you must begin a topic about the tag". It says you remove it when "No discussion about neutrality issues was started on this article's talk page." Its quite obvious there was discussion about neutrality issues started before and after the tag. You are involved enough in them to know they obviously exist.Gsonnenf (talk) 12:54, 8 February 2012 (UTC)

As quoted above, it states: "The editor placing this template in an article should promptly begin a discussion on the article's talk page." So where is it?

Also, as explained above, the existence of discussions involving neutrality does not justify a tag. If they did then tags would effectively be permanent, since it is fairly normal for such discussions to take place. In fact, tags are intended to be temporary, existing for just long enough for the specific issues that led to tagging to be assessed and, if legitimate, resolved. For that reason, it is essential that these specific actionable issues are identified in one place (the {{POV|talk page section name}} syntax helps identify the specific section associated with the tag). Jakew (talk) 13:18, 8 February 2012 (UTC)

Gsonnenf, you have again tagged the article but failed to state what specific policy issues exist with it. Please state them clearly. Jayjg ^(talk) 18:25, 8 February 2012 (UTC)

discussions about neutrality are in topics "Rewrite of controversies paragraph", "Poor summary of controversies in the lead" and "Medical associations". There are others from when the POV tag was added in the recent archives. You have contributed substantially to all 3, and are in disagreements with old or new content regarding POV and UNDUE. Please discuss these under the respective topic. Discussing all 3 here would obfuscated the issue as each is a unique discussion. Please do not remove the tag based on what you consider "technical" breaches if you are aware of POV disputes on the article.Gsonnenf (talk) 21:28, 8 February 2012 (UTC)

Gsonnenf, I still can't understand your justification for this tag. Please state which policy is currently being violated, and exactly how, quoting the relevant parts of the policy. Jayjg ^(talk) 21:34, 8 February 2012 (UTC)

Jayjg please see the following 3 active topics you have made contributions to:[ 1 ], [ 2 ] and [ 3 ]. If you have trouble seeing that there is WP:UNDUE or WP:NPOV in these, please do a "find" for the NPOV UNDUE terms. As one example of the many POV/UNDUE disputes going on please see your own post in topic "medical associations":

The KNMG's view on what other medical associations say is simplistic at best, and unduly weights the opinion of one relatively small medical association (the KNMG). Moreover, it gives the impression that the KNMG's view is a summary of the material to follow, which it is not. This is misleading. Jayjg (talk) 21:30, 6 February 2012 (UTC)

Thank you. Gsonnenf (talk) 05:26, 9 February 2012 (UTC)

Gsonnenf, it is almost three weeks since you added the tag, and multiple editors have explained that it is not sufficient to point to discussions in which NPOV has been mentioned. I do not understand your continued refusal to enumerate specific, actionable points. Jakew (talk) 09:01, 9 February 2012 (UTC)

Jakew, please stop WP:IDIDNTHEARTHAT, it is becoming disruptive.Gsonnenf (talk) 13:19, 9 February 2012 (UTC)

Most recently, Jayjg asked you to "state which policy is currently being violated, and exactly how, quoting the relevant parts of the policy". In response, you listed three sections of this talk page in which NPOV has been mentioned. Not only does this utterly fail to answer Jayjg's question, it's completely irrelevant to the tag, as several other editors have explained (eg., Johnuniq's observation that "Referring to commentary elsewhere is not adequate"). Accusing me of IDHT and disruption seems an excellent example of WP:KETTLE, don't you think?

Now, once again, please explain your justification for the tag, clearly stating which policies are presently being violated, in what part(s) of the article, and how they are being violated, quoting the relevant portions of policies where necessary. Please note that I am not asking you to list discussions in which NPOV has been mentioned, nor am I asking for a list of editors who've complained about the page. Nor, for that matter, am I asking for a list of banana milkshake recipes.

Consider a reader who sees the tag: (s)he should be able to click on a link to the corresponding section (the {{POV}} instructions explain how to link to a section of the talk page), and see at a glance a list of specific issues that are non-NPOV, explained in sufficient detail to allow him/her to fix them, if (s)he is so inclined. Then (s)he should be able to remove the tag with confidence, knowing that the reasons for its existence have been addressed. That's what a tag is for. It's not for vaguely protesting that some people aren't happy about the content of the page. Jakew (talk) 13:43, 9 February 2012 (UTC)

Is there a deadline for keeping a tag? None of many editors' specifics have been addressed. Yobol dismissed them in one word "silly". Chevara (talk) 17:20, 9 February 2012 (UTC)

There are so many violations of neutrality. For one, excessive reliance on a United Nations political body is a no-no. Chevara (talk) 17:27, 9 February 2012 (UTC)

True, but what constitutes excessive, and is that condition met in this article? Jakew (talk) 18:07, 9 February 2012 (UTC)

Each time you are asked why the tag belongs, you present a new reason, which gives the appearance of moving the goalposts. Moreover, you have still failed to state which policy is currently being violated, and exactly how, quoting the relevant parts of the policy. You've been asked to do so several times now. Jayjg ^(talk) 19:03, 9 February 2012 (UTC)

The current lede has 19 footnotes. #1, #8, #9, #14 directly cite United Nations publications. #12, # 13, #17, # 19 rely on United Nations publications. # 10 published in Africa in 2008 does not give the United Nations any credibility in the discussion. By my count, about 50% of the current lede relies on the United Nations, a political organization. Chevara (talk) 16:59, 10 February 2012 (UTC)

After so much discussion and begging for a specifics, the only specific "problem" that can be pointed out is that mainstream, global expert organizations such as the WHO and UN are used too much? Really? Yobol (talk) 17:07, 10 February 2012 (UTC)

I'm afraid I can't make any sense of your statement that 12, 13, 17, and 19 "rely on United Nations publications". Ref 1 and 8 supports totally non-controversial points, so it doesn't really matter who is cited in support of them. That leaves us citing the World Health Organisation for two of the 19 points, consistent with WP:MEDRS. Are you seriously claiming that this is a problem? Jakew (talk) 17:12, 10 February 2012 (UTC)

I have to agree with the posters above; is this really meant as a serious objection? Jayjg ^(talk) 21:11, 10 February 2012 (UTC)

I have already pointed out 3 active discussion on POV which users, including Jayjg and JakeW, are disputing content or defending content others claim violate POV. When these discussions resolve we will review active discussions again to see if there are POV disputes about current content. If these can't be resolved among the current authors we will have to seek an alternate form of resolution. Thank you for your understanding. Gsonnenf (talk) 11:46, 11 February 2012 (UTC)

Given that several editors have already explained to you that the existence of discussions in which NPOV has been mentioned it not a justification for the tag, could you explain why you keep referring to such discussions? Jakew (talk) 12:32, 11 February 2012 (UTC)

I've already explained with proper sources that those concerns are not justified. I would have no problem with you taking the time to add them, but the tag is proper without them added.Gsonnenf (talk) 01:16, 12 February 2012 (UTC)

You have still failed to state which policy is currently being violated, and exactly how, quoting the relevant parts of the policy. Please do so here. Jayjg ^(talk) 02:17, 12 February 2012 (UTC)

Resolving ownership issues

Wikipedia needs an outside adjudicator to investigate possible long-term Multiple-editor ownership of this article. http://en.wikipedia.org/wiki/Wikipedia:Ownership_of_articles — Preceding unsigned comment added by 198.189.145.4 (talk) 18:25, 7 February 2012 (UTC)

There appears to be enough dispute among a few long term authors and new authors that it is warranted. Gsonnenf (talk) 10:05, 8 February 2012 (UTC)

It appears much of controversial areas have been written after lengthy (often repetitive) debates. New editors are as much welcomed as old, but not every new editor should expect a re-write from his/her perspective unless he/she can show that consensus has changed. It's not ownership - it's consensus and it works. Sometimes, your views are not the consensus of the editors - mine, often times - but it is really unproductive to re-hash everything over and over again, especially as nearly every viewpoint is addressed in some manner in the argument and people are just arguing over how much emphasis each viewpoint should get. Carlossuarez46 (talk) 23:52, 10 February 2012 (UTC)

Your point is very understandable carlos, but the problem I'm seeing is that its the same 2 or 3 people arguing "the same point" against many new set of people. There is seldom consensus, just a war of attrition until the new people leave first because they have less vested interest.Gsonnenf (talk) 01:57, 12 February 2012 (UTC)

On the other hand, Gsonnenf, the "new" people to whom you refer often come with the same, flawed, arguments that have been repeated here for years. The fact that "new" people espouse changes to the article that are not in accord with Wikipedia's principles and guidelines does not give us permission to ignore those principles and guidelines. -- Avi (talk) 03:16, 12 February 2012 (UTC)

It is called WP:ARBCOM Doc James (talk · contribs · email) 17:01, 12 February 2012 (UTC)

Avi, reading through the logs, it appears that the flaw sometimes resides with the other side. It is because there is disagreement that you goto outside opinions. I do agree that people belonging to pro/con circ groups do try to insert un-supported material, this material is usually rejected by visiting and vested authors alike. Gsonnenf (talk) 04:19, 13 February 2012 (UTC)

Data, not emotion. Please?

Some problems I came across:

This article only includes circumcision devices with negative connotations or disturbing images such as Gomco clamp while ignoring, for example, Brit milah.

Descriptions use terms with a high emotional quotient such as 'crushed'. While these may be medically accurate they bias the casual reader.

The assertion that a restraining device is used references a medical supply company, [17] There may or may not be better sources.

There are two general things which would help, a useful table of competing studies at Sexual effects of circumcision, and indication that some referenced articles are only available from pro- or anti-circumcision sites should be directly after the reference rather than as a note. Right now the article is frozen, and with good reason, but at some point they could be added.

This isn't an argument against anti-circumcision groups: I really do want additional clear, scientific information from them without high emotional quotient. Without that I can't compare the two views, much less get actual data, and the article is so muddled that only these stand out. (Needless to say the talk page has been less than useful.)

Would people reply to this only with links to websites and a brief summary of what they say, or at least what you think they say? Or, if you have a link that counters the information of one posted, post that. If you disagree with the way someone summarized the information add your own summary. If you have issues with a study give information as to why: how participants were chosen, sample size, or whatever. In short, let's collect the available data and go from there.

--Kovar (talk) 23:10, 13 February 2012 (UTC)

medical summary in lead

On 2/9 Jakew removed the medical summary we had in our lead. He has replaced it with " Most medical associations recommend neither universal circumcision nor a prohibition against the practice." This has been reverted many times and there is currently an ongoing RFC about it but there is clearly no consensus so far to change it. Avi just put it back saying it is the original summary statement and that KNMG statement never had consensus. Avi also tried to say I just coined it on 2/3 and added it to the article then. Truth is it's been there for about 7 months when it replaced our old summary from the AMA. I explained to Avi while reverting him that my addition was a duplicate into the top of the medical summaries section (which has been reverted on the grounds that it was NPOV???) Anywho Jakew just removed the KNMG summary in favor of his own (which NEVER gained consensus) stating "regardless of anything else, we do not need to duplicate sentences". Wow. First please point out the duplicate sentence Jakew and secondly please self revert your medical summary that clearly has no consensus. Garycompugeek (talk) 20:22, 21 February 2012 (UTC)

Here is a link to your version of the text, Gary. As you will see, the last two sentences of the third paragraph read: "According to the Royal Dutch Medical Association (2010), no professional association of physicians currently recommends routine circumcision.[16] Some bodies have discussed under what circumstances circumcision is ethical.[17][18]" The fourth paragraph contains those two sentences as well. This is the duplication to which I referred.

As for the sentence in question, it was added by LizardWizard, in July 2011, interestingly with no apparent consensus at the time. I am quite happy to remove both sentences, or to include both, as compromises while discussion continues. It is unreasonable, however, to ask me to violate NPOV by replacing the neutral summary with the non-neutral one. Jakew (talk) 20:41, 21 February 2012 (UTC)

Unacceptable Jake. The KNMG summary was fine for over half a year then because you decide it's NPOV we must cater to you. I'm tired of your delusions of ownership Jake. The rfc clearly demonstrates there is no consensus for your change. Garycompugeek (talk) 00:27, 22 February 2012 (UTC)

Gary, the RFC clearly shows no consensus for LizardWizard's addition, and your statement I'm tired of your delusions of ownership Jake is highly uncivil. Jayjg ^(talk) 01:11, 22 February 2012 (UTC)

It is incredible that Avi a WP:Bureaucrat and Jayjg an WP:Administrator are maintaining that the KNMG medical summary never had consensus even though the article history cleary shows the real story. Garycompugeek (talk) 14:44, 22 February 2012 (UTC)

I don't see what your comment has to do with article content. Please review WP:NPA and WP:TPYES. Jayjg ^(talk) 23:14, 22 February 2012 (UTC)

I believe what Garycompugeek is saying, is that if you go into the history, there was consensus for the KNMG medical summary. Since whether or not to put the KNMG medical summary is being discussed above, it is germane to article content. If there was consensus, there was consensus. If there was not, there was not. A look in the history should make it unambiguous for everyone. Tftobin (talk) 00:09, 23 February 2012 (UTC)

Correct Tom. My comment, Jayjg, is addressing the article's lead, and the fact that you and Avi are pretending Jake's removal of KNMG's medical summary and replacing it with his own had consensus. I bring attention to your stations because the wikipedia community holds you to a higher standard than edit warring and ignoring policy. Garycompugeek (talk) 19:15, 23 February 2012 (UTC)

These comments appear to be about editors (e.g. "you and Avi are pretending Jake's removal" etc.). Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor." Jayjg ^(talk) 20:01, 23 February 2012 (UTC)

This is about the content. He stated that authors are changing content as if there was consensus when there was not consensus which is vital to this discussion. Please stop misapplying wiki rules.Gsonnenf (talk) 04:12, 24 February 2012 (UTC)

"you and Avi are pretending Jake's removal" is a comment about editors, not content. Please make more accurate talk page comments. Jayjg ^(talk) 04:56, 24 February 2012 (UTC)

cite error

This info is missing from the article: <ref name="CDC-2008">{{Cite web|title=Male Circumcision and Risk for HIV Transmission and Other Health Conditions: Implications for the United States |publisher=Centers for Disease Control and Prevention |date=7 February 2008 |url=http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm |accessdate=15 July 2011}}</ref> (I took this from an earlier version. Maybe not the most recent with this information.) Currently the article says "cite error..." in red in the "notes" section. ☺Coppertwig (talk) 23:53, 26 February 2012 (UTC)

Please fix ref 80, which has a missing citation. The reference, as supplied by Coppertwig above, is: <ref name="CDC-2008">{{Cite web|title=Male Circumcision and Risk for HIV Transmission and Other Health Conditions: Implications for the United States |publisher=Centers for Disease Control and Prevention |date=7 February 2008 |url=http://www.cdc.gov/hiv/resources/factsheets/circumcision.htm |accessdate=15 July 2011}}</ref> Jakew (talk) 16:40, 28 February 2012 (UTC)

• Done -- Avi (talk) 17:19, 28 February 2012 (UTC)

Wasting time

Please stop saying stop wasting our time posting to this talk page. This is an article talk page, everyone is free to comment. No one is forced to read other editors comments. If you could care less about the issue an editor is talking or you feel it has been beaten to death then ignore it but making disparaging comments like "stop wasting our time" is unproductive to this talk page and completely contrary to the spirit of the wiki. Garycompugeek (talk) 14:31, 29 February 2012 (UTC)

You mean like this? --jpgordon^{::==( o )} 16:31, 29 February 2012 (UTC)

Perhaps he may mean edits like this. Therewillbefact (talk) 18:31, 29 February 2012 (UTC)

I don't think Gary would suggest that this applied only to other editors, not himself. Jayjg ^(talk) 19:07, 29 February 2012 (UTC)

Therewillbefact is right, though: Gary isn't the only editor who is guilty of having made this sort of remark. I've done so too, and I'm sure that I've employed such language more often than I should have. Jakew (talk) 20:30, 29 February 2012 (UTC)

I think the core issue here that whilst no one is forced to read all the comments, topics or discussions that have been had multiple times in the past, and have always resulted in the same consensus, do not need to be perennially rehashed. Consensus does change, and testing it every now and then is reasonable, but too often would not be. A nicer way should be found to phrase it that "wasting time," I agree. How about "your suggestion to review this discussion is inefficient in maintaining this article as it has been rejected in the recent past". -- Avi (talk) 18:42, 29 February 2012 (UTC)

That is certainly much nicer way to put it Avi. Garycompugeek (talk) 19:02, 29 February 2012 (UTC)

(edit conflict) I have struck out my uncivil comment but I would like to explain it taken in context. I was asking a question to Jake when Jayjg replied with three summerizing questions. This was the second one.

Jayjg wrote "Its use unduly weights the opinion of one relatively small medical association, that of the KNMG."

I replied with "They are over 53,000 strong and would not be impressed by your assessment of them and all other major medical associations in the Netherlands also signed and endorsed this document. Please bring sources to back up your statements or stop wasting our time with your on OR/POV." Without a source Jayjg's assertion is completely WP:OR and not relevant. He later went on to endorse the opinion of one professor not even in the medical field for their medical summary which seems to be a complete flip flop in my book. Regardless I was wrong and should not have said that and I apologize Jayjg. Garycompugeek (talk) 18:58, 29 February 2012 (UTC)

We've all made a few or many borderline comments, but let's agree to try to stop the following:

1. Accusing others of wasting their time.
2. Asserting there is consensus, unless you can demonstrate consensus on the topic, this includes the past month or so of archived threads.(Many editors are not full time editors and may go missing for weeks at a time [ such as doc james who is on holiday currently] ).
3. Assuming there is consensus on debates early. Editors should have a week or two to comment.
4. Assuming there is consensus because you had the last word. Declared yourself winner if no one responded and waiting for archive is not consensus.
5. Reduce the WP:FILIBUSTERS in non-consensus debates. This will be difficult. We're going to need to get better at going to RFC or finding compromise when no new useful information is being presented.

We are also going to have to find a better way to track non-consensus threads. Many threads are archived because the conversation was stale after 4 short days, they are later repeated. These repeats are legitimate. Being the last person to comment, revert or add does not mean the change is legitimate. If other authors rather go back to the talk page, instead of edit war, that is a good thing. I think we can find a better way though. It would be good if we could keep non-consensus threads active, or perhaps keep a record, a summary of sort so that past data does not get lost, and the same debate doesn't keep taking place.Gsonnenf (talk) 22:02, 29 February 2012 (UTC)

Re: heartfelt comment by 97.101.49.230

Yobol deleted an extremely poignant comment a few minutes ago. We are not robots. There is no other talk page that enforces such tight interpretations of policy. I object and commend 97.101.49.230 for speaking truth to tyranny. 118.96.148.92 (talk) 01:11, 7 March 2012 (UTC)

If you didn't know that your impassioned little speech violated protocol here, you would have logged in, and used your user name. Even people who agree with the content, totally disagree with the method and the delivery. It was inappropriate, and that comes as no surprise to you. Yobol did nothing wrong. Tftobin (talk) 14:35, 7 March 2012 (UTC)

Hello, If you feel the ethics portion of the article is lacking, you can help by pointing out valuable sources, such as articles and papers from authoritative sources via WP:RS. Finding excellent source material is appreciated by all Wikipedia authors. Gsonnenf (talk) 23:05, 7 March 2012 (UTC)

There's a history of chasing new people away from this article. Rather than delete someone's contribution, it would be better to understand their point of view and help them learn the rules to make a contribution to the article. A summary judgment against newcomers is much too authoritarian for this subject matter. Anonymous 178.48.44.2 (talk) 17:31, 8 March 2012 (UTC)

We're telling you the rules. You will need to abide by them, if you want anything positive to happen. It is true that people involved with this particular article can be very punishing to newcomers. What you do is learn, observe, and ask questions. You don't come in, post something that is sure to inflame passions using an IP address or Anonymous, and then leave. I understand where you are coming from. I've been seriously attacked. You don't stop being attacked, by breaking the rules. You stop being attacked by abiding by them, and then trying to work within the tiny space given to you. If you want to fast track, go through the recent history, look for my ID, and see how many times WP: occurs with them. You'll learn fast. Welcome. Tftobin (talk) 17:59, 8 March 2012 (UTC)

The removed post was not about improving the article but rather about expressing a personal opinion about the subject. At WP:TALK we find: "Talk pages are for improving the encyclopedia, not for expressing personal opinions on a subject or an editor." Bus stop (talk) 20:04, 8 March 2012 (UTC)

I'll give all your comments some more thought. The idea that we can discuss this article without expressing our opinions seems, well, "not grounded in human nature." Anonymous 178.48.44.2 (talk) 05:56, 9 March 2012 (UTC)

This is all just more disruption by the banned sockpuppeter Joe Circus. Jayjg ^(talk) 01:18, 11 March 2012 (UTC)

Possible compromise?

So far, at least, there's an interesting division of opinion in the above RfC, with similar levels of support for #1 and #2. There seems to be some support for including more than one summary, and I've been thinking about how to do so in a concise manner. I'm just whether there's any support for something like the following:

• Summaries of the views of professional associations of physicians have included that none currently recommend routine circumcision, that most recommend neither universal circumcision nor a prohibition against the practice, and that most support it for HIV prevention.

