Thursday, February 24, 2011

Cuando es la circuncisión la ética?

La circuncisión es ética en los 2 siguientes situaciones:
1. No Terapéutica Circumcison (sin indicación médica) es ética cuando el propio hombre es lo suficientemente grande, lo suficientemente maduros, y con conocimiento suficiente para dar consentimiento informado para el procedimiento. Esto es por lo general en la edad adulta cuando el hombre ha llegado a un mínimo de 18 años de edad.
El consentimiento informado debe incluir el conocimiento de los siguientes:
a. Que es un procedimiento doloroso. b. Que el prepucio es la anatomía masculina normal y saludable, que tiene 20.000 nervios placer y las estructuras anatómicas que faciliten la mecánica y el disfrute del sexo, y que estos se pierden todos a la circuncisión. c. Que el sexo seguro todavía tiene que ser practicada por los hombres circuncidados en todo el mundo están infectadas con el VIH y las ITS. La circuncisión países como los EE.UU. tienen 33 veces más infecciones gonnoreah 19 veces las infecciones por Chlamydia y 3 veces las infecciones por el VIH que las culturas no-circuncisión como Holanda que los niveles altos de la práctica del sexo seguro. d. Que el grado de beneficio médico de circumcison al compararse con los costos y los métodos clínicos y médicos para achieiving estos supuestos beneficios no se garantiza la circuncisión. Que los métodos alternativos clínicos, conductuales y médicas pueden lograr resultados superiores a la circuncisión, sin los daños y pérdidas. e. Que los beneficios de los más grandes de la circuncisión no terapéutica son psicológicos, ya que ha sido una decisión consciente de uno mismo sobre su propio cuerpo, y es también psicológicamente relacionado conscientemente decidir por sí mismo de pertenecer a un grupo socio-cultural de un *.

2. La circuncisión es ética si es médicamente su autoestima por (que es muy raro: los datos de Finlandia 1 en 16.761 casos), es decir. todos los métodos de tratamiento conservador se han considerado, tratado y fracasado o se considera médicamente aptos, y la circuncisión es el último recurso, y la única manera de proporcionar tratamiento.
Nota: * Mucha confusión surge de la pertenencia a un grupo de discusión Socio-Cultural. la circuncisión no terapéutica de menores de edad pueden proporcionar un beneficio psicológico para los adultos, los ancianos, los padres o figuras de autoridad dentro de un grupo socio-cultural, pero a expensas de las violaciónes de derechos humanos del niño. Los adultos de esa comunidad podría ajustar sus creencias y declarar que "todos los niños varones con un prepucio también pertenecen a nuestro grupo socio-cultural". Así que no confundamos las necesidades psicológicas de adultos con necesidades psicológicas de los niños. Todo lo que un niño necesita es un sentimiento y la creencia de que son amados y queridos por lo que son, prepucio y todo.

When is circumcision ethical?

Circumcision is ethical in the 2 following situations:

1.  Non-Therapeutic Circumcison (No medical indication) is ethical when the male himself is old enough, mature enough, and informed enough to give informed consent to the procedure.  This is usually in adulthood when the male has reached a minimum of 18 years of age.

Informed consent should include knowledge of the following:

a. That it is a painful procedure.
b. That the foreskin is normal and healthy male anatomy, that has 20,000 pleasure nerves and anatomical structures that facilitate the mechanics and enjoyment of sex, and that these are all lost to circumcision.
c.  That safe sex still needs to be practiced because circumcised men all over the world are infected with HIV, and STI's.  Circumcision Countries like the USA have 33 times gonnoreah infections 19 times Chlamydia infections and 3 times HIV infections than Non-circumcision cultures like Holland that practice high levels of safe sex.
d. That the degree of medical benefit from circumcison when weighed against the costs and the alternative clinical and medical methods for achieiving these claimed benefits does not warrant circumcision.  That alternate clinical, behavioural and medical methods can achieve superior outcomes than circumcision without the harms and losses.
e. That the greatest benefits from a non-therapeutic circumcision are psychological, in that a conscious decision has been made for one-self about one's body, and it is also psychologically related to consciously deciding for one self to belong to a socio-cultural group*.


2. Circumcision is ethical if it is medically therapuetic (which is very rare: Finland data 1 in 16,761 cases), ie. all conservative treatment methods have been considered, tried and failed or considered medically unsuitable, and circumcision is the last resort, and only way of providing therapy.

