Pure Parents

Question:

- Hide quoted text — Show quoted text – > … (my post snipped) >You are a pretty smooth talker yourself. > Thank you, I guess. >You can analyze this to death >and still fail to see the forest for the trees. And don’t apologize for >cutting and pasting. It is very efficient since the same things are said >here over and over and over and over again. >Morris’ site it is not a fraud. That you should see it as such says more >about you that it does about it. > That you see Morris’ site as "an interesting essay on the subject" and > not a fraud says as much about you as it does about it. >Morris simply comes to a conclusion >different from yours and that of course is something you cannot accept. >In the final analysis and in summary from your sources above: >"American College of Pediatrics: The College believes INFORMED >DISCUSSION (emphasis mine) with parents regarding the possible health >benefits of routine male circumcision and the risks associated with the >operation are essential." end reference > Yes, I believe that is the exact quote.  Morris took that and twisted > it into "The American College of Pediatrics has moved far closer to an > advocacy position."  He neglected to mention that the ACP spoke of > "possible" benefits, but did not use a modifier before "risks."

nit-picking >And again from above. >"The overall evidence of the benefits and harms of circumcision is

major deletion >And I have suggested nothing more than that. THAT IS THE POINT. Parents >should be in a position to make a well-informed decision. > I belive so to.  And when medical societies recommend that > circumcision not be performed, and Morris conveniently (for his > postion) leaves it out of his essay, I feel the need to jump in and > object.

I am not aware of any medical society that recommends that circumcision not be performed. In summary then: From above: CMAJ: Option: Whether to recommend the ROUTINE (empasis mine) circumcision of newborn male infants. From above: Recommendation: Circumcision of newborns should not be routinely ROUTINELY (empasis mine) performed. From above: Canadian Paediatric Society: "When parents are making a decision about circumcision, they should be advised of the present state of medical knowledge about its BENEFITS and HARMS (emphasis mine)." From above: "American College of Pediatrics: The College believes INFORMED DISCUSSION (emphasis mine) with parents regarding the possible health benefits of routine male circumcision and the risks associated with the operation are essential." >One of the purposes of the Canadian study was COST-EFFECTIVENESS: >circumcision".

major deletion >Nowhere are potential benefits denied or is the practice actively >discouraged. > Correct.  Too many payments on Mercedes would be missed.

That comments speaks volumes. >Yes. "Investigate for yourself."  Don’t let a smooth talker like Neal major deletion > John was circumcised at his own volition as an adult, but somehow > believes that all newborn boys sould be circumcised.  He states that > he has never recommended newborn circumcision.  He just publishes > posts like this one.

That is correct. I was circumcised as an adult. From my personal experience, from occasional discussions with family and friends over the years and from what I have been able to read here and elsewhere, I believe that on balance the decision comes down in favor of neonatal circumcision.  I have never recomended it for others. I believe that parents have the right to make an informed decision. On what basis should I remain mute and silent: simply because I disagree with your extreme views?   This current thread started out because I stated "For an interesting essay on the subject see http://www.physiol.su.oz.au/brianm/circumcision.htm" and I continue to feel comfortable making that suggestion. I think that it helps level the playing field. And earlier and valued contributor, who personally opposes neonatal circumcision, made this observation "My sample may not be characteristic, but again and again when I carefully examine claims made by apparently well-informed anti-circ activists, I find that the claims are gross distortions of what the literature actually says. On the other side, I find that well-informed pro-circ’ers (Wiswell, Schoen, Morris) are a bit selective with facts, but they maintain a reasonable fidelity to the literature." Circumcision—How could anyone compare it to Child Abuse?) Newsgroups:   sci.med,misc.kids.health,misc.kids.pregnancy,misc.kids I will leave it at that for this round. John – Hide quoted text — Show quoted text -> — > Neal > Note:  To contact, remove the ".NS" from address

Response:

… (my post snipped) >You are a pretty smooth talker yourself.

Thank you, I guess. >You can analyze this to death >and still fail to see the forest for the trees. And don’t apologize for >cutting and pasting. It is very efficient since the same things are said >here over and over and over and over again. >Morris’ site it is not a fraud. That you should see it as such says more >about you that it does about it.