Any thoughts? Jakew (talk) 20:33, 19 February 2012 (UTC)

I'm puzzled. Why are you now suggesting we integrate HIV prevention here? It does not dovetail at all with the sentences we are deciding between. Therewillbefact (talk) 00:38, 20 February 2012 (UTC)

"that most recommend neither universal circumcision nor a prohibition against the practice" is awkward, tortured syntax. Bloggurzz (talk) 03:21, 20 February 2012 (UTC)

I quoted the relevant sentence from that source above ("With few exceptions, [...] professional medical associations [...] supported male circumcision for the prevention of HIV infection"). I think it's no less useful a summary of the views of such associations as either of the others. And if we're to take a step back and say that there are several different summaries, it makes sense to include a broad selection. That is to say, I couldn't think of a good reason to exclude it. Jakew (talk) 09:48, 20 February 2012 (UTC)

Aside the last phrase it is ok but I think there is quite a lot of missing context in the HIV phrase. I mean, no one supports routine circumcision worldwide for HIV prevention (which is how the comment is likely to be read). There are specific circumstances in which "most believe it has a role in HIV prevention". --BozMo talk 12:17, 21 February 2012 (UTC)

Hmm. If we changed the order of presentation, we could minimise the chances of the HIV phrase being misinterpreted as being about routine circumcision: "Summaries of the views of professional associations of physicians have included that most support it for HIV prevention,[4] that most recommend neither universal circumcision nor a prohibition against the practice,[3] and that none currently recommend routine circumcision.[1]" Jakew (talk) 12:27, 21 February 2012 (UTC)

jakew, you might want to review an elementary book on style and composition. You're trying to stuff too much into one sentence. 189.115.193.157 (talk) 15:33, 21 February 2012 (UTC)

the irony is "too" much.--brewcrewer (yada, yada) 15:37, 21 February 2012 (UTC)

It's an awkward, hard-to-decipher sentence, Jakew. It would give a reader the impression that state most professional associations of physicians support circumcision because of its HIV prevention qualities... Therewillbefact (talk) 19:01, 21 February 2012 (UTC)

The source states that most professional medical associations "supported male circumcision for the prevention of HIV infection"; I fail to see why there is any problem with doing the same... Jakew (talk) 19:05, 21 February 2012 (UTC)

Maybe because not a single professional medical association recommends circumcision to prevent HIV. Garycompugeek (talk) 19:44, 21 February 2012 (UTC)

Perhaps, perhaps not. It's a moot point anyway, since the statement is that they support it, rather than recommend it. Jakew (talk) 19:50, 21 February 2012 (UTC)

6 people supported 1 and 2 people suport both, which totals to 8. This means #1 should be in the lede somehow, right?. Pass a Method talk 10:05, 22 February 2012 (UTC)

It seems likely that we'll need to negotiate a compromise of some sort. Jakew (talk) 10:47, 22 February 2012 (UTC)

old compromises

How about we add the two together like this; "According to the Royal Dutch Medical Association (2010), no professional association of physicians currently recommends routine circumcision, but most medical associations recommend neither universal circumcision nor a prohibition against the practice." Pass a Method talk 13:05, 22 February 2012 (UTC)

That would read as though the KNMG were making both statements, which they don't (and if they did, it would be redundant, since routine and universal circumcision have the same meaning). Jakew (talk) 13:20, 22 February 2012 (UTC)

I think 4 people supported using both, so how about we use both in seperate sentences? similar to above but in two setences? Pass a Method talk 14:29, 22 February 2012 (UTC)

I think we need to give some indication of why we're including summaries that at least partly overlap. Otherwise it reads oddly due to the redundancy. The real reason for including more than one summary is that different authors have summarised these policies differently (perhaps reflecting their own different viewpoints). That's why I proposed "summaries of the views ... have included" wording: to make explicit the fact that we're including multiple summaries. Jakew (talk) 16:25, 22 February 2012 (UTC)

How about this wording?

"Views from medical associations vary from claiming no professional association of physicians currently recommends routine circumcision, or that most recommend neither universal circumcision nor a prohibition against the practice." Pass a Method talk 16:50, 22 February 2012 (UTC)

It's poorly worded. Firstly, it's not that the views from medical associations vary per se; it's that summaries of such views vary. Also, the usual sentence structure ("vary from ... or") is unconventional. More usual would be "vary from ... to ...", but that raises the question of whether these are actually the extremes. That's why I chose the "have included" format: it doesn't imply that these represent the extremes. Jakew (talk) 17:11, 22 February 2012 (UTC)

Fourth try.

"Views from medical associations include claims that no professional association of physicians currently recommends routine circumcision, and that most recommend neither universal circumcision nor a prohibition against the practice."

Pass a Method talk 18:05, 22 February 2012 (UTC)

Please see WP:CLAIM. Jayjg ^(talk) 18:22, 22 February 2012 (UTC)

Also, the same problem as above, these are summaries of views of medical associations, not views themselves. Jakew (talk) 18:23, 22 February 2012 (UTC)

Compromise for lede

What's your opinion of this inclusion?

"Summaries of views from medical associations have included that no professional association of physicians currently recommends routine circumcision, and that most recommend neither universal circumcision nor a prohibition against the practice."

Pass a Method talk 18:52, 22 February 2012 (UTC)

Much better, but why exclude "and that most support it for HIV prevention" (from my initial compromise proposal above)? Jakew (talk) 18:54, 22 February 2012 (UTC)

I think the lede speaks about HIV too much as it is as othershave already implied. Pass a Method talk 19:40, 22 February 2012 (UTC)

That's not a valid argument. The question is what summaries of the views of medical associations have been published. To argue that some summaries are unacceptable because you don't think the content is very important is ludicrous. It's not supposed to be your summary; it's theirs. Jakew (talk) 19:50, 22 February 2012 (UTC)

I hope we're not going to go back to counting the number of words in the lede and calculating percentages again. Jayjg ^(talk) 20:08, 22 February 2012 (UTC)

The wording of the last RFC did not include any mention of HIV, therefore it is disrespectful to the 15 editors above, none of whom supported any HIV mention. If you want to mention HIV, discuss that in a subsequent discussion. Not this one. Pass a Method talk 20:15, 22 February 2012 (UTC)

The RFC clearly stated: "The two options considered so far include the following" (emph added). Hence it did not exclude discussion of alternatives. Jakew (talk) 20:19, 22 February 2012 (UTC)

Okay, but why do you think its important to be so repetitive on HIV? The lede already mentions something very similar twice: (a) "circumcision reduces the risk of HIV", (b) "The WHO currently recommends circumcision for prevention of HIV" Pass a Method talk 21:27, 22 February 2012 (UTC)

I don't think it is repetitive. The statement which you've labelled (a) is about the association between circumcision and HIV, not what any organisation thinks about it. Statement (b) is about what a single medical organisation (albeit a highly influential one) recommends. Neither statement provides information about how medical associations as a whole have responded. Jakew (talk) 21:37, 22 February 2012 (UTC)

You're missing the point. The lead should not give information on every single medical finding about circumcision. More detailed descriptions go to the subsections. For this reason things such as urinary fistulas, chordee, cysts, lymphedema, ulceration of the glans, hypospadias, epispadias etc. are not in the lede - so a not to clog it.

Why would we need to add "most support it for HIV prevention", when it sounds very similar to two phrases in the same paragraph? Your suggestion is not only repetitive, but it is extremely repetitive. In fact, it is so repetitive i can't believe you proposed it. Pass a Method talk 21:27, 22 February 2012 (UTC)

As I explained, I don't think it is repetitive, and "sounding similar" does not imply that it has a similar meaning. Frankly, I think that "most recommend neither universal circumcision nor a prohibition against the practice" is a perfectly adequate summary of the views of medical associations. However, if it's so important to include the KNMG's summary as well, then you're introducing a certain amount of redundancy. It's difficult to justify including one in spite of redundancy, but excluding another because it "sounds similar" to something else. Jakew (talk) 21:56, 22 February 2012 (UTC)

We're getting sort of off-topic now. Instead of debating the HIV section now, why not instead first add it without the HIV bit, and then later try seek consensus for the HIV part? Deal? Pass a Method talk 22:18, 22 February 2012 (UTC)

I don't understand why we'd leave out one summary of medical association views while leaving in two others - there does not appear to be any specific policy or guideline-based rationale that I can discern. On the contrary, it would seem to violate WP:NPOV to do so. Jayjg ^(talk) 23:12, 22 February 2012 (UTC)

That sentence is about whether Circumcision is recommended, not what it is recommended for. HIV is discussed adding it again violates WP:UNDUE.Gsonnenf (talk) 04:03, 24 February 2012 (UTC)

Your response does not address the point I have raised. Please re-word or re-state it in a way that directly addresses the point regarding leaving out one specific summary out of three, and therefore violating WP:NPOV. Jayjg ^(talk) 05:04, 24 February 2012 (UTC)

Not only have you failed to address Jayjg's point, but you're also incorrect. It's about how others have summarised the views of medical associations. I'm sorry that you find this particular summary lacking; but I assure you that few people will be satisfied with every summary. That, after all, is why we're trying to find a compromise. Jakew (talk) 09:30, 24 February 2012 (UTC)

I would still like to see an explicit mention of the Royal Dutch Medical Association with their statement. I think it would be fair to our readers to provide them with the specific organization that holds this point of view. Therewillbefact (talk) 17:51, 25 February 2012 (UTC)

I'd prefer to treat sources equally with respect to identifying the origin or not, but as a compromise I suppose I'd be willing to name the KNMG:

• Summaries of the views of medical organisations have included: that most support it for HIV prevention, that most recommend neither universal circumcision nor a prohibition against the practice, and (from the Royal Dutch Medical Association) that none currently recommend routine circumcision.

Jakew (talk) 18:12, 25 February 2012 (UTC)

I really value your willingness to compromise here Jakew, but I'd like to draw attention to the text you interpreted to mean "that most [medical associations] support [circumcision] for HIV prevention". You'll notice that the statement pertains to HIV campaigns in high-risk areas (the title of the text is, after all, Print media reporting of male circumcision for preventing HIV infection in sub-Saharan Africa). This is further evidenced by the fact that the text that precedes and follows the statement very specifically only applies to the implementation of circumcision in high-risk areas. Please give it a read. Furthermore, this claim by the WHO is even substantiated by examples that only pertain to efforts being made in high-risk areas. The text is followed by "major donors like the Bill and Melinda Gates Foundation and the United States President’s Emergency Plan for AIDS Relief were willing to fund male circumcision programmes". Notice how the WHO did not make the distinction "the Bill and Melinda Gates Foundation as well as the PEPFAR were willing to fund male circumcision programmes in high-risk areas", even though these organizations have only expressed interest in promoting circumcision programs in high-risk areas as a hedge against HIV. This is because it would be very redundant for a text on circumcision campaigns in sub-Saharan Africa to include the qualifier "in high risk areas" or "in sub-saharan Africa" every other sentence. It is a given, if you read the context it is presented in. Additionally, the other organizations cited by the WHO for supporting circumcision here were the Southern African HIV Clinicians Society in Namibia, and Treatment Action Campaign - an HIV advocacy group in South Africa.

That said, I do not as strongly oppose mentioning this in its appropriate context (that most support it for HIV prevention in high-risk areas, particularly sub-Saharan Africa), but even then we already include the WHO's recommendation, so it seems a tad redundant that we would include the WHO's recommendation in the lead as well as a source by the WHO that states most organizations support the recommendation made by the WHO. But again, I do not oppose this as much as suggesting that most professional medical associations support universal circumcision for HIV prevention. Therewillbefact (talk) 21:29, 25 February 2012 (UTC)

The text that I interpret to mean "that most [medical associations] support [circumcision] for HIV prevention" is the sentence: "With few exceptions, donors, academia, professional medical associations and HIV advocacy groups supported male circumcision for the prevention of HIV infection." Note that it doesn't qualify this as "in high-risk areas, particularly sub-Saharan Africa", so if we were to do so it would be original research. Jakew (talk) 21:35, 25 February 2012 (UTC)

I would like to again highlight the ambiguity of the text (as well as its title, and the content preceding and following the statement). Notice how text mentions "major donors like the Bill and Melinda Gates Foundation and the United States President’s Emergency Plan for AIDS Relief were willing to fund male circumcision programmes", which would be factually incorrect if interpreted at face value, as I've pointed out. The Bill and Melinda Gates Foundation as well as the PEPFAR have only expressed interest in endorsing male circumcision programmes in high-risk areas. Therewillbefact (talk) 22:08, 25 February 2012 (UTC)

That argument doesn't make sense. If an organisation has been willing to fund at least two male circumcision programmes, the statement "organisation X has been willing to fund male circumcision programmes" is true. Similarly, if I've eaten at least two apples in my life, the statement "Jake has eaten apples" is true. To stretch the analogy a little, you're essentially saying that if I only eat golden delicious apples, and have never have consumed a braeburn, then it is incorrect to say that I've eaten apples. But that's not the case. Willingness to fund male circumcision programmes does not imply willingness to fund every conceivable male circumcision programme. Jakew (talk) 22:23, 25 February 2012 (UTC)

I do not think you understand my point. Let's take a step back: first, the organizations BMGF and PEPFAR were only interested in funding circumcision campaigns in high-risk areas; the sentence is written in past tense, pay close attention to use of the word "were" by the WHO. This text fails to distinguish this important detail - probably because it is laden in content that only discusses the merit of circumcision in high-risk areas. Additionally, I've tried finding a single medical organization that recommends universal circumcision for HIV prevention, and I couldn't even find a single one. It stands to reason that we need to find other secondary sources that make this claim, since the WHO also neglected to provide a single instance of an organization that supported circumcision for HIV prevention (it did, however, provide four organizations that support circumcision efforts in high-risk regions). The burden of proof still falls on the WHO if we are to interpret this at face value, since it did not even provide a single medical association that recommends circumcision everywhere for HIV prevention. Therewillbefact (talk) 23:12, 25 February 2012 (UTC)

First, neither the source itself nor the sentence fragment proposed for the article claims that any organisations recommend universal circumcision for HIV prevention, so the relevance of that is unclear. You also say that "it did not even provide a single medical association that recommends circumcision everywhere for HIV prevention", which is odd because they don't claim that organisations recommend circumcision everywhere. What they do say is that they support circumcision for HIV prevention, which doesn't necessarily imply recommendation or that the support is without geographical context. Second, you appear to contradict yourself by stating "the WHO also neglected to provide a single instance of an organization that supported circumcision for HIV prevention" and "it did, however, provide four organizations that support circumcision efforts in high-risk regions". Were there zero or four? Finally, please note that the KNMG did not provide a list of every single medical association in the world, nor any indication that they had checked every single one; you therefore seem to be demanding different standards of proof from different sources. Jakew (talk) 09:40, 26 February 2012 (UTC)

To address your first comment, I think that if the topic does not address the opinions of medical organizations with respect to the merits of general (universal) circumcision procedures, it is far narrower in scope than the two sentences we were deciding between. Actually, I'm actually happy you've acknowledged that the text makes no recommendation regarding circumcision - because this helps us see that it is in fact far narrower in scope than the sentences we were working with. Please keep in mind that the topic we are discussing is whether or not most medical associations routinely recommend for (or against the procedure).

To address your second comment, I left out a word -- I meant to type "the WHO also neglected to provide a single instance of an organization that supported routine circumcision for HIV prevention". Sorry for the confusion there Jake.

Regarding your third point, the viewpoint that no medical association does not recommend routine circumcision has been one stated for many years. Only one organization recommending routine circumcision would have to surface in order to prompt the KNMG to re-evaluate their statement. To give credence to the WHO's text regarding organizations that support general routine circumcision, I'd like to see at least one organization that advocates for this. The four organizations I cited from the text support circumcision specifically in high risk areas only. Therewillbefact (talk) 23:17, 26 February 2012 (UTC)

As I've noted below, we're actually concerned with a question broader in scope than whether universal circumcision is recommended.

Regarding your omitted word, that makes things a little clearer, but I'm afraid I still don't understand. Why on earth do you expect the WHO to supply an organisation supporting routine circumcision when they haven't stated that any exist?

Finally, you're again misrepresenting what the WHO actually say. The WHO do not make any statement "regarding organizations that support general routine circumcision". Jakew (talk) 09:38, 27 February 2012 (UTC)

Then it actually looks like there's much more room to integrate the summaries of medical associations in this sentence than I imagined, considering this widened scope we are now working with. Please see my comment dated 00:59, 28 February 2012 under Talk:Circumcision#Another_compromise_idea and we can continue our compromise there. Therewillbefact (talk) 07:47, 28 February 2012 (UTC)

Another compromise idea

The above discussion (which is by no means finished) suggests that compromise material is likely to be rather long. This is a little concerning, as the lead is already rather long. I therefore suggest that we consider an alternative:

• At the start of the Circumcision#Positions of medical associations section, we can introduce a paragraph outlining the various summaries, as discussed above. We should try to keep the paragraph concise, but we don't need to condense the material quite as much as in the lead, so we can discuss the nature of each source & some information about it.
• In the lead, we either remove the material altogether, or include a brief, neutral sentence that occupies a "middle-ground" in terms of the summaries. (This may be easier said than done.)

Thoughts? Jakew (talk) 22:35, 25 February 2012 (UTC)

Thank you for trying to move this forward. I propose reconciling the two sentences in question by just stating them both. Perhaps:

• Summaries of the views of medical organisations have included: that most recommend neither universal circumcision nor a prohibition against the practice, and (from the Royal Dutch Medical Association) that none currently recommend routine circumcision.— Preceding unsigned comment added by Therewillbefact (talk • contribs) 23:32, 25 February 2012‎

I still don't understand why all of these "compromises" involve leaving out one specific summary out of three, and therefore violating WP:NPOV, and I've yet to see a response that specifically addresses that issue. Jayjg ^(talk) 02:41, 26 February 2012 (UTC)

Yes. Therewillbefact, please don't waste time by proposing things that have already, in effect, been rejected. It is a slap in the face to those of us who are genuinely trying to negotiate a compromise. Jakew (talk) 09:48, 26 February 2012 (UTC)

First, I do not appreciate being told that I am wasting time, Jakew. That is not - and never was - my intention. I'm trying to be civil and productive here, and you just singled me out as an editor who is not genuinely trying to negotiate a compromise. I would appreciate it if your editing comments fell more in line with proper Wikipedia:Etiquette.

Second, the topic in question is summarizing the opinions of medical organizations with respect to whether the procedure should generally be performed. Anything else is probably too narrow in scope here; we seem to be taking this in a different direction. Additionally, the 2009 text Print media reporting of male circumcision for preventing HIV infection in sub-Saharan Africa concentrates its efforts on the merits of circumcision in, obviously, sub-Saharan Africa. Again, it would be redundant for the text to make the qualifier "in high-risk areas" or "in sub-Saharan Africa" every sentence (as I've pointed out, this qualifier is missing in other areas of the text where it absolutely does apply). Summarizing this statement in the manner you suggested does not put it in its appropriate context - please read the preceding paragraph of the text, and the text that follows it. It all very obviously applies to supporting circumcision programmes in high-risk areas. I am also attempting to get clarification on this from correspondence of the text as we speak. Therewillbefact (talk) 22:39, 26 February 2012 (UTC)

Please also see my comment dated 23:17, 26 February 2012 under Talk:Circumcision#Compromise_for_lede for further explanation. Therewillbefact (talk) 23:22, 26 February 2012 (UTC)

I see hypocrisy in these authors accusing therewillbefact of "wasting there time". I have no doubt that most authors feel that way about there opposition but do not state it to remain civil. After the RFC, it became clear that #1 should definitely be included, and #2 should probably also be included. His suggestion has also NOT been rejected in the current RFC. It seems very close to the above suggestion. Though I think passamethod statement:

"Summaries of views from medical associations have included that no professional association of physicians currently recommends routine circumcision[1], and that most recommend neither universal circumcision nor a prohibition against the practice."[7]

would probably work best and has the most support.Gsonnenf (talk) 07:10, 27 February 2012 (UTC)

I still don't understand why all of these "compromises" involve leaving out one specific summary out of three, and therefore violating WP:NPOV, and I've yet to see a response that specifically addresses that issue. Jayjg ^(talk) 13:18, 27 February 2012 (UTC)

Well, Therewillbefact, it does seem rather uncivil to propose something that fails to include X right after another proposal has been rejected for failing to include X.

Second, it's not specifically about "whether the procedure should generally be performed"; rather, it's about how others have chosen to summarise the views of medical organisations. There are many narrower questions that those sources could focus on. Some focus on whether universal circumcision is recommended, some address whether parental discretion is addressed, some address whether medical benefits are discussed, some whether HIV programmes are supported. To argue that only one of those is a valid summary is to introduce serious bias in a sentence that purportedly presents a range of summaries.

Finally, as noted, we cannot add our own qualifiers to a sentence: that's original research by definition. Jakew (talk) 09:30, 27 February 2012 (UTC)

Alright. Now that we have established that the scope of this sentence has been widened beyond professional recommendation regarding whether or not circumcision should be routinely performed, I'd like to present another source we can integrate with the summaries we are working with. PMID 21716785 states the following: "Most medical institutions in various countries agree that although there may be health benefits, there is no medical justification for routine circumcision in neonates or children". Now that we've widened the scope of this sentence to the extent that we have, there seems to be merit to including this pubmed-indexed source as well with the others. I am also looking into more sources that we can include here, but this is the first one I'd like to present.

I'd also like to remind you that up until your edit dated 20:33, 19 February 2012 in Talk:Circumcision under Possible compromise, the topic in question dealt solely with what professional medical opinions believed with respect to routinely recommending the procedure. Now we've taken it into a different direction, by summarizing the opinions of medical associations with regard to health benefits and adversities. Therewillbefact (talk) 19:58, 27 February 2012 (UTC)

Are you proposing to include this source instead of the KNMG? The reason why I ask is that is says something very similar, and including both would consequently be rather redundant. Anyway, I suggested above that we include lengthier discussion of various summaries at Circumcision#Positions of medical associations. If that proposal were followed, I think it would seem reasonable to include this source there (as long as care was taken to avoid redundancy).