NB* Much confusion arises out of the Belonging to a Socio-Cultural group argument.  Non-Therapeutic circumcision of minors may provide a psychological benefit to the adults, elders, parents, or authority figures within a socio-cultural group, but at the expense of the human rights violations of the individual child.  The adults of that community could adjust their beliefs and declare that "all male children with a foreskin also belong to our socio-cultural group".  So let us not confuse adult psychological needs with children's psychological needs.  All a child needs is a sense and belief they are loved and wanted for who they are, foreskin and all.

Monday, February 21, 2011

Circuncisão: Ensaios Clínicos vs Mundo Real


Existem muitas razões pelas quais os ensaios clínicos a circuncisão provavelmente não necessariamente se traduzem em efeitos no mundo real.

 
1. Os efeitos do ensaio clínico são muito baixas, um efeito de 50% clínica leva a proteção da baixa população de nível. O pesquisador francês Garenne, demonstrou que os efeitos clínicos nem sempre se traduzem em efeitos População (Major tamanho razão de ser do efeito clínico), e que pesquisas anteriores tinham mostrado que as vacinas que teve um efeito de 50% clínica tinha praticamente zero efeitos população.


 
2. Os homens vão adaptar o seu comportamento para compensar a circuncisão. Seja qual for a perda de homens experimentam a sensação, será composta na adaptação dos comportamentos e isso pode significar, o sexo mais freqüente, o sexo mais vigoroso, embora especulativo não poderia ser mais variada, incluindo sexo, a possibilidade de coito anal, mais parceiros sexuais, menos preservativos uso, comportamento sexual mais seguro.
3. Os ensaios foram terminou mais cedo a exagerar os efeitos clínicos.
4. O mundo real não terá os mesmos níveis de suporte clínico, eficácia clínica e da educação que os ensaios clínicos tinham.
5. O risco relativo e proteção episódica não é uma proteção ao longo da vida, ou uma protecção absoluta.
6. Mulheres podem ser infectados em 50% as taxas mais elevadas quando ter relações sexuais com um homem circuncidado. Isto pode ser devido à retomada sexo muito cedo, antes da ferida ter cicatrizado, o sexo mais forte ou mais freqüente do sexo para compensar a perda de prepúcio.
7. Ensaios demonstraram confiabilidade interna elevada, mas pouca evidência de validade externa, que aparece bastante baixa ao examinar populações. Garenne descobriu que certas populações de homens circuncidados têm taxas mais altas de infecções por HIV, que as populações não-circuncidados, em certos Africano das Nações.
8. Neste momento, pode ser uma confiança maior do circumcison que usar preservativo e praticar sexo seguro.
9. Nenhuma ênfase foi feita em tratar as causas principais das taxas de população elevada de infecção, ou seja, alto grau de promiscuidade, ao elevado número de parceiros sexuais, e é este fenômeno cultural behavioiural que exige, mudança de cultura massiva.
10. Os ensaios não foram duplo-cego do reserachers sabia que estavam no grupo circuncidado, e do grupo "circuncidado recebido mais atenção, o tempo, a educação, com ênfase em usar preservativos.
11. Os EUA, que tem as maiores taxas de circuncisão no mundo ocidental, e também as maiores taxas de HIV e DST's no mundo ocidental. Estudos que examinaram as diferenças observadas americanos tendem a ter um maior número de parceiros sexuais e usaram menos o preservativo do que os seus pares europeus. Isso pode ser que os homens americanos que são circuncidados adaptar os seus comportamentos para compensar a falta de prepúcio, ou outros fatores podem estar contribuindo, como práticas culturais sexual. Aquilo que se pretende demonstrar é que o aumento de comportamentos sexuais seguros, elimina qualquer efeito de protecção que podem ser evidentes em um ajuste do ensaio clínico.