That you see Morris’ site as "an interesting essay on the subject" and not a fraud says as much about you as it does about it. >Morris simply comes to a conclusion >different from yours and that of course is something you cannot accept. >In the final analysis and in summary from your sources above: >"American College of Pediatrics: The College believes INFORMED >DISCUSSION (emphasis mine) with parents regarding the possible health >benefits of routine male circumcision and the risks associated with the >operation are essential." end reference

Yes, I believe that is the exact quote.  Morris took that and twisted it into "The American College of Pediatrics has moved far closer to an advocacy position."  He neglected to mention that the ACP spoke of "possible" benefits, but did not use a modifier before "risks." – Hide quoted text — Show quoted text ->And again from above. >"The overall evidence of the benefits and harms of circumcision is so >evenly balanced that it does not support recommending circumcision as >a routine procedure for newborns." So Dr Morris’ statement about >balanced benefits and harm is true.  But he left off the second half of >the sentence. >But the Canadians did make a recommendation, which Dr Morris >conveniently left out.  They said:  "Recommendation: Circumcision of >newborns should not be routinely performed." end reference >Let us clarify this even more just in case YOUR comments are incomplete. >Excerpt from >Neonatal circumcision revisited >http://hpb1.hwc.ca:8080/cma/journals/cmaj/vol-154/0769e.htm >quote >Values: The literature was assessed to determine whether neonatal >circumcision improves the health of boys and men and is a COST-EFFECTIVE >(emphasis mine) approach to preventing penile problems and associated >urinary tract conditions. Religious and personal values were not >included in the assessment. >Benefits, harms and COSTS: The effect of neonatal circumcision on the >incidence of urinary tract infection, sexually transmitted diseases, >cancer >of the penis, cervical cancer and penile problems; the complications of >circumcision; and estimates of the COSTS (emphasis mine) of neonatal >circumcision and of the treatment of LATER (emphasis mine) penile >conditions, urinary tract infections and complications of circumcision. >Recommendation: Circumcision of newborns should not be routinely >performed. >end quote >additional quote from ‘Neonatal circumcision revisited’. >   * There is evidence that circumcision results in a reduction in the >incidence of PENILE CANCER and of HIV TRANSMISSION (Emphasis mine). >However, there is inadequate information to recommend circumcision as a >PUBLIC HEALTH MEASURE (emphasis mine) to prevent these diseases. >end quote

But you leave out (from the CMAJ article):   "Objective: To assist physicians in providing guidance to parents regarding neonatal circumcision. Options: Whether to recommend the routine circumcision of newborn male infants." >No one has suggested *routine* neonatal circumcision as a matter of >public policy. Rather (again as yours above) the Canadian Paediatric >Society: "When parents are making a decision about circumcision, they >should be advised of the present state of medical knowledge about its >BENEFITS and HARMS (emphasis mine)." >And I have suggested nothing more than that. THAT IS THE POINT. Parents >should be in a position to make a well-informed decision.

I belive so to.  And when medical societies recommend that circumcision not be performed, and Morris conveniently (for his postion) leaves it out of his essay, I feel the need to jump in and object. >One of the purposes of the Canadian study was COST-EFFECTIVENESS: that >is to say that from the point of view of the health care provider (in >the case of Canada, the government, or in U.S., an  H.M.O. or insurance >company), it may be financially cheaper to deal with problems when they >arise than to try to avoid them. This is not an approach that new >parents may want to follow; certainly not one that I would want to >follow. Note too that the report recognizes a relationship between >circumcision and the incidence of penile cancer and of HIV transmission.

But there is very little discussion of costs in the CMAJ article, and they did no work on costs themselves.  The only place that I recall where dollar costs were assessed were in respect to cancer of the penis. In the discussion of UTIs, and other places in the article, costs were discussed in terms of number of UTIs prevented vs number of circumcision complications, with no attempt to assess dollar costs. So please do not attempt to to pass the whole stude off as a public policy-costs study. >For what it is worth and for what role if any it may play, observe that >some members at least of the CPS seem to be personally opposed to >neonatal circumcision and to be associated with anti-circumcision >activists. (Yet in spite of this alleged association they  still refer >to  ’benefits’.)