As for your "reminder", it's factually incorrect. The RFC was opened eight days earlier than the edit you mention (20:55, 11 February 2012), and one of the sentences offered for comment discusses whether medical associations advocated a prohibition against the practice, which wouldn't make sense if the scope was only whether they recommended universal circumcision. Jakew (talk) 20:14, 27 February 2012 (UTC)

I am suggesting it stands to reason that we need to include both the KNMG's statment in addition to the one made by PMID 21716785, since we have widened the scope here to the extent that we have. Please pay special attention to the rhetoric of the sources. One source states that no professional association of physicians recommend routine circumcision, while the other states that medical institutions agree that there is no medical justification for routine circumcision in neonates or children (emphasis mine). As such, they both provide important information that merits summarizing. Given that we have now widened the scope of the sentence beyond just professional recommendation for-or-against circumcision, it would be original research to suggest that these two sources can be summarized by only utilizing one of them. We need to state what the sources say and let our readers figure out if it means the same thing for themselves, Jake.

What these sources state seems like very important information, information that our readers will very likely want to infer when they visit this page; it should absolutely be included in the lead for Circumcision. Therewillbefact (talk) 00:59, 28 February 2012 (UTC)

As noted, there's a certain amount of repetition between the two, but there's no reason why PMID 21716785 shouldn't be included in the detailed discussion in the body of the article. Jakew (talk) 09:05, 28 February 2012 (UTC)

It looks like I have to explain myself here. It would be original research to suggest that both sources can be summarized by only using one of them here, since they do not state the same thing. Again, one suggests that most medical institutions agree that there is no medical justification for routine circumcision in neonates or children, the other states that there is no professional association of physicians currently recommends routine circumcision (emph mine). These are both important summaries that deserve summarization, given the widened scope of medical summaries we are now allowed to work with. Therewillbefact (talk) 17:43, 28 February 2012 (UTC)

The KNMG's statement is logically equivalent to saying that all such associations do not currently recommend routine circumcision. Consequently, there is no need to say that "most" do not recommend routine circumcision (or similar), because "most" is a subset of "all". It's like quoting one source that says "humans have one head" and another saying "no humans have three heads": needlessly repetitive. Jakew (talk) 18:09, 28 February 2012 (UTC)

Let's be clear that PMID 21716785 makes absolutely no mention with respect to what most medical associations explicitly recommend, which renders your argument that "there is no need to say that 'most' do not recommend routine circumcision" as logically invalid. Again, the word "recommend" is nowhere to be found in what I quoted from the source, so please stop trying to do your own original research to infer what the source is trying to say. Also please remember that we have widened the scope here beyond mere recommendations by medical associations. Your figurative comparison of my argument also does not fall in line with what my point here at all; please make more accurate Talk:Circumcision comments. Therewillbefact (talk) 21:27, 28 February 2012 (UTC)

It is important to include that medical professionals state there is no medical justification for routine neonatal circumcision. Therewillbefact makes a solid argument.Gsonnenf (talk) 21:33, 28 February 2012 (UTC)

Ah, I see you've changed the emphasis; previously you drew attention to the words "no" and "most". I agree that this source doesn't explicitly use the term "recommend", and therefore it shouldn't be used when describing that source (if it is ultimately used). Nevertheless, the need to avoid redundancy does require us to consider whether sources say similar things, even if the language used isn't identical. Protesting that this is "original research" is a creative application of that policy, but ultimately unconstructive, as understanding the meaning of sources and the relationships between them is a necessary part of the editorial process. One question that we might consider is: are there any plausible circumstances under which might such an organisation recommend routinely doing something if it were not medically justified? Jakew (talk) 09:29, 29 February 2012 (UTC)

Why? That seems like it is absolutely original research to me. Tftobin (talk) 16:54, 29 February 2012 (UTC)

I thought I'd just explained why. If we declare that deciding whether two sources say the same thing is "original research", and hence disallowed, then the result would be that we'd have to include every article on every topic, unless they used exactly the same words in the same order to describe their viewpoint. Articles would grow ad infinitum, be highly repetitive, tedious, and essentially useless for the reader. Similarly, if we disallow comparing the viewpoints expressed by sources then the question "have we discussed major viewpoints regarding this issue" is unanswerable, and it is thus impossible to implement NPOV. It therefore stands to reason that there is and must be a reasonable allowance for understanding what sources mean and how they compare. In contrast, original research more often refers to one's own opinions about the subject, or criticism or praise of a particular source. Jakew (talk) 17:26, 29 February 2012 (UTC)

"are there any plausible circumstances under which might such an organisation recommend routinely doing something if it were not medically justified?" is not a question I see in those sources. This is why I ask. This is what seems like original research to me. Tftobin (talk) 18:52, 29 February 2012 (UTC)

Correct, it's not in the sources. It's a question that I asked to help us to understand whether there is significant overlap between the two statements. Jakew (talk) 18:54, 29 February 2012 (UTC)

Please read my response above, dated 21:27 28 February 2012, where I clearly explained that PMID 21716785 made no mention with regard to what most medical associations recommend; conversely, please acknowledge that the quoted part of the KNMG source deals solely with professional recommendation. Again, this renders your argument that "there is no need to say that 'most' do not recommend routine circumcision" as rather moot, not to mention original research. As a reminder, please remember that we've widened the scope here beyond professional recommendation by medical associations regarding the procedure, permitting for us to mention what this source states most medical institutions believe. Also, please at least provide relevant Wikipedia policy to substantiate your argument the next time you assert that editors are permitted extrapolate the meaning of different sentences to mean the same thing. Therewillbefact (talk) 19:28, 29 February 2012 (UTC)

I read that response, Therewillbefact, and replied to it in my post dated 09:29, 29 February 2012. Jakew (talk) 19:31, 29 February 2012 (UTC)

Then I'm sure you understand why it is increasingly more difficult to give credence to your rebuttals here - given that you have neither provided relevant Wikipedia policy to substantiate your argument, nor a satisfactory explanation regarding how editors are permitted to interpret these two different sentences to mean the same thing. Therewillbefact (talk) 20:40, 29 February 2012 (UTC)

On the contrary, "it is increasingly more difficult to give credence to your rebuttals here", because they appear to be premised on the notion that sources can never be summarized or paraphrased, and that all relevant sources must always be included in all articles, even if they say essentially the same thing. Jayjg ^(talk) 23:39, 29 February 2012 (UTC)

I still have yet to see any relevant wiki policy that gives any weight to the notion that as editors, we are permitted to interpret one source that addresses recommendation by professional association of physicians and another regarding medical justification of medical institutions to mean "essentially the same thing". This is the second time I've had to say this, and neither you nor Jake have addressed it in your responses. Will I have to state it again? Therewillbefact (talk) 03:15, 1 March 2012 (UTC)

As explained above, it would be effectively impossible to edit Wikipedia if we, as editors, were not permitted to evaluate sources to determine and compare viewpoints expressed in them. Jakew (talk) 09:00, 1 March 2012 (UTC)

Permitted to compare viewpoints is one thing. Coming up with an original statement such as "are there any plausible circumstances under which might such an organisation recommend routinely doing something if it were not medically justified?" is not comparing viewpoints expressed in them. It seems like it is trying to synthesize a new viewpoint, from something not in the originals. Tftobin (talk) 14:26, 1 March 2012 (UTC)

Answering that question will help shed light on whether there is a significant difference between not recommending routine circumcision and saying that there is no medical justification for routine circumcision. It is interesting, I think, that there is such resistance to addressing it. Jakew (talk) 14:39, 1 March 2012 (UTC)

It's not to insult you Jake, but before I devote the time to address it, I'd just like to see the relevant wiki policy that gives any weight to the notion that as editors, we are permitted to interpret one source that addresses recommendation by professional association of physicians and another regarding medical justification of medical institutions to mean "essentially the same thing". This is the third time I've had to say this without being shown any relevant policy. I'm growing a little tired of repeating myself here. FactoidDroid (talk) 17:21, 1 March 2012 (UTC)

I'm sure you're not the only one growing tired of the repetition, Therewillbefact. Wikipedia policy rarely provides an exhaustive list of permitted behaviours; it usually provides general principles and editors are expected to interpret them in a sensible manner that is consistent with itself, with other policies, and with the fundamental task of building an encyclopaedia. Jakew (talk) 17:33, 1 March 2012 (UTC)

I'm actually quite surprised you could not find a single Wikipedia policy that addresses this issue, given that it would prompt articles to become "effectively impossible to edit" and "highly repetitive, tedious, and essentially useless for the reader". Surely, if these instances could surface as often as you state, there has to be some sort of policy by now that addresses it. It still seems to me that inferring between two different sentences (one regarding recommendation by professional association of physicians and another regarding medical justification of medical institutions) to mean "essentially the same thing" is, to put it lightly, a questionable editing practice. FactoidDroid (talk) 18:17, 1 March 2012 (UTC)

If such an interpretation would lead to articles becoming impossible to edit, then no policy is needed, just a more sensible interpretation. Jakew (talk) 18:33, 1 March 2012 (UTC)

Your conclusion seems like one deduced by mere surmise, Jake. FactoidDroid (talk) 18:49, 1 March 2012 (UTC)

I think you could drive a truck between the statements, "recommendation by professional association of physicians" and "medical justification of medical institutions". Some have made careers, industries, money, and crusades, out of the difference. Tftobin (talk) 19:09, 1 March 2012 (UTC)

Arbitrary section break

(unindenting) Returning to the subject, the proposed text seems to be growing as discussion continues. This isn't terribly surprising — it's rare, unfortunately, for material to become more concise during these discussions — but we do need to consider what to do given the fact that only a fairly small amount of space is available in the lead. The most logical approach, I think, is to include this lengthier summary at the beginning of the Circumcision#Positions of medical associations section, and write a shorter summary for the lead. The real question is whether a suitably neutral sentence can be written. I suspect that it would be difficult, though perhaps not impossible, to summarise the policies themselves. We might try providing an overview of summaries, perhaps selecting two in order to represent the different extremes. Jakew (talk) 19:23, 28 February 2012 (UTC)

I think a summary like so could do well. Here I'm summarize the results from the articles we have read, and give the conclusions we find in them.

Reviews from medical associations have included that no professional association of physicians recommend routine circumcision[1], but most support circumcision as an optional procedure."[7]

I think this sums up the position of medical associations very well and also accurately represents our source material, avoiding OR. Gsonnenf (talk) 22:42, 29 February 2012 (UTC)

I still don't understand why all of these "compromises" involve leaving out one specific summary out of three, and therefore violating WP:NPOV, and I've yet to see a response that specifically addresses that issue. Jayjg ^(talk) 23:40, 29 February 2012 (UTC)

If you've read Jake's comment above dated 19:23, 28 February 2012, you would know he stated that we will likely have to summarize fewer than all the sources available to us, given the small space available in the lead. Therewillbefact (talk) 03:15, 1 March 2012 (UTC)

There are only two summaries specific to this RFC. There are an infinite number of other additions we can make, giving one special status for this RFC does not make sense.Gsonnenf (talk) 07:47, 1 March 2012 (UTC)

Gsonnenf, can I ask you to read through the preceding compromise discussions, including those in the box labelled "old compromises"? Once you've done so you might wish to make another proposal. This, unfortunately, suffers from several of the same problems as those discussed above. Jakew (talk) 09:00, 1 March 2012 (UTC)

Thank you for acknowledging that, Therewillbefact. It does make a difference.

May I suggest that we consider what should be included in the body of the article first, then worry about the lead afterwards? It seems to make more sense to do things that way around. Here's a rough draft of what I have in mind:

• A number of authors have published summaries of the views of medical organisations. The Royal Dutch Medical Association, in their 2011 policy statement, state that no professional association of physicians recommend routine circumcision. Viens, in an analysis of the ethics of circumcision, notes that while most organisations do not recommend universal circumcision, most regard it as justifiable, and do not advocate for prohibition against the practice. Wang et al, reporting on a systematic review of print media reporting of circumcision for HIV prevention in an African context, reported that most medical associations supported circumcision for HIV prevention.

Jakew (talk) 12:11, 1 March 2012 (UTC)

A meta analysis of medical associations circumcision policies state that the risks outweigh the benefits which is why they do not recommend routine neonatal circumcision. To say it is justifiable seems to contradict the prevalent medical opinion in these summaries. If we were to expound and say it is justifiable in a religious or cultural sense I would feel we are adhering to NPOV standards and our sources. I also feel the addition of the HIV in the summary is still WP:UNDUE unless we plan on removing the previous HIV paragraph as a compromise. Garycompugeek (talk) 15:45, 1 March 2012 (UTC)

First, what meta-analysis are you referring to? Second, justifiable refers to the cited source, which states: "However, this is a different question of whether infant male circumcision is a justifiable procedure—that is, whether the provision of this procedure can be allowed. Most medical associations maintain that it is in fact justifiable—no medical body has advocated a policy that calls for the prohibition of circumcision." As you'll see, it doesn't say "justifiable in a religious or cultural sense". Jakew (talk) 15:51, 1 March 2012 (UTC)

no medical body has advocated a policy that calls for the prohibition of circumcision? I'd say the Swedish Paediatric Society (BLF) advocates for a ban. "In a statement submitted to the National Board of Health and Welfare (Socialstyrelsen), the society called the procedure an assault." "We consider it to be an assault on these boys," Staffan Janson, chairman of BLF's committee for ethical issues and childrens' rights, said to newspaper Göteborgs-Posten (GP)." "After discussing the matter for several years, BLF has now concluded that the procedure ought to be banned on the grounds that the children are unable to form a decision in the matter." http://www.thelocal.se/39200/20120219/ Tftobin (talk) 20:48, 1 March 2012 (UTC)

The question is, is this Viens' summary or Tftobin's? Jakew (talk) 20:50, 1 March 2012 (UTC)

Not really. If her assertion is factually incorrect, perhaps it shouldn't be used. I didn't make up the Swedish Paediatric Society's statement. Tftobin (talk) 21:19, 1 March 2012 (UTC)

Of course we only have the word of a newspaper, which are generally considered unreliable (see WP:MEDRS#Popular press). Regardless, Wikipedia is usually concerned with whether a reliable source supports a statement, not whether that statement is true (or, as policy puts it, "Verifiability, not truth, is one of the fundamental requirements for inclusion in Wikipedia.") This is for the best because Wikipedia editors frequently dispute the truth of many claims in articles. A number of editors have expressed doubts above about the KNMG's claim, for example. Jakew (talk) 21:33, 1 March 2012 (UTC)

How's your Swedish? http://medicin24.se/barnlakare-vill-stoppa-omskarelser/

I'm not nominating the Swedish Paediatric Society's statements for inclusion, so no need to lecture me about WP:MEDRS. What I am saying, is that I'm not certain including Viens is a good idea, even if it is considered a 'reliable source', because it is not necessarily true. Tftobin (talk) 23:02, 1 March 2012 (UTC)

I understand what you're saying, Tom. Please see my post immediately above, where I addressed that. Jakew (talk) 08:43, 2 March 2012 (UTC)

We now have two sources which contain the Swedish Paediatric Society's statements,

and one is medical. If what Viens is saying is not true, it doesn't belong in an encyclopedia. Tftobin (talk) 12:07, 2 March 2012 (UTC)

See above. Jakew (talk) 12:24, 2 March 2012 (UTC)

What I am hearing is, "Viens is staying, truthful or not". If her work was verified,

and then something changed, it's still hitting the presses. Tftobin (talk) 13:19, 2 March 2012 (UTC)

What you ought to be hearing is, "it doesn't matter whether you or I think a statement is true; what matters is whether it has been published in a reliable source." That is core policy, and while it may seem odd at first, you'll probably come to realise in time that it makes sense in a collaborative editing environment where articles are frequently edited by individuals with radically different opinions as to what constitutes the truth. This essay might help. Jakew (talk) 13:26, 2 March 2012 (UTC)

I don't find the essay odd. It seems a good faith attempt. There is, if you will, a shelf life for information. It can be verified

true today, and be out of date tomorrow. There seems to be no process for 'that which was true the day before, verified yesterday, and out of date today'. To be putting information into an encyclopedia which is out of date, just because it is verifiable, seems like a rationalization, and a bit of a failure. Tftobin (talk) 17:48, 2 March 2012 (UTC)

From what you've said, Tom, I think you've misunderstood the term "verifiable". It does not mean "can be confirmed to be correct". It means "has been published in a reliable source".

I do understand that you object to putting information which you regard as wrong into the encyclopaedia, but please understand that those of us who regard the KNMG claim as certainly misleading and probably wrong feel exactly the same way about including that. (There are other statements in the article, as well, with which I strongly disagree, and I'm sure the same is true for you.) Finally, note that nowhere do we suggest that these summaries are correct, just that they have been published. Jakew (talk) 18:00, 2 March 2012 (UTC)

Where is PMID 21716785? You stated on 09:05, 28 February 2012 that "there's no reason why PMID 21716785 shouldn't be included in the detailed discussion in the body of the article". FactoidDroid (talk) 18:27, 1 March 2012 (UTC)

I asked if you wanted to replace the KNMG's statement with that paper, and your response seemed to be negative. Hence I didn't include it. Jakew (talk) 18:33, 1 March 2012 (UTC)

Could both be included? There are many articles stating the benefits of circumcision, its role in HIV prevention, etc. It doesn't seem like PMID 21716785 and the KNMG's statement are so redundant, compared to those articles. Tftobin (talk) 21:38, 1 March 2012 (UTC)

As discussed at length above, both say such similar things that it would be needlessly repetitive to include them both. It's not just a stylistic issue: it would have NPOV implications for the same reason. I'm afraid I don't follow your argument about articles surrounding circumcision's benefits. If we included something like: "circumcision significantly reduces the risk of HIV.[ref] Circumcision substantially reduces the risk of HIV.[ref]" then I could see the similarity. Jakew (talk) 21:44, 1 March 2012 (UTC)

One source in question states no professional association of physicians recommend routine circumcision (KNMG), the other states that while most medical institutions acknowledge potential health benefits, they believe there is not enough medical justification to routinely perform the procedure on infants and children (PMID 21716785). Comparing these two statements as similar in narrative to summarizing a source that says "circumcision significantly reduces the risk of HIV" and another that states "circumcision substantially reduces the risk of HIV" seems like a pretty flimsy supposition, to put it nicely. FactoidDroid (talk) 00:54, 2 March 2012 (UTC)

I'm sorry you feel that way. Jakew (talk) 08:43, 2 March 2012 (UTC)

I'm not agreeing with Therewillbefact to be contrary, or to be one-sided, or as pack mentality. I honestly believe he has a point, and it is one of basic fairness.

Nobody needs an apology in this instance, or to give an apology. His concern should be addressed, with action, not sympathy. Tftobin (talk) 17:57, 2 March 2012 (UTC)

Given that you've both avoided answering my question, and have instead resorted to mere assertion that there is a difference, discussion about the similarity between the two statements seems to have ended. Jakew (talk) 18:03, 2 March 2012 (UTC)

I have just been through about 800 lines, and have found several questions. If you would succinctly state the question, or give me

a specific phrase that will turn up your question, I will be happy to try and answer it. Tftobin (talk) 21:59, 2 March 2012 (UTC)

I requested an explanation regarding why are are allowed infer from the narrative of these texts in particular, and have highlighted the differences between what they claim. I haven't actually been given a single policy-based reason yet, only surmises. FactoidDroid (talk) 03:35, 5 March 2012 (UTC)

As I explained to you above, Wikipedia policy rarely provides a list of specifically allowed actions, so requesting such things is ultimately pointless. Jakew (talk) 09:09, 5 March 2012 (UTC)

This discussion is starting to feel like WP:FILIBUSTERS. Lets settle on a conclusion consistent with the RFC.Gsonnenf (talk) 09:52, 5 March 2012 (UTC)

That's what we've been trying to do, Gsonnenf. Unfortunately, since there's no obvious consensus in the RfC (as of the present time), it requires some creative thinking and willingness to compromise. Jakew (talk) 10:14, 5 March 2012 (UTC)

I still find myself in the awkward position of being told I'm avoiding answering a question, and being told discussion seems to have ended. I have yet to hear what the question is, though I asked 3 days ago. Tftobin (talk) 11:52, 5 March 2012 (UTC)

[18] Jakew (talk) 12:20, 5 March 2012 (UTC)

I see this question as arbitrary and hypothetical. We really shouldn't be speculating in either direction. "are there any plausible circumstances under which might such an organisation recommend routinely doing something if it were not medically justified?"Gsonnenf (talk) 13:08, 5 March 2012 (UTC)

I also responded, "Absolutely not" to "One question that we might consider is: are there any plausible circumstances under which might such an organisation recommend routinely doing something if it were not medically justified?" It's outside the scope of what was being discussed. It is also unethical for a medical organization to suggest surgery which is not medically justified. Tftobin (talk) 15:14, 5 March 2012 (UTC)

You didn't respond previously, but thank you for doing so. So you'd agree, then, that if organisations say that routine circumcision is not medically justified, that implies that it is not recommended by those organisations? In which case, wouldn't you agree that it would be redundant and unnecessary to include both summaries. Jakew (talk) 16:01, 5 March 2012 (UTC)

Yes, I did reply previously that the sentence "are there any plausible circumstances under which might such an organisation recommend routinely doing something if it were not medically justified?" was not acceptable, because it was original research. No, I would not agree that it would be redundant and unnecessary to include both articles. The statements are not identical, as I stated in "It doesn't seem like PMID 21716785 and the KNMG's statement are so redundant" on 1 March. I'd also like to thank you for the clarification, for helping to move this along, and for your continued cool head, when sometimes you must feel like screaming. I respect how difficult it is. All our mutual patience and civility from everyone is much appreciated. I wish it could be replicated in international diplomacy Tftobin (talk) 16:38, 5 March 2012 (UTC)

Yes, Tom, I remember you claiming that the question was original research, but I think that's more a case of refusing to answer the question than a response per se. Anyway, you've now provided a response, for which I again thank you, but having done so you're mysteriously backing away from the logical consequences of that response, instead providing without explanation a contradictory conclusion. Jakew (talk) 16:46, 5 March 2012 (UTC)

Perhaps I was too hasty in my praise. I don't believe you, or anyone else for that matter, knows my motives, so I'll ask you not to speculate. As I said, I was in favor of using both articles, because they said different things. If I am missing a point, please don't be oblique, or ascribe motives to me, simply come out and ask me. I think it is improper to ask for a medical group or organization concerned with health, to recommend surgery routinely which is not medically justified. It's an invalid question. It's out of their league. It's like asking the Kidney Association if there is a heaven and a hell. Tftobin (talk) 18:20, 5 March 2012 (UTC)

I'm sorry for causing any offence, Tom, but I must admit that I'm struggling to see how. As you rightly say, I can't possibly have any clue about your motives, so I haven't and wouldn't discuss them. All I can do is comment on what you've said, and on the logical consequences of that. I agree that it would be truly astonishing if a medical organisation were to recommend routine surgery if it did not consider that surgery to be medically justified; I would only expect them to recommend doing it routinely if they judged that doing it routinely were justified. Consequently, "does this medical organisation consider this routine surgery to be medically justified" and "does this medical organisation recommend this routine surgery" seem to be such similar questions that asking both is redundant, repetitive, and poorly weighted. I can't see the justification for including both summaries. Jakew (talk) 19:24, 5 March 2012 (UTC)

You would and did discuss them. 16:46, 5 March 2012. And it is not only you. Others get ascribed the blackest of motives, routinely, though not typically by you, Jakew. It gets so ugly in here at times, I will never, ever ascribe motives to my life partner again. Apology accepted. Now back to some garden variety miscommunication. I am counting on you to help me out. You said, "I agree that it would be truly astonishing if a medical organisation were to recommend routine surgery if it did not consider that surgery to be medically justified; I would only expect them to recommend doing it routinely if they judged that doing it routinely were justified." You also said, "One question that we might consider is: are there any plausible circumstances under which might such an organisation recommend routinely doing something if it were not medically justified?" There is a total contradiction, at least in my mind, between the two statements, to the point where I get lost. This is why I need your help. That is aid request #1. Aid request #2 has something to do with PMID 21716785 and the KNMG's statement. I see them as different. From what little I am understanding of what you are saying, you seem to think they are redundant. Are you saying that there is a lead sentence from both which is similar, and you are trying to put the two together into one cohesive sentence? Or are you saying that the articles themselves are essentially saying the same thing? I find it confusing that the (PMID 21716785 and the KNMG's statement) discussion got lumped in with the "One question that we might consider is: are there any plausible circumstances under which might such an organisation recommend routinely doing something if it were not medically justified?" Thanks. Tftobin (talk) 19:46, 5 March 2012 (UTC)

Tftobin, there's nothing in Jakew's comment of 16:46, 5 March 2012 that discusses motives. Not one word. If you think there is, quote the words. Jayjg ^(talk) 20:04, 5 March 2012 (UTC)

"Yes, Tom, I remember you claiming that the question was original research, but I think that's more a case of refusing to answer the question than a response per se." Other than that, I really don't care to discuss it with you. Jakew and I are handling it well, and I don't feel that any additional help is needed. Tftobin (talk) 21:50, 5 March 2012 (UTC)

Not one word of that is about or relevant to motive; it's all about actions not motive. If you want the Talk: page to be less toxic, I recommend you start by making more accurate Talk: page statements. Jayjg ^(talk) 23:12, 5 March 2012 (UTC)

You have no idea what Jakew's motive was. You are not the judge of the intent of his words. He already apologized. I've already accepted his apology. I've already explained that I don't care to discuss it with you. Thanks for the attempted hostility, but I'm not playing that game with you. Tftobin (talk) 03:11, 6 March 2012 (UTC)

I haven't talked about Jakew's motive, any more than he's talked about yours. Inaccurate talk page comments make discussion difficult. Please make more accurate and relevant talk page comments. Jayjg ^(talk) 01:50, 11 March 2012 (UTC)

Please see WP:TPYES, specifically "Comment on content, not on the contributor: Keep the discussions focused upon the topic of the talk page, rather than on the personalities of the editors contributing to the talk page." Tftobin (talk) 05:23, 11 March 2012 (UTC)

Exactly. In the future, please abide by WP:TPYES. In addition, in the future, please don't accuse people of things they haven't done - see WP:CIVIL#Identifying incivility, "ill-considered accusations of impropriety". I also recommend you review the meaning of the word "motive". Jayjg ^(talk) 05:45, 11 March 2012 (UTC)

Re request #1, I've re-read those statements several times, and I'm afraid I still don't understand what contradiction you perceive. If you could explain, I'd be happy to help. Jakew (talk) 20:24, 5 March 2012 (UTC)

Again, I freely admit to being lost, which is why I am asking for help. I see your statement, "I agree that it would be truly astonishing if a medical organisation were to recommend routine surgery if it did not consider that surgery to be medically justified; I would only expect them to recommend doing it routinely if they judged that doing it routinely were justified." I translate it as, "I wouldn't expect a medical organization to recommend surgery on a non-medical basis. This seems reasonable to me. The other statement, "One question that we might consider is: are there any plausible circumstances under which might such an organisation recommend routinely doing something if it were not medically justified?", seems just the opposite to me. It seems like it is saying, "Is there any way that a medical organization can recommend, even though it is not medically justified". It seems like the second is saying, can we include something which has medical organizations recommending it for reason X, which is not medical in nature, but social. This reminds me of the Sufi parable of the blind men identifying the different parts of an elephant by feel, and coming to completely different conclusions. You and I will get to the bottom of this somehow, because there is so obviously a misunderstanding at the root of it. Once again, I appreciate your candor, and willingness, Jakew. Tftobin (talk) 22:10, 5 March 2012 (UTC)

I'm afraid you misunderstood, Tom. The question was purely hypothetical, intended to explore the relationship between a medical organisation recommending routinely doing something, and that same organisation stating that routinely doing something is medically justified. Jakew (talk) 09:21, 6 March 2012 (UTC)

I'm only wishing I misunderstood the question. Tftobin (talk) 13:28, 6 March 2012 (UTC)

Re request #2, PMID 21716785 states that (to paraphrase) "most associations state there is no medical justification for routine circumcision", and the KNMG state that (again, paraphrasing) "all associations do not recommend routine circumcision". In my view, these statements are sufficiently similar that we should include one or the other, but not both. I asked the "one question" which you quoted in order to demonstrate the remarkable and fundamental similarity between an association recommending routine X and declaring that routine X is medically justified. Jakew (talk) 20:24, 5 March 2012 (UTC)

I think this is a simple difference of opinion. Both pieces state similarly that "x number of associations do not recommend routine circumcision". or close enough. I think there is divergence after that point. In my opinion, the divergence is enough to include both. You seem like you may be of a different opinion. Is it merely the headline you are talking about, or the substance of the articles?

On a separate note, the one question you asked, had a hand grenade in it, for me, and I believe for others as well. If it opens the door to including something which has medical organizations recommending circumcision for reason X, which is not medical in nature, but social, I want no part of it. That, to me, is the blurring of (medicine and science), and (pop culture). Nothing good can come of that. Witness the blending of news and entertainment, leading to the hideous beast 'infotainment', which is neither news, nor entertaining. Tftobin (talk) 22:10, 5 March 2012 (UTC)

I shouldn't worry, Tom. I would think it exceedingly unlikely that any organisations recommend circumcision for non-medical reasons. It wouldn't make sense. And even if any did exist, it wouldn't belong in a summary of summaries unless an existing, published summary had referred to them. If/when any do recommend routine circumcision, I'm sure it will be for medical reasons. Jakew (talk) 09:21, 6 March 2012 (UTC)

I wish I shared your optimism. I can't. I just saw a powerpoint presentation which listed bathroom splatter as a valid reason, and a medical paper which recommended routine circumcision, because "circumcision provides strong protection against foreskin tearing" Peer-reviewed, meta-analysis, the whole bit. Tftobin (talk) 21:55, 6 March 2012 (UTC)

Newspaper story on another study

"Circumcision doesn't reduce HIV spread, study reveals" "Contrary to recent popular claims that male circumcision reduces HIV/Aids transmission by 60 per cent, a group of researchers has disputed the findings, saying the action will only increase the spread of HIV/Aids and can only reduce its transmission by 1.3 per cent at most. Researchers Gregory Boyle and George Hill in a study published by Australia's Thomson Reuters, base their argument on a recent male-to-female transmission of HIV study in Uganda, which showed that more women contracted the virus after unprotected intercource to infected circumcised male partners. They concluded that male circumcision is associated with a 61-per-cent increase in HIV transmission." http://www.nyasatimes.com/malawi/2012/03/08/circumcision-doesn%E2%80%99t-reduce-hiv-spread-study-reveals/ Robert B19 (talk) 17:36, 11 March 2012 (UTC)

Please read WP:MEDRS with respect to what is required as evidence. Cheers Doc James (talk · contribs · email) 17:53, 11 March 2012 (UTC)

To elaborate on Jmh649's statement, we need review articles, not newspaper stories. This has already been explained several times; please don't continually bring cherry-picked individual studies to the Talk: page. Jayjg ^(talk) 18:04, 11 March 2012 (UTC)

Ah interesting new and recent information. Thank you for your contribution. We will review this to see if the referred article qualifies for inclusion.Gsonnenf (talk) 18:55, 11 March 2012 (UTC)

Making the HIV sentence clearer

For readers who are briefly skimming the lead (as readers often do) they might not notice the fact that the strong evidence for HIV reduction only applies to high-risk areas. This is an important point we need to ensure we clearly distinguish for our readers. As the paragraph currently states: "Strong evidence indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66% in populations that are at high risk,[12] and studies have concluded it is cost effective in sub-Saharan Africa." An important detail is currently buried in the middle of a 34 word-salad of a sentence.

I suggest we make this sentence clearer. Perhaps we can edit it to something along the lines of: "Strong evidence suggests that for high-risk areas, circumcision reduces the risk of HIV infection in heterosexual men by 38-66%,[12] and studies have concluded it is cost effective in sub-Saharan Africa." Therewillbefact (talk) 20:45, 19 February 2012 (UTC)

Actually, I'm glad you've drawn my attention to this, because the "in populations that are at high risk" part appears to be original research. The cited source doesn't include that qualification. It says: "There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months." Jakew (talk) 21:03, 19 February 2012 (UTC)

I'm also glad that you've drawn attention to this as well, as now it allows for us to integrate the conflicting evidence that exists when we make the broad far-reaching claim that circumcision universally decreases HIV rates. I noticed that you've already gone ahead and changed the sentence without input from other editors (again) here. Citing this article alone places undue weight on a view held by the Cochrane HIV/AIDS Group in 2009. Why were you reluctant to integrate a view expressed by The Royal Dutch Medical Association (in this discussion: Talk:Circumcision#RfC:_how_should_the_lead_summarise_positions_of_medical_associations.3F), but eager to cite an opinion coming from the editorial base at the University of California, San Francisco? Additionally, you'll have to substantiate why you have chosen to ignore the conflicting evidence that shows there no clear evidence of HIV reduction among those circumcised in other areas, and the views expressed by medical associations across the globe that agree with this line of reasoning. Houston, we have a NPOV problem.

Consider this text, which states "the inclusion of circumcision in the health policy of developed countries will require further investigation". Or this text, which argues that using the sub-saharan trials "exaggerate the relevance of the African random-controlled trials findings to [Australia's HIV epidemic]". The text additionally states" "That the relationship between circumcision and transmission of HIV is at the very least unclear is illustrated by the fact that the US combines a high prevalence of STDs and HIV infections with a high percentage of routine circumcisions. The Dutch situation is precisely the reverse: a low prevalence of HIV/AIDS combined with a relatively low number of circumcisions. As such, behavioural factors appear to play a far more important role than whether or not one has a foreskin." This source also states that there is a "lack of unanimous consent on the real usefulness of protective circumcision, even if several studies have recently demonstrated the protecting role of male circumcision against HIV infection." There is zero content in the lead discussing this, although almost a quarter of it is dedicated to HIV.

Let's take a look at the first sentence of the lead in Circumcision and HIV for further context: "Over forty epidemiological studies have been conducted to investigate the relationship between male circumcision and HIV infection.[1] Reviews of these studies have reached differing conclusions about whether circumcision could be used as a prevention method against HIV.[2][3][4][5]" Sorry Jakew, but your edit does not seem like a sustainable one, with its current ambiguity. There is a lot to address in terms of reconciling this edit with the amount of conflicting evidence arguing the contrary. We will need to draw attention to the conflicting evidence that runs contrary to this edit if we are to keep it in its current form. Thank you again for drawing attention to this. Therewillbefact (talk) 00:00, 20 February 2012 (UTC)

You seem mostly to be raising points that have already been discussed, so rather than wasting further time on them I direct you to those discussions (one, in which you participated heavily, is here). The newer sources you seem to be misinterpreting; for example the sentence you quote from PMID 20844437 does not consider whether circumcision reduces the risk in developed countries but whether circumcision should be promoted there for that reason. There is scientific consensus that circumcision reduces the risk of female-to-male HIV transmission, but there is no consensus that it should be promoted everywhere. The reason for this is simple: a relative risk reduction of 60% or so translates to a much larger absolute risk reduction in countries with a high lifetime risk of HIV than those where it is low. Consequently the benefits may clearly outweigh the risks in one situation, but in another the relationship may be less clear. Jakew (talk) 10:01, 20 February 2012 (UTC)

The discourse we've had earlier applied to HIV reduction particularly in sub-saharan countries - not universal HIV reduction rates. Applying our previous discussion to this new issue will not hold very much water, as the rhetoric has dramatically changed in the lead. You also stopped responding to me in the link you provided, we did not even finish our discussion...

You additionally did not address my last paragraph citing Circumcision and HIV, please reread the first two sentences of this lead and let's reconcile it with the current narrative of Circumcision, which only mentions the "strong evidence" of circumcision as HIV reducing. I assure you I was not "raising points that have already been discussed" by mentioning this. Please refrain from pigeonholing my input like you have going forward, especially if you aren't even going to address it. Therewillbefact (talk) 16:09, 20 February 2012 (UTC)

I agree that the lead of circumcision and HIV needs to be updated. Jakew (talk) 16:18, 20 February 2012 (UTC)

Again, you are picking and choosing which comments of mine to address. I've drawn attention to the fact that you didn't bother to finish our discussion to the link you provided, and it conveniently fell by the wayside with your next comment. Beyond that, we need to acknowledge that the editorial base at the University of California, San Francisco interpreted evidence gathered from three trials in sub-saharan Africa and applied them universally. The problems with doing this should be intuitive. I am having trouble understanding how data gathered from sub-Saharan Africa (with their own sexual behavior and culture) can accurately be applied to the rest of the world. This is a perplexing extrapolation of data, and one we will need to address if we are to summarize this view.

We additionally draw no attention to the ethical concerns that remain with respect to implementing the circumcision campaigns in the paragraph. Please see this text for more. Therewillbefact (talk) 17:15, 20 February 2012 (UTC)

What do you mean when you state "...we need to acknowledge that the editorial base at the University of California, San Francisco interpreted evidence gathered from three trials in sub-saharan Africa and applied them universally. The problems with doing this should be intuitive. I am having trouble understanding..." etc. Are you expressing some sort of personal issue or concern, or is there some peer-reviewed paper I can read about this? Jayjg ^(talk) 22:47, 20 February 2012 (UTC)

Ethical concerns inhere in almost all medical issues, why should it be singled out here? The ethical concerns on circumcision seem to revolve around rights of children (hence, irrelevant for adult men seeking circumcision) and those that basically frown on anyone having free will to do with their body as they see fit (plenty of those around, too). Neither of which are unique to this topic, and it is anyway addressed since the controversy is already mentioned in the lead. Carlossuarez46 (talk) 18:50, 21 February 2012 (UTC)

I agree there are ethical issues with this as well that are not given proper weight in the lead. Though, it would be off topic for this thread. In the next week or two lets start a thread to discuss how we can give ethical considerations proper weight in the lead as the current lead violates WP:UNDUE.Gsonnenf (talk) 04:27, 24 February 2012 (UTC)

I feel strongly that we should return the "in high risk heterosexual males" as we specifically have review articles which state there is insufficient evidence for those at low risk or women or MSM. Internet is to poor right now for me to dig up the refs but I read through them all a while ago. --Doc James (talk · contribs · email) 15:21, 23 February 2012 (UTC)

The sentence says: "Strong evidence indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66%..." Isn't that sufficient to exclude women or MSM? As noted above, the cited source doesn't limit the scope to only high-risk heterosexual men. Also, there seems to be general consensus that it does reduce the risk of infection in heterosexual men; however, there's active debate over whether it should be promoted in developed countries due to the relatively low prevalence of HIV and hence smaller potential for benefit. As far as I can determine from the abstract, the paper cited in the article re developed countries is discussing the latter issue. I think we need to be careful not to mistake the latter for debate about the former. Jakew (talk) 15:47, 23 February 2012 (UTC)

Yes, as I noted earlier the phrase "heterosexual men" by definition excludes "women" and MSM, and there's no point in redundancy in the lede. Also, the sources don't restrict the risk-reduction to "high-risk" men; as you point out, the question here is not whether it reduces the risk for all heterosexual men, but rather whether it's worthwhile promoting circumcision for low-risk heterosexual men. Jayjg ^(talk) 20:06, 23 February 2012 (UTC)

This ref http://www.ncbi.nlm.nih.gov/pubmed/20844437 states "Male circumcision will likely play an important role in HIV/STI prevention programs in Africa; the inclusion of circumcision in the health policy of developed countries will require further investigation.". Thus we either need to state "high risk" or "in Africa". Does not matter to me. But what we have now is not really accurate as evidence does not support its use generally for the heterosexual population. We can add this ref to the text in question maybe... Doc James (talk · contribs · email) 11:27, 25 February 2012 (UTC)

As I indicated above, "the inclusion of circumcision in the health policy" is a statement about whether circumcision should be used/promoted, not whether it reduces the risk. The statement in the article is about whether it reduces the risk. Jakew (talk) 11:31, 25 February 2012 (UTC)

The assertion in the lead should reflect the article. Including "high risk" or "Africa" gives a more accurate summary of the source.Gsonnenf (talk) 08:47, 28 February 2012 (UTC)

Please quote the relevant passages of the source that support your claim that such terms are needed to accurately reflect it. Given that the term "high risk" doesn't appear in the abstract, and "Africa" appears only in the "Background" (and in references to the country, South Africa), I think you might find that challenging. Jakew (talk) 09:13, 28 February 2012 (UTC)

Another good source to look at is from the American Urological association. They do recognize the studies and present it as an option for health benefit, which we are not disputing but state, "...the results of studies in African nations may not necessarily be extrapolated to men in the United States at risk for HIV infection...". [19]Gsonnenf (talk) 02:47, 29 February 2012 (UTC)

Which, considering the fact that the main at-risk populations in the US are IV drug users and gay men, isn't surprising. Jakew (talk) 09:17, 29 February 2012 (UTC)

For the time being, I would at least like to the see the sentence prefixed by the organizational entity that stated the information. I propose: "According to the Cochrane Group, strong evidence indicates (...)" Therewillbefact (talk) 03:31, 1 March 2012 (UTC)

We usually avoid excessive attribution, because it can create the impression that a view is held by only a small minority. For example, we wouldn't say, "according to John Smith, hypertension can raise the risk of heart attacks or strokes". Nor would we say "According to Fred Bloggs, asthlete's foot is a fungal infection". These are established facts, and so we assert them. Jakew (talk) 09:08, 1 March 2012 (UTC)

Hypertension and athlete's foot are not very controversial. Circumcision, as we have all demonstrated beyond a shadow of a doubt in here, is *very* controversial. A lot of these views are held by certain camps, and not by others. Differences can be extreme...such as whether or not circumcision is effective in preventing HIV. While I think excessive attribution is tedious, I think attribution would make clearer the differing beliefs of the differing groups. I don't think anyone is going to mistake the WHO or KNMG for a small minority. Attribution in this instance would help people keep track, of the sometimes bewildering and even disorienting divergence of views. Tftobin (talk) 21:29, 1 March 2012 (UTC)

There is, however, no serious dispute in reliable sources that circumcision reduces the risk of female-to-male HIV transmission. Jakew (talk) 21:37, 1 March 2012 (UTC)

There is serious dispute to it. The figures have been questioned time and again,

but so far only in primary sources. That they are not admissible here because they are primary, does not equate to 'they are unreliable'.

http://jme.bmj.com/content/36/12/798.short?rss=1

http://www.ncbi.nlm.nih.gov/pubmed/20965388

http://onlinelibrary.wiley.com/doi/10.1111/j.1753-6405.2011.00761.x/full or

http://www.thewholenetwork.org/14/post/2011/10/new-study-australia-rejects-circumcision-as-a-preventative-for-hiv.html

http://www.circumcisionandhiv.com/files/mcnotavaccine.pdf

The point is, since there is controversy, it is worthwhile identifying who said what Tftobin (talk) 12:52, 2 March 2012 (UTC)

No, Tom, there isn't a serious dispute. A handful of papers (and you've included some duplicates) does not prove otherwise; one could gather a list of papers arguing that vaccinations are hazardous (like this), or that HIV doesn't cause AIDS, or that smoking doesn't cause cancer, but that wouldn't prove the existence of a serious dispute about any of these statements. It just demonstrates that a small fringe viewpoint exists. That's all. Jakew (talk) 12:59, 2 March 2012 (UTC)

I don't think that thirty-two doctors in one paper is a small fringe viewpoint. Certainly less of a fringe viewpoint than when a

group of non-medical professionals get together with a few doctors, and put out a paper which goes against the medical advice of

the medical organizations of every country, to pick a random but current example. I included the duplicates because you can read

them in one source, but not in the more highly respected source, as a courtesy. Some may have a vested interest in believing that

this isn't a serious dispute, but it is becoming more questioned every day. Why the resistance to identifying who said what?