Yes.  What they said was "Our review of the literature leads us to conclude that, for routine neonatal circumcision, the benefits have not been shown to clearly outweigh the risks and costs."  And "The overall evidence of the benefits and harms of circumcision is so evenly balanced that it does not support recommending circumcision as a routine procedure for newborns. There is therefore no indication that the position taken by the CPS in 1982 should be changed." >quote >What Dr. Walker conveniently did not convey to Ms. Kirkey is that, when >the Canadian Pediatric Society conducted its review of circumcision, the >panel went into it with their minds already made up that "circumcision >was medically unnecessary." In a 1996 flyer produced by one of the U.S. >anti-circumcision groups, it was widely reported that the president of >the >Canadian Pediatric Society bragged to an anti-circumcision activist >that, in spite of the review, the CPS had no intention of changing its >position. >http://www.geocities.com/HotSprings/2754/daveblckman.html

For what it is worth and for what role if any it may play, observe that some members, to include the chairman of the 1989 ACP study seem to be personally highly committed to neonatal circumcision and to be associated with circumcision activists.  The chairman of the study group has written a book promoting circumcision and is famous for his Ode to Circumcision. – Hide quoted text — Show quoted text ->Note further (if I remember correctly) that according earlier articles >posted here by Martin Novoa (a very staunch anti-circumcision activist), >he (Mr. Novoa) and Dr. Alwin are close personal friends. >Again from yours above >"Note that we are again dealing with "potential benefits," compared to >real and actual risks.  But do not read this as condoning circumcision. >After the newspapers misinterpreted the 1989 findings, such as they >were, Dr Schiff, President of the AAP, said: >Donald W. Schiff, M. D., professor of pediatrics at the University of >Colorado in Denver and president of the AAP.  "We’ve changed it a bit, >but its really just a bit.  ……. and I think I said that, there may >be some advantage to doing circumcision, but I think the data is still >indefinite, etc." end reference >Note evidence of your own bias by trying to match "potential benefits" >with "real risk". In both cases we are dealing with statistical data. Is >the statistical evidence that one uncircumcised man in 700 will develop >penile cancer ‘real’ or ‘potential"? The statistic is ‘real’. The >benefit (that of avoiding penile cancer) for any particular individual >is ‘potential’.

All the cancer stuff is old hat and was known when the statements of 1971 and 1975 were written.  The 1989 wording of "potential benefits" was added over the UTI controversy.  And since Wiswell’s numbers, which though widely quoted are still not as fully accepted, they used "potential." >Note further that Dr. Shchiff says "there may be some advantage to doing >circumcision". >Nowhere are potential benefits denied or is the practice actively >discouraged.  

Correct.  Too many payments on Mercedes would be missed. – Hide quoted text — Show quoted text ->Yes. "Investigate for yourself."  Don’t let a smooth talker like Neal >Smith do your thinking for you. Regarding your earlier reference to >manipulation of sources, after many requests I have been unable to have >anyone point out to me a SINGLE positive reference to circumcision at >the anti-circumcision resource sites. >For further reading, see below. (Do any of these appear in the anti-circ >literature?) >John P >                     Medical Benefits of Circumcision >Edwin Kiester, Jr. and Sally Valente Kiester tell of the popularity of >circumcision in the United States after World War II and the lapse that >followed, including the disclaimer of medical benefit by the American >Academy of Pediatrics in the 1970s. The Keisters point out that, while >the >matter is not disputed, the evidence indicating a lower incidence of >urinary tract infection, foreskin infections, cancer of the penis and >sexually transmitted diseases, including HIV, among the circumcised >suggest that the benefits of the procedure outweigh the risks. >–Reader’s Digest, January 1996, pp. 150-154 >http://www.apfmed.org/med_news.htm

So we are quoting Readers Digest now, John.  A real source of medical information.  Who  was on the peer review team on this one?  Don’t get the mag.  Hear it was very pro-circ. – Hide quoted text — Show quoted text – >Title >     A perspective on controversies over neonatal circumcision [see