It would help the reader sort through a terribly confusing medical minefield. Tftobin (talk) 18:07, 2 March 2012 (UTC)

As I've already explained, Tom, attribution can misrepresent the situation by presenting established fact on which there is scientific consensus as an opinion. See my post dated 09:08, 1 March 2012. Jakew (talk) 18:25, 2 March 2012 (UTC)

Is this by consensus, or a unilateral decision? How does citing a source misrepresent a situation? Do you have any reason to

believe that people would take established fact, and somehow view it as opinion, just because they know the source?

I see no evidence for that in everyday life, and wonder where that hypothesis is coming from. Tftobin (talk) 22:05, 2 March 2012 (UTC)

"Avoid presenting uncontested assertions as mere opinion. Uncontested and uncontroversial factual assertions made by reliable sources should normally be directly stated in Wikipedia's voice. Unless a topic specifically deals with a disagreement over otherwise uncontested information, there is no need for specific attribution for the assertion, although it is helpful to add a reference link to the source in support of verifiability. Further, the passage should not be worded in any way that makes it appear to be contested." WP:YESPOV Jakew (talk) 22:15, 2 March 2012 (UTC)

[unindenting] It seems like we may need to revive the discussion we had here, where we discussed the omission of the sentence that stated:

• "Whether it is of benefit for women is disputed[12][13] and whether it is of benefit in developed countries and among men who have sex with men is undetermined.[14][15][16]"

If you read jayjg's response to my inquiry dated 04:59, 27 January 2012, you will notice that he said this sentence became unnecessary because the high-risk qualifier in the HIV sentence made it unnecessary. To avoid poorly paraphrasing him, I will provide what he stated in his words:

• "It was a tautology/redundant; the lede already states it reduces the risk in heterosexual men in populations that are at high risk."

Now that we've eliminated the high-risk qualifier, it seems like we may need to reinstate the part of the ommitted sentence that stated "whether it is of benefit in developed countries is undetermined". FactoidDroid (talk) 17:32, 1 March 2012 (UTC)

As pointed out above, though, the source that was used was misrepresented. It didn't claim that circumcision wasn't of benefit in this respect; it questioned whether it should be promoted. Jakew (talk) 21:37, 1 March 2012 (UTC)

Given that we are now telling readers that it decreases HIV rates by up to 66% without drawing any attention to conflicting evidence (such as data garnered from low-risk populations), it seems like we may need to reinstate the part of the ommitted sentence that stated "whether it is of benefit in developed countries is undetermined". FactoidDroid (talk) 22:31, 1 March 2012 (UTC)

There is never a good reason to misrepresent a source. Jakew (talk) 08:50, 2 March 2012 (UTC)

Is anyone really asking you to misrepresent a source? Perhaps, if you feel that way, we need to cite another source, which does state

"whether it is of benefit in developed countries is undetermined". There doesn't seem to be a shortage of them. Tftobin (talk) 18:10, 2 March 2012 (UTC)

I am suggesting we draw attention to conflicting data garnered from low-risk populations regarding HIV infection, since the lead currently does not address this. I am not suggesting that we misrepresent a source. FactoidDroid (talk) 03:32, 4 March 2012 (UTC)

What reliable, secondary sources do you propose to cite? (Please, not fringe sources that have already been discussed at length.) Jakew (talk) 09:44, 4 March 2012 (UTC)

Okay so we go with in Africa per "Three randomized trials in Africa demonstrated that adult male circumcision decreases human immunodeficiency virus (HIV) acquisition in men by 51% to 60%, and the long-term follow-up of these study participants has shown that the protective efficacy of male circumcision increases with time from surgery" http://jama.ama-assn.org/content/306/13/1479.full.pdf and "Three large RCTs of men from the general population were conducted in South Africa (N = 3 274), Uganda (N = 4 996) and Kenya (N = 2 784) between 2002 and 2006." http://www.ncbi.nlm.nih.gov/pubmed/19370585. Thus I propose we change it to "Strong evidence indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66% in Africa" with these two refs as support. Otherwise we are over generalizing the conclusions of the authors in question and potentially misleading our readers. I can put together a RfC if anyone sees this change as controversial. Doc James (talk · contribs · email) 17:01, 4 March 2012 (UTC)

The sources you cite say that the evidence comes from studies performed in Africa, but you're proposing to cite them in support of a statement that circumcision is only protective in Africa. That isn't what they state; in fact both sources interpret this evidence to mean that circumcision is protective against female-to-male transmission (without a geographical qualifier). The first source you cite goes on to say: "These findings are consistent with a large number of observational studies in Africa and in the United States that found male circumcision reduces the risk of HIV infection in men.1 Thus, there is substantial evidence that removal of the foreskin reduces the risk of male heterosexual HIV acquisition." The second source concludes: "There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months." That is to say that the generalisation is theirs, not ours. I guess one could say "strong evidence from Africa indicates that...", however. Jakew (talk) 17:13, 4 March 2012 (UTC)

Great I would say that is a fair compromise and will make the change in question.Doc James (talk · contribs · email) 17:26, 4 March 2012 (UTC)

Might be better to attribute it to African studies as so: "Strong evidence from African studies indicate that...". Evidence "from Africa" sounds a bit silly.Gsonnenf (talk) 09:44, 5 March 2012 (UTC)

yes, "from Africa" is not right any more than "from South America" or "from Asia" would be right. Those are all continents. 118.96.148.92 (talk) 00:21, 7 March 2012 (UTC)

I'd advise wording such as "strong evidence from Uganda" to alert the reader to its importance. 118.96.148.92 (talk) 01:04, 7 March 2012 (UTC)

First, only one of the three trials was conducted in Uganda, and second, that's a statement about origin, not importance. To reply to 118..., it's perfectly valid to say that something comes from a continent. Jakew (talk) 09:33, 7 March 2012 (UTC)

POV Tag

JakeW has removed this tag despite the prior archived thread showing no consensus to remove it and clear evidence that authors apposed to the tag involved in NPOV allegations. There is obvious POV dispute going on here, as the page has been protected several times over POV edit warring. There are also active RFCs. This tag should not have been removed and needs to be re-added.Gsonnenf (talk) 03:52, 24 February 2012 (UTC)

Tags are not supposed to be Scarlet Letters. Rather, they are meant to alert editors to problems so they can be fixed. This article has plenty of attention now from lots of editors, though no actual apparent problems. Thus there is no policy-based reason to add a tag. Jayjg ^(talk) 05:15, 24 February 2012 (UTC)

Please see the following policy on when to remove the tag:

When to remove:

This template is not meant to be a permanent resident on any article. Remove this template whenever:

1. No discussion about neutrality issues was started on this article's talk page.

2. Discussion about neutrality issues is dormant.

3. There is consensus in the discussion that the problems have been resolved.

It would be fine and a benefit to this article to attract more editors. There is POV dispute that you are involved in. If you did not feel there were problems, you would not be reverting content and participating in RFC.Gsonnenf (talk) 05:58, 24 February 2012 (UTC)

The usage notes on the tag page are not "policy". The page itself says "Place this template on an article when you have identified a serious issue of balance and the lack of a WP:Neutral point of view, and you wish to attract editors with different viewpoints to the article." Since no serious issues of any sort have been identified – and in fact, very few issues of even the most trivial nature have been identified – and since this page has already had 19 different editors comment in the RFC above, which already served to bring the attention of editors to the article, it is clear that the article has the attention of enough editors, and that the tag was spuriously or mistakenly applied. Jayjg ^(talk) 07:22, 24 February 2012 (UTC)

(unindent) Let's take a moment to review the events surrounding the tag, shall we?

• According to the instructions at {{POV}}, "The editor placing this template in an article should promptly begin a discussion on the article's talk page. In the absence of any discussion, or if the discussion has become dormant, then this tag may be removed by any editor." The editor who placed the tag was Gsonnenf (talk · contribs), in this edit dated 07:19, January 20, 2012. Gsonnenf did not begin a discussion about it. After waiting a generous period of roughly a week, I removed the tag, in complete accordance with the material quoted by Gsonnenf above.
• Gsonnenf promptly reverted, and still failed to open a discussion. Eventually, in order to find out the justification for the tag, I opened a discussion. In that discussion, multiple editors asked Gsonnenf to "explain on the article's talk page why you are adding this tag, identifying specific issues that are actionable within Wikipedia's content policies" (again quoting from {{POV}}), but no such specific, actionable issues were ever enumerated.
• At 04:15, February 16, 2012‎, the discussion about the tag was archived due to inactivity. (As pointed out above, this wasn't even opened in accordance with {{POV}}, but it was the closest thing we ever had to the "discussion" referred to in the removal instructions).

Clearly, therefore, the tag could have been removed in accordance with either (1) (since Gsonnenf never created any discussion about it), or (2) (since the only discussion ever created was sufficiently dormant to have been automatically archived). Jakew (talk) 09:49, 24 February 2012 (UTC)

Gsonnenf made a point the whole talk page is dispute about content. people never respond to his points. they archive the page while its active. Robert B19 (talk) 19:06, 24 February 2012 (UTC)

That's completely irrelevant, though. As explained previously, it is normal for talk pages to contain disputes, and normal for editors to invoke Wikipedia policies in these discussions. But that doesn't mean that most pages in Wikipedia should be permanently tagged. Tags are supposed to be temporary, and they are there as a last resort to gather additional attention to resolve a specific issue (or list of issues). So a tag without an accompanying list of issues serves no purpose. Jakew (talk) 19:16, 24 February 2012 (UTC)

While the article still needs work I do not think this tag is needed. Doc James (talk · contribs · email) 11:33, 25 February 2012 (UTC)

I agree with Jakew that articles usually have discussion about content on the talk page. I find that such discussion very often revolves around NPOV issues. However, I agree that articles generally should not have tags most of the time. This is one of the most-often-viewed pages on Wikipedia, and has been very extensively discussed and edited. Editors may disagree about content, but that in itself isn't enough reason for having a tag. ☺Coppertwig (talk) 00:30, 26 February 2012 (UTC)

Apparently JakeW still doesn't understand that you DO NOT NEED TO START A DISCUSSION IF THERE ARE ACTIVE NPOV DISPUTES on the page. This is an article with very active POV discussions that are changing the page exceptionally often. When the content of the articles becomes stable, and the disputes are shot down by consensus, then the tag should be removed. There have been many people suspected of intentional bias, and the best way to solve this is to involve more neutral authors.Gsonnenf (talk) 06:44, 27 February 2012 (UTC)

Yes, you do need to start a discussion whether or not other discussions are active. Jakew (talk) 09:12, 27 February 2012 (UTC)

Gsonnenf, most editors in this thread (not just Jakew) have stated that the tag does not belong. Also, your comment included a statement or statements about editors, not article content (specifically "JakeW still doesn't understand"). Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor." Jayjg ^(talk) 13:15, 27 February 2012 (UTC)

Many editors supported this tag in the archive discussion from last week. As soon as it was archived, the tag was removed. I believe we know the arguments of both camps. Let's see how things play out and we'll goto the NPOV board to get advice on the tag.Gsonnenf (talk) 08:39, 28 February 2012 (UTC)

The discussion from last week ended with unanswered questions regarding exactly what the tag referred to. This discussion is more focused, and has produced a fairly clear result. Jayjg ^(talk) 18:30, 29 February 2012 (UTC)

Many of us don't agee that the discussion ended. Robert B19 (talk) 21:34, 29 February 2012 (UTC)

I answered the question to the satisfaction of several editors. You didn't like the answer so you kept asking the same question until I stopped responding to it.Gsonnenf (talk) 22:13, 29 February 2012 (UTC)

If you could link to a diff of your answer, I'm sure it would be appreciated. Jakew (talk) 22:15, 29 February 2012 (UTC)

There were 3 topics concerning WP:UNDUE or WP:NPOV. Here is the diffs. [20]. Editors were told to discuss the issue under the appropriate heading. The content of this article has been under full protection due to NPOV edit warring. Now, there are two WP:UNDUE discussions going on, one with an RFC. The other will likely go to RFC. Gsonnenf (talk) 23:04, 29 February 2012 (UTC)

As is quite obvious, the discussion ended, and days after it ended was automatically archived. The reason we know it ended was that no-one commented in the thread for days. As is also quote obvious, the thread ended with an unanswered request from me. Jayjg ^(talk) 23:33, 29 February 2012 (UTC)

I see. So when you say you "answered the question", what you mean is that you failed to answer the question, but instead answered a completely different question, one which hadn't actually been asked. Jakew (talk) 09:10, 1 March 2012 (UTC)

Your concerns had been addressed to a reasonable standard. Continually answering more questions after such serves no purpose but wp:filabuster through wp:wikilawyer and Wikipedia:Tenditious. Having the last question everyone thinks too tedious and irrelevant to answer is not consensus for your change.Gsonnenf (talk) 22:44, 1 March 2012 (UTC)

Failing to respond to questions at all is not "addressed to a reasonable standard"; in fact, it's not addressed at all. Please make more factual Talk: page statements. Also, this Talk page is now back up to 188k and still growing rapidly; if anything, the archiving rate is too slow. Jayjg ^(talk) 22:52, 1 March 2012 (UTC)

I agree, failing to respond to any questions is not a reasonable standard. We all agree on that. You forgot that you were in wp:undue dispute and asked me to find them for you. I found them for you, but you forgot again where the wp:undue disputes were and kept asking me to point them out. I can't help it if your forgetful. The page is 188k because we have people debating [WP:NPOV]] and WP:UNDUE,and possible wp:filibuster. The RFC is 2/3's of this. Though, if we could get the electrical engineering page up to that in 4 days, we wouldn't have posts from 2007.Gsonnenf (talk) 23:15, 1 March 2012 (UTC)

Your comment included a statement or statements about editors, not article content. Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor." I will be happy to read and respond to comments that refer only to article content. Jayjg ^(talk) 23:25, 1 March 2012 (UTC)

Edit request - new source/reference

New reference described as "the most comprehensive assessment of international evidence on the issue" should be added to the article. Published 2012 in JAMA.
Klausner, J., Morris, B. (2012), "Benefits of male circumcision". JAMA: The Journal of the American Medical Association, 455-456. Whiteghost.ink 00:28, 2 March 2012 (UTC) Abstract

Perhaps it may also be worth reconciling this source with the JAMA response to Morris and Klausner written by Aaron A. R. Tobian, MD, PhD; Ronald H. Gray, MD, MSc. FactoidDroid (talk) 05:00, 2 March 2012 (UTC)

I think this edit request is premature. We need a specific proposal (ie., what should the article say about the source?) and an opportunity to discuss it. Jakew (talk) 08:49, 2 March 2012 (UTC)

Not done for now: per Jakew. Anomie⚔ 21:37, 2 March 2012 (UTC)

The source was proposed as it is a review by 12 medical experts, under the leadership of a Professor of Medicine at a highly reputable university, published in a peer reviewed highly reputable medical journal, containing an up to date review of the issues already discussed in the article - "the most comprehensive assessment of international evidence". For these reasons, it seems appropriate, relevant and helpful to readers of the article if it were added as a source to the list under "Further Reading". While cultural practices and historical views are important in such an article, when it comes to medical opinion and scientific research, references go out of date. Research that is specifically about "comprehensively assessing previous evidence" would be the most suitable type for an encyclopaedia. Just to be clear, I was only suggesting updating the "Further Reading" list, not changing the article. Whiteghost.ink 22:38, 3 March 2012 (UTC)

Someone needs to write the specific line or lines that need to be inserted, and other parties to the discussion should have opportunity to agree or disagree with it. Only then should someone reactivate the {{editprotected}}. Anomie⚔ 16:27, 4 March 2012 (UTC)

Whiteghost, I think you have the wrong citation. The citation which you've provided (and the abstract to which you've linked) clearly lists a publication with two authors, not twelve. I'm guessing you probably meant to cite:

• Morris B, Wodak A, Mindel A, Schrieber L, Duggan K, Dilley A, Willcourt R, Lowy M, Cooper D, Lumbers E, Russell C, Leeder S. [www.scirp.org/journal/PaperInformation.aspx?paperID=17415 Infant male circumcision: An evidence-based policy statement]. Open Journal of Preventive Medicine 2012; 2: 79-92.

Am I correct? Jakew (talk) 16:41, 4 March 2012 (UTC)

What a surprise. Brian Morris and company take evidence from good quality studies that include meta-analyses and randomized controlled trials, and showed that MC provides strong protection against a plethora of diseases. What do they look at? Several websites associated with Brian Morris, such as http://www.circumcisionaustralia.org and http://www.circinfo.net/. Fifteen references in which he is listed as the author. Some resources in which he is not the author. The evidence is in. Is this one of the references we're going to decline to cite, because it is based on research by a wikipedia editor? Tftobin (talk) 00:46, 5 March 2012 (UTC)

Sorry, I don't understand - what does your comment have to do with article content? Jayjg ^(talk) 01:09, 5 March 2012 (UTC)

When a person reviews a body of work, and much or most of the content they are reviewing is their own, is this objective science? Is it newsworthy, or encyclopedia-worthy? Tftobin (talk) 11:43, 5 March 2012 (UTC)

I'm struggling to see how 17 of 199 references can constitute "much or most of the content they are reviewing", but in any case I can't think of any precedent on WP for rejecting a paper based on a handful of self-citations. I haven't yet seen an argument for why it should be included, but that does not seem to be a valid argument for why it shouldn't. Jakew (talk) 12:26, 5 March 2012 (UTC)

Wikipedia relies on medical journal publishers to assess the reliability of a paper through a standard peer-review process, rather than relying on Wikipedia editors to assess the reliability of a paper by second-guessing that process. Jayjg ^(talk) 13:42, 5 March 2012 (UTC)

Let's just agree to disagree. If I feel more strongly as I think about it, there are other venues. Tftobin (talk) 15:19, 5 March 2012 (UTC)

Typically, I am a bit hesitant to heavily weight a secondary source, wherein the author is mainly self citing his primary source. It is a valid source, but we'd have to look at the publisher and review process to see how much we should wp:weight the secondary source.Gsonnenf (talk) 09:05, 6 March 2012 (UTC)

Revision needed regarding health benefit for women

The words "Whether it is of benefit for women is disputed[68][69]" are deceptive and untrue. Quoting from one of the two references: "There is weak evidence that circumcision has a direct protective effect on HIV infection in women, although there is likely to be an indirect benefit, since HIV prevalence is likely to be lower in circumcised male partners." Lowering HIV prevalence in males means that women are less likely to contract HIV from males. There is, at the least, an indirect benefit, and the sentence does not reflect this reality.

As a note, the other source notes that "There is also no evidence that MC protects women with HIV-positive partners". This does not imply that there is not a benefit for women.

Unless references are found to support these statements, I suggest that the sentence be amended to read "By lowering prevalence of HIV in males, circumcision indirectly reduces the risk of contracting HIV by females" or something similar. Morrowulf (talk) 09:11, 9 March 2012 (UTC)

You're right: "of benefit" is too imprecise. Sources do disagree, however, regarding whether it reduces the risk of male-to-female transmission. Let's rephrase as: "Whether it protects against male-to-female transmission is disputed." Jakew (talk) 10:53, 9 March 2012 (UTC)

Sometimes it depends on the conditions. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2905212/ Tftobin (talk) 17:19, 9 March 2012 (UTC)

Indeed. Bear in mind, however, that we're interested in secondary sources. Jakew (talk) 17:29, 9 March 2012 (UTC)

Tftobin, that article is used as a source in the following secondary source. [21] Gsonnenf (talk) 17:33, 9 March 2012 (UTC)

Jakew, I don't think that it's disputed that circumcision indirectly benefits females. It is only unclear whether it directly benefits them; that is, whether it reduces the risk of transmission from an HIV-infected man. I think that both of these things need to be pointed out, if effects on women are noted. See this review article, beginning with the sentence "Male circumcision provides long-term indirect protection to women by reducing the risk of heterosexual men becoming infected with HIV." If you need a secondary source analyzing that original research, check out this Nature commentary. Morrowulf (talk) 18:21, 9 March 2012 (UTC)

Didn't Gsonnenf just point out that there are conditions under which male circumcision raises the HIV infection rate of females, and it's in a secondary source? Tftobin (talk) 18:43, 9 March 2012 (UTC)

No, Gsonnenf pointed out that this secondary source cites Wawer et al (as their ref 90). Here's what they say: "Although the benefit to women of their male partner not acquiring HIV is obvious, whether voluntary male circumcision has benefit for the woman if her partner is already positive is unclear. Findings from one randomised controlled trial suggested no immediate benefit of VMMC in reduction of transmission from infected men to their female partners,90 but an older observational study91 and a recent prospective study92 showed reductions of up to 46% in male-to-female transmission. These data have led to revised calculations of the potential population-level effect of VMMC, with estimates of infection reductions for men and women as high as 28% in Zimbabwe.93" Jakew (talk) 18:47, 9 March 2012 (UTC)

"The researchers detected viral load spikes in antiretroviral-naive men after circumcision. They suggest that the stress of surgery might heighten infectivity. Further subanalysis showed that resumption of intercourse prior to complete wound healing might also increase the likelihood of transmission." From the Nature commentary on the subject. It seems that circumcision may raise infectivity in the short term, as a result of patients' failure to adhere to physicians' instructions. However it seems pretty obvious that any type of wound to the penis would increase the risk of transmission until healing is complete, and heightened viral load due to surgical-induced stress is certainly not an issue unique to circumcision, so I don't think those points need to be noted in the article. Morrowulf (talk) 20:24, 9 March 2012 (UTC)

The trials to determine if "By lowering prevalence of HIV in males, circumcision indirectly reduces the risk of contracting HIV by females" are ongoing. While it may be intuitive to believe that lowering HIV in males will decrease HIV in females this has not been determined by proper study. Circumcised males for example may have more unprotected sex as they believe they cannot get HIV and thus those who have it (but do not realize it) will spread it more. I have no evidence for this hypothesis but there is not evidence for the other "indirect effect" at this point either. This we need to keep the conclusions tentative IMO until proper secondary sources come out with strong statements one way or the other.--Doc James (talk · contribs · email) 08:24, 11 March 2012 (UTC)

I'm not convinced that we need to say anything at all about indirect effects. It's true that most secondary sources I've seen that have discussed the issue have generally agreed that there is an indirect beneficial effect, but it doesn't seem to receive a lot of attention. Isn't it sufficient just to document the state of the literature re direct transmission, as I suggested in my post dated 10:53, 9 March 2012? Jakew (talk) 09:43, 11 March 2012 (UTC)

Wouldn't that be citing rumor and innuendo, and not secondary, verifiable sources? Tftobin (talk) 18:30, 12 March 2012 (UTC)

Not as far as I can tell, no. I didn't propose to change the sources, and merely proposed to clarify what is disputed. I'm a little puzzled by your question. Jakew (talk) 18:36, 12 March 2012 (UTC)

So, your comment was to clarify discussion on the talk page, and not in regards to changing the article. I understand now. Tftobin (talk) 20:03, 12 March 2012 (UTC)

No, Tom. I proposed to change "Whether it is of benefit for women is disputed" in the article to "Whether it protects against male-to-female transmission is disputed", citing the same sources. Jakew (talk) 20:05, 12 March 2012 (UTC)

Thanks for taking the time to explain, Jake. For what it is worth, I agree that the statement you propose is much more clear, and less ambiguous. Tftobin (talk) 20:56, 12 March 2012 (UTC)

Mm, it's certainly superior to the current one and is pretty agreeable; sounds good to me, though I still think it's worth considering that one of the two cited reviews finds it "likely" that the indirect benefit exists. Morrowulf (talk) 05:19, 13 March 2012 (UTC)

We seem to have consensus on that, so I've gone ahead and made the change. I'm not wholly opposed to mentioning indirect benefit, but I think it needs further discussion. Jakew (talk) 09:13, 13 March 2012 (UTC)

Suggested edits

"One of the supporting studies, Taddio 1997, found a correlation between circumcision and intensity of pain response during vaccination months later. While acknowledging that there may be other factors than circumcision to account for different levels of pain response, they stated that they did not find evidence of such. It therefore recommended to use pain relief for circumcision."

• Change "Taddio 1997" to "Taddio et al. (1997)" (add parentheses and add "et al." in italics) because there is more than one author and to match the format of other refs in the article.
• Change "It therefore recommended" to "They therefore recommended". (or possibly "The authors therefore recommended" or "The report concluded with a recommendation that ..."). To me, "It therefore recommended" sounds as if it's a typo meant to say "It is therefore recommended", which would violate NPOV (Wikipedia doesn't make recommendations). If there wasn't the intervening sentence using "they", the "it" could mean "the study", which would be not so bad though not ideal since, it seems to me, a thing (study) can't make recommendations.

"The effect of circumcision on sexual function is poorly determined with studies reporting mixed effects."

• Add a comma after "determined". ☺Coppertwig (talk) 14:48, 11 March 2012 (UTC)

I'd agree with the above, but there's no particular need to name the study in prose as it's unlikely to be useful to the casual reader and the reference is sufficient to identify the paper. So I propose to simplify the sentence instead: "One of the supporting studies found ..." Jakew (talk) 18:15, 11 March 2012 (UTC)

Implemented. Jakew (talk) 09:23, 13 March 2012 (UTC)

Circumcision and prostate cancer

In the news today: it appears that circumcision could decrease the risk of prostate cancer, and the paper. — Preceding unsigned comment added by Morrowulf (talk • contribs) 05:26, 13 March 2012 (UTC)

It's an interesting study, but this particular paper is a primary source, so we shouldn't cite it directly. We could, however, cite an older secondary source. For example, [www.scirp.org/journal/PaperInformation.aspx?paperID=17415 Morris et al.], cited in the above section, say: "In the case of prostate cancer the evidence is mixed, yet sufficient data exist for a protective role that MC should be explored more extensively (see review [137]). If verified, MC could greatly reduce disease burden and associated costs [140]." We might paraphrase this as: "there is some evidence, albeit mixed, that circumcision may protect against prostate cancer." Or there's section 8 in this article (disclosure: I'm a co-author of that paper), which is more detailed, but could be summarised with much the same words. Jakew (talk) 09:09, 13 March 2012 (UTC)

I totally disagree. All the news articles were full of conjecture. The older Morris source is no more deterministic. If causality is not established, the guesswork is just noise on the line. It is equally likely that the HPV vaccine would protect against prostate cancer, with no surgery being advisable. We simply do not know at this point. Nothing personal intended, Jake, and I appreciate the disclosure. Tftobin (talk) 14:56, 13 March 2012 (UTC)

Tom, causality can only be established by experimental studies (ie., randomised controlled trials). There are quite a few existing sections that rely on observational data: all penile cancer studies, most HPV, UTI, and balanitis studies, and several of the complications studies, for example. So the standard you are proposing — proven causality — doesn't seem consistent with the rest of the article. Nor is it consistent with the literature, given that multiple secondary sources have discussed this material in spite of its limitations. I'm not proposing to cite any news articles, so your objection to them appears irrelevant. What I am proposing is to cite a source that explicitly acknowledges that the evidence is mixed and that it needs further investigation, and I'm proposing to do so using cautious language: "some evidence, albeit mixed ... may protect". To object to this on grounds that the evidence is inconclusive is illogical. Jakew (talk) 16:28, 13 March 2012 (UTC)

That is exactly my point. Let me make it more clearly. Researcher A comes up with some conclusion, which no reasonable person would reach, by taking the most extreme interpretation of the data possible, or even by saying "we don't have any idea of causality, but X may prevent it", or "X is recommended to prevent it." Before you think "That is a stretch", this is exactly what has happened with the recent spate of articles on circumcision and prostate cancer. Despite the document's limitations, and never having anything conclusively proven with real, valid, randomised controlled trials (which control for only one factor), Researcher A gets it written up, and peer-reviewed by someone careless. It is now available for meta-analysis, and becomes the bedrock on which wikipedia is based, and on which medicine relies...despite having proven nothing at all. Your points serve to illustrate the problem more clearly. Risk factors for penile cancer, according to the American Cancer Society, are HPV infection, and smoking. Balanitis is easily cured with nappy cream with zinc oxide. How many researchers do you know, who recommend circumcision to prevent HPV infection or balanitis? I never objected to news articles, since I knew they would not be accepted. I objected to the older Morris article, with indeterminate wording. I am OK with an appropriately deep set of disclaimers as you suggest, especially with the second set of wording (far preferable to the first) depending on the mix. I simply want you to understand my deep reservations. Tftobin (talk) 19:04, 13 March 2012 (UTC)

So, to return to my suggestion ("there is some evidence, albeit mixed, that circumcision may protect against prostate cancer"), are you saying that you don't object to it? Jakew (talk) 19:31, 13 March 2012 (UTC)

I'm not sure that experimental evidence will even be possible, as prostate cancer doesn't appear until so late in life. Unless circumcision is performed on children before sexual activity, it seems probable that a protective effect would not be apparent, and unless these trials began decades ago, these retrospective studies are the best evidence that will be had for a great while, and demanding experimental evidence of a risk reduction before noting the possibility strikes me as unfair in this case. I also wouldn't be so confident that HPV alone is responsible, and the possibility strikes me that any of the numerous other strains of HPV not protected against by current HPV vaccines could also play a role. At the very least and for the moment, I think that it's worth noting that there may be a protective effect. Morrowulf (talk) 20:19, 13 March 2012 (UTC)

I would appreciate it if you could add on that "More research is needed", but, yes, I can live with it, Jake. As far as the experimental evidence, it's easy, though it will take time, as Morrowulf notes. Innoculate boys before puberty with the HPV vaccine, and see if they get prostate cancer. If not, circumcision has nothing to do with it. As you are unconvinced that HPV has anything to do with it, I am equally unconvinced that circumcision has anything to do with it. None of the researchers in the press articles are recommending that circumcision will prevent prostate cancer. They are more full of disclaimers than the statement we are crafting. As I said, I have no objection to Jake's appropriately cautious wording. It is not misleading. It is also not determininstic. It's a shot at what we do know...more later. Tftobin (talk) 20:43, 13 March 2012 (UTC)

I don't mind adding that part, but since WP itself can't call for research we'll need to transform the sentence into an attributed statement. How about: "Morris et al. reported that there is some evidence, albeit mixed, that circumcision may protect against prostate cancer; they called for more extensive research into the matter."

As an aside, and I hope you'll forgive a little personal opinion, my view before the publication of this latest study was that circumcision might be protective. The evidence is a bit stronger now, but it's still inconclusive. I don't think we'll ever see RCTs, simply because it's barely practical to run those over 50-70 years, so good-quality observational studies that control for potential confounders will have to suffice. I don't think we've enough of those good-quality studies at the present time. Jakew (talk) 11:29, 14 March 2012 (UTC)

Of course, circumcision might be protective. You might prevent cancer of the mouth, by removing the tongue, to keep it dry. It doesn't mean is is an optimal, or even viable, solution. We need to not leap to the latest conjecture, but to build upon established facts. I don't find the evidence strong. Neither does anyone else, in the news articles. Scientists and doctors need to test to see if administering HPV vaccine works, and prove what works, and doesn't, even if it takes a while. That way, no one loses body parts involuntarily, for what may later turn out to be spurious reasons. I hope you'll forgive a little skepticism. This is not personal. I want more evidence than theories from non-doctors, and guesses from doctors and scientists. Tftobin (talk) 21:18, 14 March 2012 (UTC)

(unindenting) Since we seem to have reached consensus re changes to the article, I've implemented my above suggestion. Jakew (talk) 17:17, 15 March 2012 (UTC)

No "More research is needed"? Multiple doctors in each of the newspaper articles said it was true. Tftobin (talk) 21:06, 15 March 2012 (UTC)

Did you not notice the words "they called for more extensive research into the matter"? Jakew (talk) 21:24, 15 March 2012 (UTC)

Medical associations

I've again reverted Gary's addition to the "Positions of medical associations" section. The problem with the addition is that it skews coverage too much in favour of the KNMG's position. KNMG's summary reflects their own viewpoint and biases; an equally valid summary, skewed in another direction, might say that "most medical associations agree with parental choice.

In the lead, one might argue that this is acceptable, since we get a concise summary supported by a secondary source. But in the section in question, the sentence was inserted immediately before the recommendations of the individual organisations; there's no obvious need for a summary, and it only serves to skew coverage. Jakew (talk) 16:10, 6 February 2012 (UTC)

I have reverted Jake once again becasue I do not see his arguement as valid. A concise summary of medcial positions should be before the recommendation of the individual organizations in the section "Position of medical associations". Our old summary used to be here and in the lead where it belongs, and this one is no different. If you have a source that counters this assertion feel free to provide it. Garycompugeek (talk) 16:56, 6 February 2012 (UTC)

I didn't say it was wrong, Gary, so asking me for a source countering the assertion is unreasonable. My point is not that it's wrong, but, rather, that there are several different ways in which one could summarise the various statements, and each of those ways reflects and reinforces a particular point of view. Given that there's no need for a summary here, due to the proximity of the quoted statements, it is best not to skew coverage in the direction of any specific point of view by favouring a particular summary. Jakew (talk) 17:03, 6 February 2012 (UTC)

Agree with Jakew, it seems odd to summarize this view right before it is made here, and that "summary" is probably not the best anyways given the various different positions by the different associations. Please get consensus instead of edit warring to add it back. Yobol (talk) 17:11, 6 February 2012 (UTC)

A summary in the beggining of the section is not only normal but what we have had for years in this section until recently. As I have said previously, if you have a better summary, or one that contest the current, I'm all ears. Yobol please read the definition of WP:EW before accusing someone of it. Garycompugeek (talk) 17:59, 6 February 2012 (UTC)

I don't see a need for a summary there, as the various positions are laid out plainly and they are all quite nuanced and different, making a complete but accurate summary somewhat difficult. For the record, I did not accuse anyone of anything. Yobol (talk) 18:02, 6 February 2012 (UTC)

For the record Yobol, you were replying to me since you already agreed with Jake and this statement "Please get consensus instead of edit warring to add it back." implies that I had, or were going to, edit war. Sounds like an accusation to me. There is nothing in KMMG's statement that contradicts any of the medical statments that follow it. As a reader, if I came to the page and was curious of medical consensus regarding routine infant circumcision and skipped the lead and clicked on the "Position of medical associations" I would find the summary quite informative. Garycompugeek (talk) 19:42, 6 February 2012 (UTC)

I was making a recommendation, as you had already reverted once. I did not accuse anyone of anything. Secondly, the statement by KNMG does not capture the nuances of the various positions of the different societies, and therefore would not be an appropriate lead in to the section. Yobol (talk) 20:22, 6 February 2012 (UTC)

It's a summary, it's not supposed to (and doesn't claim too) capture all of the nuances of the various medical societies but the gist of their stance. It is helpful to the reader, properly sourced, and at the top of the section it is referring to, therefore it is appropriate. Garycompugeek (talk) 21:03, 6 February 2012 (UTC)

I guess we'll have to agree to disagree on both points. Let's see what other editors think. Yobol (talk) 21:17, 6 February 2012 (UTC)

The KNMG's view on what other medical associations say is simplistic at best, and unduly weights the opinion of one relatively small medical association (the KNMG). Moreover, it gives the impression that the KNMG's view is a summary of the material to follow, which it is not. This is misleading. Jayjg ^(talk) 21:30, 6 February 2012 (UTC)

It is stating one simple fact, "no professional association of physicians currently recommends routine circumcision", and if it good enough for the lead it is certainly good enough for the beginning of the section it is describing. Why do we repeat the HIV information there? Is that WP:UNDUE also? Might that not skew perception and lead readers to believe the following associations are on board with their findings and recommendations? Aside from the WHO (which is not a professional association of physicians) none of the professional association of physicians that follows it recommends routine infant circumcision. Garycompugeek (talk) 16:42, 7 February 2012 (UTC)

Gary, nobody is saying that the statement isn't technically true (I've no way of knowing whether it is or not), but it's an extremely narrow perspective that doesn't take into account whether the organisations support or oppose parental discretion, whether they take a stand about the medical benefits of the procedure, what position they take about the information that should be given to parents, etc. It simply categorises associations according to whether they hold an extreme position (that all newborn boys should be circumcised). And because of looking only at that question, it's not a good summary. Consider, say, the American Urological Association, which recommends that circumcision should be presented as an option for health benefits. Jakew (talk) 17:01, 7 February 2012 (UTC)

Actually Jake your reasoning is exactly why it is a good summary. As I recently explained to Yobol, a good summary is "not supposed to (and doesn't claim too) capture all of the nuances of the various medical societies but the gist of their stance." and if the reader wants more detail they may read on and get it. Common sense tells us most readers come here to find out more about circumcision to weigh it as an option for their son and advice from medical associations probably weigh heavily on their decisions. The summary is quick and to the point, which is why it's in the lead and why it should lead the section it describes. They all say there are benefits but the risks do not outweigh them enough to recommend routine infant circumcision. Garycompugeek (talk) 19:51, 7 February 2012 (UTC)

I can see that, if one wishes to dissuade parents from electing circumcision, it's a good summary. For an NPOV encyclopaedia, however, it's a poor summary. Jakew (talk) 20:16, 7 February 2012 (UTC)

It's an accurate summary that reflects the current state of all professional associations of physicians. Readers/Parents may draw their own conclusions. First it was UNDUE now its NPOV eh? I suppose you feel all professional associations of physicians are biased because they do not recommend circumcision? Your conclusion is your own POV/OR Jake. It is the best summary we have and if its good enough for the lead it is certainly good enough for the section it is describing. Why do we repeat the HIV information there? Is that WP:UNDUE also? Might that not skew perception and lead readers to believe the following associations are on board with their findings and recommendations? Aside from the WHO (which is not a professional association of physicians) none of the professional association of physicians that follows it recommends routine infant circumcision. Garycompugeek (talk) 21:14, 7 February 2012 (UTC)

The WP:NPOV policy includes WP:UNDUE, Gary (in fact the latter is a section of the former). Jakew (talk) 21:18, 7 February 2012 (UTC)

I am aware of that Jake, just as I am aware that you are copping out and refusing to answer any of the questions I keep repeating. Garycompugeek (talk) 21:26, 7 February 2012 (UTC)

To repeat,

1. The KNMG's view is simplistic at best, and does not accurately reflect the actual positions espoused by medical associations in the rest of the section.
2. Its use unduly weights the opinion of one relatively small medical association, that of the KNMG.
3. Its use as the section "summary" gives the impression that the KNMG's view is a summary of the material to follow, which it is not.

None of these points has been adequately addressed. Jayjg ^(talk) 22:10, 7 February 2012 (UTC)

1. Summaries are supposed to be simplistic, its accurate and does not contradict any professional association of physicians.
2. They are over 53,000 strong and would not be impressed by your assessment of them and all other major medical associations in the Netherlands also signed and endorsed this document. Please bring sources to back up your statements or stop wasting our time with your on OR/POV.

1. Sure it is... What material do you claim it's contradicting? Garycompugeek (talk) 14:02, 8 February 2012 (UTC)

The quoted section of KNMG is not a 'view', it is a verifiable statement about the policies of medical organizations. It is not a medical opinion and it is consistent with all of our other sources making it broadly accepted. Leaving it in does not violate WP:UNDUE. Though, the summary of this section should indicate where medical associations recommend circumcision and their position when culture circumcision is performed. This information would compliment it appropriately.Gsonnenf (talk) 10:23, 8 February 2012 (UTC)

It's only verifiable in the sense that we can verify that the KNMG expressed this opinion, but that's true of any sourced statement. It's fundamentally a viewpoint, and we've no way to verify its veracity. What we do know is that it's a poor summary, and it clearly gives undue weight to the KNMG by giving extra emphasis to what they view as important about the other associations' policies. Jakew (talk) 10:38, 8 February 2012 (UTC)

It is verifiable because all other sources containing the positions of medical associations affirm it. The summary should discuss the positions of medical associations. As editors, we have the latitude to decide what is important to include. The medical associations position about routine circumcision, which has a historical context for being extremely common, is given proper weight.Gsonnenf (talk) 10:51, 8 February 2012 (UTC)

I'm afraid you're incorrect. To verify the statement that "no X includes the statement Y", it is first necessary to obtain every X, since the statement is wrong if only a single X includes the statement Y. In this particular case, that means that we'd have to identify the positions of every single professional association of physicians in the world. Most of those would of course be in languages other than English, which doesn't make that task any easier. So as a practical matter, it is essentially impossible to say with any certainty that no such association has made such a statement. All we can say is that the KNMG have asserted the view.

You're also wrong in your assertion that routine circumcision was historically common. In fact, routine circumcision (literally, circumcision of all newborn boys, see footnote 2 here) has never occurred in any country. (It's possible that it may happen in Papua New Guinea, per their recently announced policies, though it hasn't yet.) Elective circumcision is and has been common in many countries, but that's another matter. Jakew (talk) 11:08, 8 February 2012 (UTC)

Do you have some knowledge that we are not privy to? If you do, please share it. If there is some peer-reviewed secondary source which

proves that the KNMG did not correctly represent the viewpoint of every single professional association of physicians in the world, I would be interested. Otherwise, it is unsubstantiated guesswork, an unproven assertion. Tftobin (talk) 02:12, 24 February 2012 (UTC)

I didn't say that the KNMG were incorrect, Tom, so it's unreasonable to ask me to supply proof for such an assertion. Jakew (talk) 10:43, 24 February 2012 (UTC)

What you said was "it is essentially impossible to say with any certainty that no such association has made such a statement." This asserts that the KNMG's statement is essentially impossible to be true. What I am saying is that it is essentially impossible for someone who does not have intimate knowledge of the KNMG process to be certain whether or not their process is esentially impossible. As such, it's guesswork. Tftobin (talk) —Preceding undated comment added 16:28, 24 February 2012 (UTC).

Actually, that's an interesting source, providing another summary:

Most medical associations, such as the American Academy of Pediatrics,12 the British Medical Association,13 the Canadian Pediatrics Society,14 and the Royal Australasian College of Physicians,15 among others, maintain that although there are potential medical benefits associated with the procedure, on balance these benefits do not overwhelmingly support a policy of universal recommendation. [...] Most medical associations maintain that it is in fact justifiable—no medical body has advocated a policy that calls for the prohibition of circumcision.