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Response:

- Hide quoted text -- Show quoted text ->>   Hi, >>   I'm very new to the newsgroup forums, having just found out about them >>  a few weeks ago... >>  I am currently 5& 1/2 months pregnant with a baby boy, and I know >> nothing about circumcisions--what is the current standing for this >> procedure; is society pro or con or somewhere in between? Any advice >>  or suggestions would be very welcome. >>  Thank you! >>  ~Lauren~ >For an interesting essay on the subject see >http://www.physiol.su.oz.au/brianm/circumcision.htm > John!!  Shame on you for continuing to point people to Morris' site. > It is a fraud and you know it.  I hate to cut and paste, but since I > seldom cross-post, and the alt.parenting.solutions thread was not see > here ... > Begin paste: > John, yes, it is interesting.  It is also very inaccurate, as you well > know. > Let us examine Dr Brian Morris' web page. > It appears to be well documented.  The web page lists 104 references. > It certainly would seem to be well reasoned, well documented, and > authoritative.  But let us take a closer look.  Let us examine Dr > Morris' third paragraph.  Dr Morris states: > "However, a reversal of this trend is starting to occur. In the light > of an increasing volume of medical scientific evidence pointing to the > benefits of neonatal circumcision a new policy statement was > formulated by a working party of the Australian College of Paediatrics > in August 1995 and adopted by the College in May 1996 [5]. In this > document medical practitioners are now urged to fully inform parents > of the benefits of having their male children circumcised.  Similar > recommendations were made recently by the Canadian Paediatric Society > who also conducted an evaluation of the literature, although concluded > that the benefits and harms were very evenly balanced. The American > College of Pediatrics has moved far closer to an advocacy position and > many recognised authorities in the USA strongly advocate circumcision > of all newborn boys. More details of their statements appear below." > Let us examine this paragraph closely.  Skip the first two sentences. > Then Dr Morris states: > "In this document medical practitioners are now urged to fully inform > parents of the benefits of having their male children circumcised." > Let us look at the policy statement itself and see what it actually > says.  What it says is:  "The College believes informed discussion > with parents regarding the possible health benefits of routine male > circumcision and the risks associated with the operation are > essential." > This is not quite what Dr Morris said.  He talked about benefits, and > the ACP speaks of "potential benefits."  Dr Morris didn’t mention that > the ACP said that there were risks, and the ACP includes that in the > same sentence, and doesn’t speak of "possible" risks.  The risks are > known and real. > If you would like, you can see the ACP statement for yourself at > http://www.cirp.org/CIRP/library/statements/acp1996/ > Before we move on to Canada, I would like to point out that Dr Morris > does not mention that in the ACP’s policy statement is this paragraph: > ‘The Australasian Association of Paediatric Surgeons has informed the > College that it is its view that routine male circumcision should not > be performed prior to the age of 6 months.  It considers that > "Neonatal male circumcision has no medical indication.  It is a > traumatic procedure performed without anaesthesia to remove a normal > and healthy prepuce."’ > If you go to the Australasian Association of Paediatric Surgeons’ > statement, which Dr Morris certainly knows about, but did not > reference, they say: > "Preamble: The Australasian Association of Paediatric Surgeons does > not support the routine circumcision of male neonates, infants or > children in Australia.  It is considered to be inappropriate and > unnecessary as a routine to remove the prepuce, based on the current > evidence available." > They go on to say: > "We do not support the removal of a normal part of the body, unless > there are definite indications to justify the complications and risks > which may arise.  In particular, we are opposed to male children being > subjected to a procedure, which had they been old enough to consider > the advantages and disadvantages, may well have opted to reject the > operation and retain their prepuce." > You can see the statement of the Australasian Association of > Paediatric Surgeons for yourself at > http://www.cirp.org/CIRP/library/statements/aaps/ > Well.  This is getting interesting.  Let’s look at Canada.  Dr Morris > says (quoting above) "Similar recommendations were made recently by > the Canadian Paediatric Society who also conducted an evaluation of > the literature, although concluded that the benefits and harms were > very evenly balanced." > Indeed the recommendations of the Canadian Paediatric Society were > similar to the Australian statements.  