Jakew (talk) 11:14, 8 February 2012 (UTC)

Because there are finite recognized professional medical associations (and fairly small) I am correct that it is verifiable (unlike something like medical benefit, which is too broad and subjective to verify). Because this can be disproved by contradiction, the burden on opposition evidence is extraordinarily low. Your argument that it shouldn't be included because you don't have time to verify it violates WP:OWNER.

Your article on the definition of "routine" isn't consistent with typical medical association definition who apply it to opt-out procedures (such as recommending routine HPV vaccination for boys). Please choose a definition from medical associations. Also, certain cultures have historically practiced routine circumcision, the medical view on routine circumcision is important. This summary should discuss medical association view of elective circumcision.

Your argument that "All we can say is that the KNMG have asserted the view." is not valid. We typically summarize something as true when it is supported and confirmed by secondary sources, and there is no evidence against it. If we didn't take this view point, we would have to do in text source of every claim in this article.

And for gods sake Jakew. This is a NPOV discussion right here that you began! Quit removing the NPOV tag! Gsonnenf (talk) 12:13, 8 February 2012 (UTC)

Firstly, I have not argued that "it shouldn't be included because [I] don't have time to verify it", and I do not appreciate having my views misrepresented. Please don't do that again. I have simply pointed out that your assertion that it is correct is unproven. The reasons why it should not be included have already been provided above.

Secondly, the definition of routine circumcision is as stated above. It is consistent with the AAP's use of language; for example compare their information for parents: "Scientific studies show some medical benefits of circumcision. How­ever, these benefits are not sufficient for the American Academy of Pediatrics (AAP) to recommend that all infant boys be circumcised." with their formal policy: "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision."

Finally, as has been explained to you previously, it is fairly typical for there to be at least one discussion in which the application of NPOV has been discussed. That is perfectly normal, and does not justify a tag. Please stop this disruptive tagging without adequate explanation. Jakew (talk) 13:03, 8 February 2012 (UTC)

Why do we repeat the HIV information there? Is that WP:UNDUE also? Might that not skew perception and lead readers to believe the following associations are on board with their findings and recommendations? Aside from the WHO (which is not a professional association of physicians) none of the professional association of physicians that follows it recommends routine infant circumcision. Garycompugeek (talk) 14:04, 8 February 2012 (UTC)

I have removed the HIV information from the beggining of this section on the basis of redundancy and the fact that they WHO does not represent the medical associations that follow it. Garycompugeek (talk) 14:11, 8 February 2012 (UTC)

I have to say, I'd have preferred to organise this material differently, including WHO under an "International" subsection and the CDC in the "US" subsection. However, they are unquestionably positions of medical associations, so removing them altogether seems difficult to justify. Jakew (talk) 14:15, 8 February 2012 (UTC)

That's a pretty bold statement considering you have no problem justifying the removal of the summary policy statement that is good enough for the lead but not the beginning of the section that it is describing. Garycompugeek (talk) 15:02, 8 February 2012 (UTC)

If I had removed the KNMG statement in its entirety, Gary, you might have a point. However, the KNMG are still listed in the "Positions of medical associations" section. The WHO and CDC are not.

As for the lead, I originally said that "one might argue that this [KNMG's summary] is acceptable". There are some serious problems with this summary, and having thought about it further I'm not sure whether the KNMG's statement is adequate. Jakew (talk) 15:20, 8 February 2012 (UTC)

Yes well that makes little sense considering they are two separate statements with separate sources. As far as KNMG's medical summary I'm sure you like it as much as the old AMA summary it replaced that took months of debate - ad nauseam - to include in the article as the best medical summary availible. If you have a better medical summary please present it. Garycompugeek (talk) 16:02, 8 February 2012 (UTC)

I don't understand what you mean by the first sentence of your response. Regarding the summary, I actually quoted a more balanced summary above, in this edit. Jakew (talk) 16:06, 8 February 2012 (UTC)

Yes I saw that earlier but you did not provide a ref for me to properly evaluate and its paints circumcision in the best light possible so I'm not sure how well balanced it is. If appropriate perhaps we can work the two together to alleviate NPOV concerns but of course it would have to gain consensus with our fellow editors. Garycompugeek (talk) 16:41, 8 February 2012 (UTC)

The ref was provided in the post immediately before, but to save you searching it's here. I'm not sure that I would agree with your claim that it paints circumcision in the best possible light; it's fairly easy to imagine a more positive summary (such as, "By and large, the statements of most of these professional bodies tend to recommend that medical practitioners fully inform parents of the benefits and minor, rare risks of having their male children circumcised."). But it seems self-evident that by addressing the questions of both routine and elective circumcision, it's more balanced than a summary that addresses only one of those dimensions. Jakew (talk) 16:50, 8 February 2012 (UTC)

The ref you supplied comes from an article written by A M Viens, Department of Philosophy, St Anne’s College, Oxford University, Oxford, UK with by her own admission sets out to prove "I shall argue that in order for policy concerning the prohibition of circumcision to be acceptable it would have to be demonstrated that such a policy could be justified to those individuals with reasonable yet conflicting doctrines and whom this policy would concern." Hardly NPOV and certainly not on the scale of the KNMG. How can we compare a philosopher with a distinguished medical body for our professional medical associations summary? Garycompugeek (talk) 17:34, 8 February 2012 (UTC)

(ec) Gary, very few sources adhere to NPOV; they all express POVs (including the KNMG). But I find it rather interesting that in your attempt to demonstrate non-neutrality you've quoted a part of Viens' paper that I hadn't proposed to include — suggesting that any non-NPOV quality is not a property of the summary itself. As for the fact that one source is a medical association, I fail to see why that matters. When acting as a secondary source (ie., summarising studies of circumcision) a medical association is a strong source because medical associations are presumed to be reliable about medical topics. But when acting as a tertiary source with respect to circumcision (ie., summarising policy statements) there's no such presumption: there's no particular reason why a medical association should be better equipped to summarise policy statements of other associations than a philosopher. Any university-educated individual should be more than capable of reading them, after all. Perhaps we ought to look at the more pressing question of which of the sentences in question best summarises the material? Jakew (talk) 18:39, 8 February 2012 (UTC)

Reiterating:

1. The KNMG's view is simplistic at best, and does not accurately reflect the actual positions espoused by medical associations in the rest of the section. Summaries are not supposed to be "simplistic", they are supposed to be brief and accurate.
2. Its use unduly weights the opinion of one relatively small medical association, that of the KNMG. 54,000 members is not a large number, and many medical associations have hundreds of thousands of members. For example, the British Medical Association has 141,000 members, the American Medical Association has 217,000 members, the Canadian Medical Association has 70,000 members, the Indian Medical Association has 1,780,000 members etc. In addition, there are hundreds (if not thousands) of medical associations throughout the world.
3. Its use as the section "summary" gives the impression that the KNMG's view is a summary of the material to follow, which it is not. The material that follows is an independent listing of medical association positions - there are no guarantees that the KNMG examined the identical list of associations, or the identical position statements from them.

None of these points has been adequately addressed. Jayjg ^(talk) 18:12, 8 February 2012 (UTC)

I have reverted Jake's attempt to rewrite our medical summary but I am open to compromise Jake. As I see it only goverments can prohibit circumcision. If you were to find a good source that states that we could modify the statement to something like,

"According to the Royal Dutch Medical Association (2010), no professional association of physicians currently recommends routine circumcision, however it has also been noted that no governments prohibits the practice. [15] Some bodies have discussed under what circumstances circumcision is ethical." Garycompugeek (talk) 14:24, 9 February 2012 (UTC)

I find Jakew's version much more in line with NPOV, as the current one weights the findings of one small medical society over others, and does not do as good a job summarizing the positions of the various societies, so I would support a change back to that version. Yobol (talk) 14:58, 9 February 2012 (UTC)

I agree with Yobol. Gary, medical associations can't prohibit circumcision, but neither can they mandate it. They could, however, recommend that it is prohibited or universal. Jakew (talk) 15:50, 9 February 2012 (UTC)

As do I. -- Avi (talk) 15:54, 9 February 2012 (UTC)

As do I. Per the issues raised above, use of the KNMG's view is highly problematic. Jayjg ^(talk) 18:59, 9 February 2012 (UTC)

I must say I am a bit perplexed at the reasoning going on here. KNMG is belittled because they are a small medical association compared to some others yet you wish to replace their medical summary with one from one person who is not even in the medical field. I have replaced the KNMG summary that Jake removed, it is still the best, most accurate, and current medical summary that we have. Garycompugeek (talk) 15:29, 10 February 2012 (UTC)

Actually, not being a medical association is arguably an advantage when it comes to summarising their views. Let me explain why that is by analogy. Would one wish to use one particular political party's manifesto to summarise the views of all political parties? Or would one prefer to use an independent publication? Jakew (talk) 16:11, 10 February 2012 (UTC)

Jakew, Is there a policy that supports your position against using medical associations? Chevara (talk) 17:06, 10 February 2012 (UTC)

I don't have a "position against using medical associations", Chevara. In many contexts they're excellent sources. Jakew (talk) 17:31, 10 February 2012 (UTC)

Sorry Jake but I simply cannot attribute the same weight of one scholar to that of an entire medical organization. Jayjg says this organization is too small to represent our medical summary then jumps right on board with your recommendation from a single non medical individual which you typically rage against saying "one person carries little weight or fridge view etc..". I have also placed KNMG summary back as the best on medical summary we currently have available. It goes against custom to remove material already in the article just because it is being discussed on the talk page. If we did that most of the lead would be gone while we debate HIV, medical summary and controversies. Garycompugeek (talk) 18:46, 10 February 2012 (UTC)

Gary, you still haven't addressed the points I've raised above. There are three of them; unless and until you explicitly do so, there is no justification at all for inserting the KNMG material. Jayjg ^(talk) 21:09, 10 February 2012 (UTC)

Jayjg's points have already been sufficiently address. JakeW's political analogy is incorrect because the researcher in question is likely a more specifically interested party than the actual society. KNME researched the position of medical societies and came to their conclusion from aggregation of the position of major medical societies. The findings of a medical society should not be replaced by a much smaller source, this violate WP:UNDUE.Gsonnenf (talk) 12:06, 11 February 2012 (UTC)

Mere contradiction is not a constructive form of debate, Gsonnenf. If you feel that Jayjg's point have been adequately addressed, then at least cite diffs as examples. You might also explain why "the researcher in question is likely a more specifically interested party"; merely asserting it isn't very convincing. In any case, both Viens and the KNMG based their statements on aggregation of the positions of these societies, and both comment on whether the societies recommend universal circumcision (they also essentially offer the same summary). Viens, however, also comments on whether they recommend prohibition of circumcision. This means that Viens can be used for a more informative summary without contradicting the KNMG's; yours is therefore a misapplication of WP:UNDUE. Jakew (talk) 12:50, 11 February 2012 (UTC)

I think it's probably time for an RfC to get outside input to settle this, as further discussion seems unlikely to be fruitful at this point. Yobol (talk) 20:28, 11 February 2012 (UTC)

RfC: how should the lead summarise positions of medical associations?

The following discussion is closed. Please do not modify it. Subsequent comments should be made in a new section. A summary of the conclusions reached follows.

I am closing this RfC based on a WP:AN request that somebody do so. I am not taking into account the support by Honorsteem and Robert B19 for option 1, becaused insofar as I can understand their opinion it is not based on a desire to make the article conform to a neutral point of view, but rather to their own point of view, as expressed by the statement "never cut in healthy meat". The remaining opinions are divided as follows:

• option 1: 5
• option 1 or both: 2
• option 2: 11
• Both: 1
• Neither: 1
• Other: 1

While option 2 enjoys majority support, that support falls short of a consensus. I therefore find that there is no consensus about how the lead should summarise the position of medical associations about this topic. Further discussion appears to be necessary.  Sandstein  16:03, 5 April 2012 (UTC)

---

There is a dispute regarding how best to summarise the position statements of medical associations in the lead (fuller discussion is at circumcision#Positions of medical associations). The two options considered so far include the following:

1. According to the Royal Dutch Medical Association (2010), no professional association of physicians currently recommends routine circumcision.
2. Most medical associations recommend neither universal circumcision nor a prohibition against the practice.

Jakew (talk) 20:55, 11 February 2012 (UTC)

• Support #2. #1 places too much emphasis on the opinion of one medical society, and WP:UNDUEly ignores that while routine circumcisions are not recommended, neither is circumcision routinely recommended against either. Of the two options, #2 is clearly a better summary of what is in the article and the positions of the various medical societies, which is the point of the WP:LEAD. Yobol (talk) 21:05, 11 February 2012 (UTC)

• Support #1 or use both. I think the KNMG source should be in the lede for several reasons; (a) Both medical organizations and general society can have polarizing views on this issue, with some countries implementing routine infant circumcisions from birth, and some trying to prohibit it. Considering KNMG represents one opinionated side of the spectrum, i think they're lede-worthy material. (b) KNMG is a reliable source and contemporary. (c) per wp:lead we should cover the most important points. If a major medical organization has taken a strong alternative stance as KNMG has, that makes it an important point, hence worthy of lede inclusion. (d) Yobols point above about "ignoring other arguments" is redundant because the third paragraph already makes that clear. (e) The second option is essentially stating the obvious, because its repeating something already covered in the third paragraph. I do not recommend this because it implies wikipedia readers are stupid.

In short, because the 3rd paragraph cites a source recommending circumcision, it would be a violation of WP:NPOV to not use a reference which has the opposite view (if one exists). Pass a Method talk 21:19, 11 February 2012 (UTC)

• Support #1. I want #1, because it is more realistic. I don't find #1 simplistic at all. It is clear, and unambiguous. It is also honest about the position of medical societies. Tftobin (talk) 00:02, 23 February 2012 (UTC)

• Support #1 or both. This is the only part of the lead that explicitly discusses dissenting professional opinion to circumcision. If we are to devote 23% of the lead to circumcision as HIV-preventative (without acknowledging dissenting opinion), and almost 10% of it to a comprehensive list of conditions circumcision is used for (again, without acknowledging dissenting opinion), is stands to reason that integrating this sentence is the least we can do for the lead's NPOV. There is a stark contrast in the rhetoric between this sentence and the one being proposed; changing this sentence to choice #2 significantly softens the sentence. What is wrong with letting our readers know that no single medical association on Earth recommends routine circumcision? It seems like there is a lot of merit to integrating this fact into the lead, especially after observing that 40% of the lead is dedicated to the benefits of circumcision. Therewillbefact (talk) 00:00, 12 February 2012 (UTC)

• Support #2. The KNMG's view is simplistic at best, and does not accurately reflect the actual positions espoused by medical associations in the rest of the section. Its use unduly weights the opinion of one relatively small medical association with 54,000 members (many medical associations have significantly more members e.g. the British Medical Association has 141,000 members, the American Medical Association has 217,000 members, the Canadian Medical Association has 70,000 members, the Indian Medical Association has 1,780,000 members etc). In addition, there are hundreds (if not thousands) of medical associations throughout the world. Also its use as the section "summary" gives the impression that the KNMG's view is a summary of the material to follow, which it is not. The material that follows is an independent listing of medical association positions - there are no guarantees that the KNMG examined the identical list of associations, or the identical position statements from them. Source 2 actually accurately summarizes the positions of medical associations. Jayjg ^(talk) 02:02, 12 February 2012 (UTC)

• Support #2. More accurate and gives less weight to one out of many associations. This is the section on medical associations, let each one speak for themselves instead of giving one particular one undue weight. -- Avi (talk) 03:13, 12 February 2012 (UTC)

• Support #2. Per WP:LEAD, the lead is an introduction and a summary of the most important topics: "The lead serves as an introduction to the article and a summary of its most important aspects." #2 is a general summary of the issue and satisfies this element of the Wiki policy. WP:LEAD also specifies that items should appear in the lead according to their importance to the topic: "The emphasis given to material in the lead should roughly reflect its importance to the topic, according to reliable, published sources..." The position by the Royal Dutch Medical Assn is covered in the summary provided by the #2 statement. The position of the RDMAssn is not a major aspect of the article that needs to be mentioned in the lead. It is just one of several positions but is given undue weight by its mention in the lead and is inconsistent with WP: UNDUE.Coaster92 (talk) 03:51, 12 February 2012 (UTC)

• Support #2. As can be seen from the body of the article, most cited associations take a middle-ground position, neither recommending universal circumcision nor prohibition, leaving the decision to parents. #1 is a poor summary in this respect, thus failing WP:LEAD, because it fails to make this clear. By considering only whether they take one extreme position (recommending routine, ie., universal circumcision), it implies that their positions are more negative than they are. #2 is a much more balanced and informative summary. I also have concerns about using one policy statement to summarise others, especially when that policy statement is notable for taking the most extreme anti-circumcision position to date. It would be questionable at best to use a political party's manifesto to summarise the views of other political parties, since it would be likely that they would present those views in the light most favourable to their own. The situation here is comparable: their statement is the most favourable to their view. That doesn't mean that it's best suited to NPOV coverage; quite the opposite, in fact. Jakew (talk) 10:15, 12 February 2012 (UTC)

Regarding Avi's last edit to the lead here, I don't understand how we can already say we've reached a consensus and that the debate is over. If input by Jayjg, Jakew, Avi, and Yobol constitutes as a consensus every time input is solicited in this talk page, I'm genuinely worried for the circumcision entry. Jakew, Avi, and Jayjg all share an extensive history of editing in favor of highlighting the benefits of circumcision while softening the narrative of dissenting opinion towards the procedure. Yobol has also exhibited a similar editing preference with these users, although to a lesser extent with respect to editing volume. Please also note that edit wars are looked down upon on Wikipedia, please see Wikipedia:Edit_warring for more.

For the record, I didn't say we had reached a consensus. However, the change to the lede of the association paragraph is to add the KNMG position, and there is no consensus as of now to have that added (to wit, see this RfC). The stable version of the article did not have that sentence, and should be the one kept until consensus to override can be demonstrated. -- Avi (talk) 14:18, 12 February 2012 (UTC)

A very key component of the lead was omitted - mention that there is not one single health organization anywhere that recommends routine circumcision. What exactly is wrong with integrating this fact, when 40% of the lead is dedicated to the benefits of circumcision? The viewpoint is also not one specific to the RDMA, as you have all made it out to be. Try this 2011 text, which explicitly states "no medical association in the world recommends [circumcision]". Perhaps we could also try this text, which states "there is no medical justification for routine circumcision" and that "it should be performed only for established medical reasons and should not be universally recommended", to give credence to the fact that there is real opposition to routine circumcision. I am having trouble reconciling why there is so much resistance among these editors when it comes to integrating the fact that no medical association recommends routine circumcision in the lead.

Additionally, we are not giving readers an accurate picture of reality with this current revision, which states "most medical associations recommend neither universal circumcision nor a prohibition against the practice". As it is now, this recent edit would actually leave one with the impression that there actually may actually be a medical association somewhere in the world that actually does recommend circumcision - I think it goes without saying that we would know by now if one existed. We are not putting reality into perspective for readers of the lead. Aside from that, this edit further lessens the already-dismal amount of coverage in the lead regarding controversy.

Again, I am not opposed to sentence #2 accommodating #1, or vise-versa... This would help us convey a more accurate description of reality for our readers. I even propose that we condense the two to: While there is currently no association of physicians that recommend routine circumcision[15], most medical associations recommend neither universal circumcision nor a prohibition against the practice.[16][17]. Therewillbefact (talk) 10:55, 12 February 2012 (UTC)

We do in fact state that most organisations don't recommend routine circumcision: "Most medical associations recommend neither universal circumcision [...]". But, as noted, we also acknowledge that they don't recommend prohibition either, so we provide additional information to the reader. As for the statement that no organisation recommends universal circumcision, we don't know that that's true. It would be a serious error to extrapolate from associations in English-speaking developed countries to the entire world. Many African countries have instituted large-scale circumcision programmes, and Papua New Guinea have recently announced a mandatory circumcision policy for all males. It doesn't seem much of a stretch to suppose that this is with the support of their medical associations, and lending support to that is a trilingual systematic review, "With few exceptions, donors, academia, professional medical associations and HIV advocacy groups supported male circumcision for the prevention of HIV infection."[22] Whether those associations go as far as to recommend universal circumcision is unknown, but it doesn't seem impossible. Please note that I'm not saying that the KNMG are wrong, but it seems entirely plausible that one of the thousands of medical organisations out there does recommend universal circumcision. Jakew (talk) 11:14, 12 February 2012 (UTC):

Regarding this sentence, "With few exceptions, donors, academia, professional medical associations and HIV advocacy groups supported male circumcision for the prevention of HIV infection.", someone checked with each of these groups, and the vast majority of them came back supporting circumcision for HIV prevention? Wouldn't this logically have the same problem brought up in critiques in the KNMG statement? There's no evidence of the contact, or documenting who approved, or disapproved. Tftobin (talk) 15:17, 26 February 2012 (UTC)

I do not have "an extensive history of editing in favor of highlighting the benefits of circumcision while softening the narrative of dissenting opinion towards the procedure" - do not make this false claim again. In fact, don't comment about me at all on this talk page; restrict your comments to discussions of article content. Jayjg ^(talk) 17:19, 12 February 2012 (UTC)

Pot, meet kettle. Jayjy, you have drawn attention to my own contribution history in the past as an editor - it would be helpful if you were consistent with your own recommendations.

Jakew, to argue that there might be a professional association of physicians somewhere out there is not a good enough reason not to include it in the lead. You've cited mandatory circumcision programs primarily in high-risk areas, the topic in question is universal circumcision. Please keep this in mind. Additionally, the statement is found in sources other than the RDMA, as I've already mentioned. This edit to sentence #2 also cut discussion of controversy in the lead in half. Therewillbefact (talk) 20:16, 12 February 2012 (UTC)

Regarding your first point, I agree: the fact that the KNMG might be wrong is not itself a reason to exclude it (there are, of course, other reasons to exclude it, such as those outlined above). I'm afraid I don't understand your second point: surely mandatory circumcision programmes imply universal circumcision in the context of the relevant geographical area? Finally, the edit is unrelated to controversy, which is discussed in the following paragraph. Jakew (talk) 20:27, 12 February 2012 (UTC)

I haven't misrepresented your editing history. You have misrepresented mine. Don't do it again. In fact, don't comment about me at all on this talk page; restrict your comments to discussions of article content. Jayjg ^(talk) 21:19, 12 February 2012 (UTC)

Jayjg, it seems unusually dualistic that you ask someone to restrict their comments to discussions of article content, when you posted excerpts of my replies from outside wikipedia to someone who happens to be a wikipedia editor in Talk:Circumcision. Does that seem as ironic to you, as it does to me? Irony is the kindest word I can think of Tftobin (talk) 02:57, 17 February 2012 (UTC)

• Support both in the lead as they both provide interesting details. Doc James (talk · contribs · email) 17:00, 12 February 2012 (UTC)
• Support 1, or Both(if #2 rephrased) The KNMG view seems non-controversial, as I've seen no opposing statement. It appears to accurately reflect the current practice as a review of major medical associations reveals. For these reasons I believe it is the establishment view and remove it would be wp:undue. A following statement should be made that circumcision is usually allowed for cultural, personal reasons, etc. #2 or something could meet this criteria.Gsonnenf (talk) 04:25, 13 February 2012 (UTC)
• Support #1 KNMG's medical summary is accurate and up to date (2010). It illustrates the world prevalent medical opinion regarding circumcision. Medical associations do not have the power to prohibit only governments can do that. Medical associations either recommend or do not recommend, end of story. I completely disagree with replacing KNMG with one persons veiwpoint or even using it as a reliable source in this context. Garycompugeek (talk) 19:23, 13 February 2012 (UTC)
  • When you say "either recommend or do not recommend", do you mean recommend universal circumcision, or recommend prohibition? Jakew (talk) 19:55, 13 February 2012 (UTC)
• Support 1 Is there any argument as to why the KNMG wouldn't be WP:RS for the statement that no medical association currently recommends the practice? If no, then I don't see why this would need in-text attribution and we could simply say that currently no medical association recommends routine circumcision. Cheers, --Dailycare (talk) 20:46, 13 February 2012 (UTC)

• Support 2. The source supporting the second statement is from a peer-reviewed publication (and more closely meets WP:MEDRS). It summarises the position in a more NPOV fashion than the KNMG statement. JFW | T@lk 20:15, 16 February 2012 (UTC)
• Support NEITHER. The lede is too big by far as it stands. Circumcise the lede. Its (current at the time of my writing this) closing para is adequate coverage for the point in question. Balanced discussion about who supports what and why (both sides) could quite reasonably be covered in the appropriate section(s) of the body of the article. Quite a lot of other current lede content should be similarly exported to the body and pared down in or removed from the lede. Within reason and in appropriate context and form there is nothing wrong with balanced representations of rival contentions in the body, but not as a rule in the lede, which should do no more than note the existence of contention, leaving details for later. JonRichfield (talk) 20:35, 16 February 2012 (UTC)
  • Article ledes for lengthy articles like this are almost always four paragraphs. Jayjg ^(talk) 02:26, 17 February 2012 (UTC)

Jayjg's remark is correct as an observation, but that is no recommendation. The only rational criterion for the structure of a lede is its helpfulness to a user who wants to know what the article is about, hardly more deeply than at dictionary level, plus what sort of subject matter to expect in the body of the article.

If it is necessary in the case of a non-contentious matter, such as the benefit of ascorbate for preventing scurvy, the lede might mention that without discussion, but in a contentious or contingent matter, such as circumcision, if one mentions it at all, one should limit the mention to the fact of the contention without going into the merits and demerits of the various divergent parties and their views. Such matters belong in the body. A lede that contains four paragraphs of material or discussion that must go up front for good reason, should be restructured into one or two lucid, compact sentences, and the residue should go into an introductory section with its own proper introductory heading. And if material is repeated elsewhere in the article in its own section, it should be no more than mentioned in the introductory section either. That is not what ledes or indeed introductions are for, either in WP, or in general good article design. More than half the long articles should have their ledes and introductions redesigned as things stand, IMO, and I speak as someone who is just a little obsessional about putting as much info as possible into an article.JonRichfield (talk) 07:33, 17 February 2012 (UTC)

• Support #1 Doctors recommending that doctors should never "cut in healthy meat". Seems uncontroversial to me. #2 is badly phrased. -- Honorsteem (talk) 10:04, 19 February 2012 (UTC)
• Support #1. Version 2 is ambiguous and badly worded (is it circumcision or routine circumcision which is not prohibited?). --BozMo talk 19:28, 19 February 2012 (UTC)
  • I'm afraid your question doesn't make much sense. Since routine circumcision (which literally means circumcision of all males) cannot realistically occur without a legal mandate anyway, it's not meaningful to prohibit it. I'm guessing you may mean "elective" circumcision, and I guess there's some room for clarification. Jakew (talk) 20:55, 21 February 2012 (UTC)

• Support #1 Honorsteem nailed it with "never cut in healthy meat." Robert B19 (talk) 01:59, 22 February 2012 (UTC)

• Support #2. better wording and more consistent with our NPOV and RS policies, as outlined above by many editors.--brewcrewer (yada, yada) 22:32, 22 February 2012 (UTC)
• Support #2...I have been looking into this myself and the overall consensus is that medical associations neither approve nor disapprove of the practice, stating it is a matter of parental preference mostly...however, it appears that the benefits of having the procedure are slightly better than to not have it...though that is not part of the wording of either option above. Therefore, the use of one medical association as the sole opinion on this matter (and one based in Europe, where this procedure is far less commonly done than in some other regions), seems to be less than authoritative.--MONGO 01:26, 25 February 2012 (UTC)
• Use all sources. I just saw this dispute under a helpme template, and I can't say who's right - fortunately, I shouldn't have to. Every one of the reputable academic sources in this revert war should definitely be in the article. Once you give up the power to throw out sources that don't say what you want, the prospects for dispute are much reduced! On what's left, I'm inclined to prefer a statement "The Royal Dutch society said" over a statement that "Most medical associations..." because I'm skeptical anyone has the time or inclination to seriously ask what every single medical association great and small thinks about anything. Wnt (talk) 11:23, 25 February 2012 (UTC)
• Support #2, there is nothing that demonstrates that the Royal Dutch Medical Association's view is more valuable than any other one; gives a more balanced no one really has any opinion either way, it seems as is reflected in the second formulation over the first. Carlossuarez46 (talk) 21:46, 25 February 2012 (UTC)
• Support #2. The second option above represents a summation of the views held by medical associations on circumcision. Bus stop (talk) 13:26, 13 March 2012 (UTC)
• I'm a bit of a recent arrival to the page (and to being an editor, really) and perhaps this comment should be moved to the RfC—I'm not entirely sure, and if it should, could someone please move it to a proper location for me (and perhaps edit out this disclaimer)? If someone is to move it, I believe I fall into the "Support 2" category or a "Support the inclusion of no statement on physicians' organization" category.

  That said, I'm not sure why including both phrases is necessary. They seem almost redundant and confusing. Saying that no organization recommends routine circumcision seems to contrast with the statement that the WHO (while not really an organization of physicians, but if the dividing line isn't immediately bright and clear in my mind, I cannot expect it would be in the mind of an average reader) recommends inclusion of circumcision in public health policy to combat high rates of HIV. If that's not a recommendation for routine circumcision, at least in some populations, I'm not sure what is. If a sentence referring to the views of professional organizations much be included in the header, a statement that no organization recommends universal circumcision seems much more useful, both in terms of clarity for the reader and brevity. Morrowulf (talk) 15:23, 16 March 2012 (UTC)

  • I've moved your comment as you requested & have made minor adjustments to its formatting, but I don't think it would be appropriate for me to edit your words. Jakew (talk) 16:04, 16 March 2012 (UTC)
  • I agree with Morrowulf. The first few times I read it, it seemed contradictory. It is simply that the wording is not clear. No medical organization of any country recommends routine infant circumcision. Some organizations (not necessarily medical) recommend it, for adults only, as a method (effectiveness debatable) of combating HPV. Tftobin (talk) 17:45, 16 March 2012 (UTC)
  • Yes, there is a certain amount of redundancy, basically because (as Viens explains) "routine circumcision" means "universal circumcision", so including both does effectively say the same thing twice. That's not an ideal state of affairs. It would be better to just include the more inclusive statement (#2), but at present it doesn't look as though we're likely to get consensus for that. The path of least resistance is likely to include multiple statements, and the choice between repetition and a serious NPOV violation, I think we'll have to choose repetition. Jakew (talk) 18:58, 16 March 2012 (UTC)

we're going in circles. there was overwhelming support for the Dutch Medical statement. Robert B19 (talk) 23:40, 27 February 2012 (UTC)

There is clearly no consensus to change our medical summary.

Votes tallies

Support One = 9

Support Two = 10

Support Both = 5

Would an uninvolved admin please close this RFC and add back the first statement that Jakew improperly removed which started this whole mess in the first place. KNMG's medical summary has been uncontested for 10 months and never had consensus to remove or replace. It replaced a similair statement by the AMA "The American Medical Association stated in 1999: "Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision, and support the provision of accurate and unbiased information to parents to inform their choice."[12] that had stood for years but was updated with a more current source. Garycompugeek (talk) 14:39, 7 March 2012 (UTC)

[comment removed, I missed one that was not bolded. Fixed.]Gsonnenf (talk) 05:42, 12 March 2012 (UTC)

First, they aren't votes, and second, your tally is incorrect. Jakew (talk) 19:42, 11 March 2012 (UTC)

The KNMG's statement was added without apparent consensus, and it is quite clear that there is no consensus for its inclusion now (indeed, it is interesting to note that among outside editors with no previous involvement with the article there are 4:1 5:1 in favour of #2). If you wish to resolve this issue I suggest that you try to help find a compromise. Jakew (talk) 15:03, 7 March 2012 (UTC) (edited 18:51, 13 March 2012 (UTC))

Exactly what are you saying about 'outside' editors with no previous involvement? Exactly what constitutes an 'outside editor'? Are the opinions of those who have had previous involvement more valued, or carry more weight? Are you agreeing with a previous assertion by an editor that groups are sending people here to sway opinion? I don't much care for the polarizing, divisive language. Tftobin (talk) 15:31, 7 March 2012 (UTC)

The main purpose of an RfC is to get input from "outside" editors; that is, those with no previous involvement in a dispute (or preferably with a page). It helps to remember that it isn't a vote; it's an attempt to find a satisfactory solution, and input from those without established positions can sometimes help achieve that. Sometimes, it may be that editors' own biases (and we all have them) cloud our judgement, making obvious solutions more difficult to see than they ought to be for those of us who are interested in the subject. Editors who are already involved can and should state their views, but if those are the only responses then the RfC is an exercise in futility.

That isn't to say that we are exclusively interested in the opinions of outside editors. We aren't. We're trying to find a consensus here. But the RfC does suggest that, if all the regular editors were to temporarily relocate to Antarctica, or if we were otherwise unable to edit, then the wider community would prefer option #2. That could change, of course: there are still a few days to go, and we may yet need to extend the time if we're unable to reach a consensus. Jakew (talk) 16:36, 7 March 2012 (UTC)

"if we were otherwise unable to edit, then the wider community would prefer option #2". One group has 9 votes for #1. One group has 9 votes for #2. One group has 5 votes for both. There is no support for the statement that the wider community would prefer option #2, unless I am really missing something. Tftobin (talk) 17:26, 7 March 2012 (UTC)

When I say "wider community", I mean editors other than those who've edited the article or talk page previously. So you need to exclude those who have done so (use this tool if you're unfamiliar with the history). The outside editors are, I believe, Honorsteem, Coaster92, JonRichfield, Wnt, MONGO, Brewcrewer, Jfdwolff, and Bus stop. (I just want to repeat, however, that I'm not saying that these are the only important responses.) By the way, they aren't votes; there's a tradition on WP of calling them "!votes", presumably from the 'not' operator in the C programming language. Jakew (talk) 18:24, 7 March 2012 (UTC) (edited 18:51, 13 March 2012 (UTC))

Jakew you state "The KNMG's statement was added without apparent consensus, and it is quite clear that there is no consensus for its inclusion now." Is completely false and the article history does not support your claim. It's unbelievable that you could even make that assertion considering YOU were the one who removed the the KNMG statement without consensus that started the edit warring, page protection and current RFC which clearly shows no consensus for your change. Garycompugeek (talk) 17:04, 7 March 2012 (UTC)

You're mixing up two different sets of events, Gary. As I noted in Talk:Circumcision/Archive 70#medical summary in lead, the KNMG's statement was added by LizardWizard in July 2011, without any real consensus at the time. Several months later, a separate event took place. In that event, I initially made a WP:BOLD edit here, replacing the sentence. You then objected and reverted, and a brief discussion took place. At 18:52, February 10, 2012, Yobol reverted you, citing the rough consensus that existed at that time on the talk page (4:1 at the time) in favour of the new version. Jakew (talk) 17:23, 7 March 2012 (UTC)

I'm mixing nothing up Jake however you are certainly in denial. Trying to stipulate that Lizardwizards addition had no consensus is also completely false (it stood for 10 months) and gained consensus as a current medical summery replacing the AMA's medical summary. Just because Yobol, Jayjg, and Avi supported your change doesn't mean a rough consensus has been achieved. I instantly reverted you and many others also protested which led to much edit warring, page protection and the current RFC. Article history does not lie and your continued objections amount to little more than WP:IDIDNTHEARTHAT. Garycompugeek (talk) 18:35, 7 March 2012 (UTC)

The Medical Journal of Australia 17 January 2011 publishes a statement from the Royal Australasian College of Physicians, reading in part "The RACP acknowledges the strong and differing opinions on this topic, ranging from the strong pro-circumcision views of Cooper et al to the equally strong diametrically opposed views of the Royal Dutch Medical Association,which believes that (for reasons of ethics and medical risks) legal prohibition of infant circumcision is warranted." 'nuff said. https://docs.google.com/viewer?a=v&q=cache:ZWAX-BxHVnkJ:www.mja.com.au/public/issues/194_02_170111/matters_170111_fm.pdf+Medical+Journal+of+Australia,+Vol.+194+%282%29,+17+January+2011,+97-101.&hl=en&gl=us&pid=bl&srcid=ADGEESgXAqxpSrB1vXlnqePMgx7_l-ydD5C5DOkSqdUYQvDQugeTaKqz9SsHAbDEcSI5o8UuyAokkrfJZwAvNfMETQrwsMiqPpbDWGuW1aSX4ADOF0WBUY5N80TQlAeY7iazaRixor9L&sig=AHIEtbTz_UQ46XN06QXLn4tVPXvtKRFP9g Robert B19 (talk) 20:15, 7 March 2012 (UTC)

10 months of history, is consensus, several weeks of on and off edit warring is not consensus. Lets change it back to the original unless we can find a compromise. ( I'm still suggesting Reviews from medical associations have included that no professional association of physicians recommend routine circumcision[x], but most support circumcision as an optional procedure."[x]).Gsonnenf (talk) 17:29, 9 March 2012 (UTC)

Sometimes edits slip through the cracks and remain for some time. The most recent consensus we had, before edit warring broke out, was in favour of #2. However, I think that the present version of the article — which includes neither sentence — is probably more consistent with the RfC so far. Compromise would definitely be preferable. Jakew (talk) 18:22, 9 March 2012 (UTC)

Is Robert B19's suggestion viable? It seems to embrace both opposite poles in one sentence. Tftobin (talk) 20:37, 9 March 2012 (UTC)

It's not a summary of the views of medical associations; rather, it's a summary of viewpoints, with one association and one group of individuals cited as examples. Jakew (talk) 21:01, 9 March 2012 (UTC)

It does seem like an appropriate source to summarize in the controversy section of the lead, though; it explicitly acknowledges the polarized "strong and differing opinions" regarding circumcision. FactoidDroid (talk) 20:10, 10 March 2012 (UTC)

There's still clearly no consensus for any of the formulations proposed, including what has been rather misleadingly referred to recently as "the original". To achieve consensus, any suggestion will have to include the views of all reliable secondary sources on the views of medical organizations. Any "compromise" that suggests some other resolution makes little sense, and is, in fact, not a "compromise" of any sort. Jayjg ^(talk) 01:25, 11 March 2012 (UTC)

Including all views would be wp:undue and is not needed for consensus. For compromise to be achieved, most authors have to agree on a specific addition. This is valid compromise. The LizardWizard addition was the content before this dispute began. To suggest a lead addition was overlooked for 10 months in a heavily edited article is silly and inaccurate.Gsonnenf (talk) 16:31, 11 March 2012 (UTC)

More realistically, there was an active dispute long before LizardWizard even made his addition. See here, for example, for a discussion that took place about a month before. Prior to that, the use of the AMA summary was disputed since at least 2007, and perhaps earlier. It seems more realistic to describe the ten month period as a temporary break in a long dispute, one that we're going to have to solve somehow. Jakew (talk) 17:25, 11 March 2012 (UTC)

Yes. In addition, I'm aware of only three sources that summarize the positions of medical associations on this topic, and it can be done in a sentence (as has already been proposed above), so WP:UNDUE is not an issue for a proper summary. Moreover, one cannot invoke UNDUE to support including a deliberately misleading lede summary. And finally, when 9 people say include the KNMG statement, 9 say include a different statement, and 5 say include both, that's not a consensus for simply including the KNMG statement. All this wikilaywering and sophistry attempting to turn that non-consensus into a consensus is disrespectful to the editors here who have voiced their views. Jayjg ^(talk) 18:14, 11 March 2012 (UTC)

Please see WP:AGF. Using words like 'sophistry' implies dishonesty, at least in the Bing dictionary. Wikilawyering isn't a great deal more pleasant. Perhaps I am being naive, but I am seeing a lot of good faith honest effort, from a lot of people of all persuasions, in the face of some very trying circumstances. Tftobin (talk) 18:08, 12 March 2012 (UTC)

I am describing the arguments being used, and quite accurately, not any individuals. The definition of "sophistry" in both the Random House and Collins dictionaries do not imply dishonesty. Before insisting others must follow WP:AGF, one should follow it oneself. Jayjg ^(talk) 01:18, 14 March 2012 (UTC)

Is Wikilawyering implying good faith? spohistry: 1. a subtle, tricky, superficially plausible, but generally fallacious method of reasoning.

2. a false argument; sophism, (according to the source you posted). Calling an method of reasoning tricky and fallacious does not imply dishonesty?

I will not be replying to any more of your postings, because I don't wish to be argumentative. Tftobin (talk) 15:42, 14 March 2012 (UTC)

There are only two primary statements that were presented in the main RfC. Trying to include these "3rd" statements is what is causing the problem in the compromise. Save those for a different RFC.Gsonnenf (talk) 19:28, 11 March 2012 (UTC)

Out of interest, how do you manage to interpret "The two options considered so far include the following" as "The only options to be considered are"? Jakew (talk) 19:33, 11 March 2012 (UTC)

Those were the options asked for comments by the RfC. You can clearly see no one has put down "Support #3 or 4 or 5". If you want to include additional content, take the proper route. Don't try to WP:FILIBUSTERS it into into a nearly finished RfC. Also the issue of medical organization recommendation of circumcision for HIV in the lead is already under discussion in the WP:UNDUE weight given to HIV section in lead thread. Trying to get it included here as a 'compromise' shouldn't be done.Gsonnenf (talk) 19:40, 11 March 2012 (UTC)

The question posed in the RfC was: "how should the lead summarise positions of medical associations?", and "options considered so far" clearly acknowledges the possible existence of other options not known at the time the RfC was filed. And, sure enough, another summary was discovered during the course of the RfC. It is entirely proper to consider it, and your attempts to find technicalities by which to exclude it while simultaneously accusing others of filibustering are, to put it mildly, entertaining. Jakew (talk) 19:48, 11 March 2012 (UTC)

Look Jake I am open to compromise on the medical summary but the RFC has run its course and you cannot be more deadlocked to get a no consensus. It needs to be closed by an uninvolved editor. As a sign of good faith, since you were the one who removed it, why don't you replace the KNMG statement and we will continue to talk about a compromise consisting of a combination of more sources? Garycompugeek (talk) 13:04, 13 March 2012 (UTC)

Please stop making proposals which have clearly not gotten any support at the RFC, but happen to coincide with your own !vote; such suggestions do not appear to be made in good faith. Jayjg ^(talk) 01:19, 14 March 2012 (UTC)

Jayjg there was never any consensus to remove or replace our medical summary and the RFC clearly demonstrates no consensus in which case the summary we have been using for the last 10 months should be put back. Your attempts to stop dialog on the talk page and your bad faith accusations are disruptive to the project. Garycompugeek (talk) 16:29, 14 March 2012 (UTC)

I have neither attempted to "stop dialog on the talk page" nor made any "bad faith accusations". It is, in fact, your demonstrably inaccurate statements here that are, if anything, "disruptive to the project". Please desist. Jayjg ^(talk) 02:55, 18 March 2012 (UTC)

The discussion above is closed. Please do not modify it. Subsequent comments should be made on the appropriate discussion page. No further edits should be made to this discussion.