But the similarity is in what > they really said, not what Dr Morris implies they said.  The Canadians > did say that parents should be informed, but like the Australians what > they really said was: > "When parents are making a decision about circumcision, they should be > advised of the present state of medical knowledge about its benefits > and harms." > That’s not exactly what Dr Morris said, is it?  He said "Similar > recommendations were made recently by the Canadian Paediatric Society" > Now the Canadians did say: > "The overall evidence of the benefits and harms of circumcision is so > evenly balanced that it does not support recommending circumcision as > a routine procedure for newborns." > So Dr Morris’ statement about balanced benefits and harm is true.  But > he left off the second half of the sentence. > But the Canadians did make a recommendation, which Dr Morris > conveniently left out.  They said:  "Recommendation: Circumcision of > newborns should not be routinely performed." > You can read the Canadian Medical Association web site at > http://www.cma.ca/journals/cmaj/vol-154/0769e.htm > Well!  This is getting interesting, isn’t it.  This just doesn’t seem > to be quite the way Dr Morris leads you to believe.  Let’s look now at > his last statement, "The American College of Pediatrics has moved far > closer to an advocacy position and many recognised authorities in the > USA strongly advocate circumcision of all newborn boys." > Yes, the ACP has moved "far" closer to an advocacy position than they > were.  They previously stated that "There is no absolute medical > indication for circumcision."  There was a 1989 statement that said > that "Newborn circumcision has potential medical benefits and > advantages as well as disadvantages and risks."  But they did not > change the previous position. > Note that we are again dealing with "potential benefits," compared to > real and actual risks.  But do not read this as condoning > circumcision.  After the newspapers misinterpreted the 1989 findings, > such as they were, Dr Schiff, President of the AAP, said: > "We have not reversed our position," said Donald W. Schiff, M. D., > professor of pediatrics at the University of Colorado in Denver and > president of the AAP.  "We’ve changed it a bit, but its really just a > bit.  I think that the distinction we’re making is that there is some > new data which suggests that the subject needs reexamination and > further examination and further examination but that, and I think I > said that, there may be some advantage to doing circumcision, but I > think the data is still indefinite enough that we’re not making a real > change of any significance.  We’re making a slight change.  We sort of > opening the door a crack, so to speak saying, "We need to reexamine on > the issue and reidentify the data so that we know just what the facts > are.  We don’t have them all yet." > You can read this for yourself at > http://www.cirp.org/CIRP/news/1989.06.08:MedicalTribune > All this goes to show how well Dr Morris is manipulating his sources. > Dr Morris asserts things, shows lots of footnotes, and it you don’t go > check, you don’t realize that Dr Morris is misquoting his sources. > Dr Morris writes a great essay, but it based on half truths, > misquotes, and conjecture.  Don’t be fooled.  104 references don’t > mean a thing when you are twisting them. > Investigate for yourself.  Don’t let a smooth talker like Dr Morris do > your thinking for you. > — > Neal > Note:  To contact, remove the ".NS" from address

You are a pretty smooth talker yourself. You can analyze this to death and still fail to see the forest for the trees. And don’t apologize for cutting and pasting. It is very efficient since the same things are said here over and over and over and over again. Morris’ site it is not a fraud. That you should see it as such says more about you that it does about it. Morris simply comes to a conclusion different from yours and that of course is something you cannot accept. In the final analysis and in summary from your sources above: "American College of Pediatrics: The College believes INFORMED DISCUSSION (emphasis mine) with parents regarding the possible health benefits of routine male circumcision and the risks associated with the operation are essential." end reference And again from above. "The overall evidence of the benefits and harms of circumcision is so evenly balanced that it does not support recommending circumcision as a routine procedure for newborns." So Dr Morris’ statement about balanced benefits and harm is true.  But he left off the second half of the sentence. But the Canadians did make a recommendation, which Dr Morris conveniently left out.  They said:  "Recommendation: Circumcision of newborns should not be … read more »

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