ขลิบ : การทดลองทางคลินิก vs โลกแห่งความจริง


มีสาเหตุหลายประการการทดลองทางคลินิกขลิบส่วนใหญ่อาจจะไม่จำเป็นต้องแปลให้ได้ผลจริง

 
1 ผลการทดลองทางคลินิกต่ำเกินไปผลทางคลินิก 50% ของประชากรนำไปสู่การป้องกันในระดับต่ำ นัก วิจัย Garenne ฝรั่งเศสแสดงให้เห็นว่าผลทางคลินิกไม่เคยแปลเป็นผลประชากร (Major เหตุผลขนาดเป็นอยู่ของผลทางคลินิก) และว่าการวิจัยที่ผ่านมาได้แสดงให้เห็นว่าการฉีดวัคซีนที่มีผลทางคลินิก 50% มีผลประชากรเกือบเป็นศูนย์


 
2 ผู้ชายจะปรับพฤติกรรมของพวกเขาจะเอาการขลิบ สิ่ง ที่สูญเสียความรู้สึกประสบการณ์ที่ผู้ชายจะถูกสร้างขึ้นสำหรับในการปรับตัว ของพฤติกรรมและนี้อาจหมายถึงเพศบ่อยกว่าเพศแข็งแรงมากขึ้น แต่การเก็งกำไรอาจมีเพศแตกต่างกันมากขึ้นรวมถึงความเป็นไปได้ของการมีเพศ สัมพันธ์ทางทวารหนักมากขึ้นหุ้นส่วนเพศถุงยางอนามัยน้อยลง ใช้พฤติกรรมทางเพศที่ปลอดภัยน้อยลง
3 สิ้นสุดการทดลองพบต้นเกินความจริงผลทางคลินิก
4 โลกแห่งความจริงเคยมีระดับเดียวกันของการสนับสนุนทางคลินิกการรับรู้ความสามารถทางคลินิกและการศึกษาที่มีการทดลองทางคลินิก
5 ความเสี่ยงและการป้องกันเป็นตอน ๆ ไม่นานชีวิตการป้องกันหรือการคุ้มครองแน่นอน
6 ปรากฏว่ามีผู้หญิงที่ติดเชื้อในอัตราที่สูงกว่า 50% เมื่อมีเพศสัมพันธ์กับคนเข้าสุหนัต นี้อาจเกิดจากเพศกลับมาทำงานเร็วเกินไปก่อนที่จะมีแผลหายเพศแข็งแรงมากขึ้นหรือมากขึ้นบ่อยเพศชดเชยการสูญเสียของหนังหุ้มปลายลึงค์
7 การทดลองแสดงให้เห็นถึงความน่าเชื่อถือภายในสูง แต่มีหลักฐานเพียงเล็กน้อยของความตรงภายนอกซึ่งปรากฏค่อนข้างต่ำเมื่อตรวจสอบประชากร Garenne พบว่าประชากรบางคนเข้าสุหนัตมีอัตราที่สูงขึ้นของการติดเชื้อเอชไอวีมากกว่าประชากรที่ไม่เข้าสุหนัตในบางประเทศแอฟริกา
8 ขณะนี้มีอาจมีความเชื่อมั่นมากขึ้นกว่าการใส่ถุงยางอนามัย circumcison และการฝึกเพศสัมพันธ์อย่างปลอดภัย
9 เน้น ไม่ได้ทำในตำแหน่งที่อยู่สาเหตุหลักของอัตราการติดเชื้อของประชากรสูงคือ ระดับสูงของสำส่อนตัวเลขสูงของพันธมิตรทางเพศและเป็นปรากฎการณ์นี้ behavioiural ทางวัฒนธรรมซึ่งจะต้องมีการเปลี่ยนแปลงทางวัฒนธรรมมาก
10 การ ทดลองที่ไม่ได้ตาบอดคู่ reserachers รู้ที่อยู่ในกลุ่มเข้าสุหนัตและกลุ่มเข้าสุหนัตได้รับความสนใจมากขึ้นเวลา การศึกษาและเน้นการสวมใส่ถุงยางอนามัย
11 ประเทศสหรัฐอเมริกาซึ่งมีอัตราการขลิบสูงสุดในโลกตะวันตกและยังอัตราสูงสุดของเอชไอวีและ STI ในโลกตะวันตก การ ศึกษาที่การตรวจสอบความแตกต่างที่ได้กล่าวถึงชาวอเมริกันมีแนวโน้มที่จะมี ตัวเลขที่สูงขึ้นของพันธมิตรเพศและใช้ถุงยางอนามัยน้อยกว่าเพื่อนชาวยุโรป ของพวกเขา นี้ อาจเป็นได้ว่าคนอเมริกันที่เข้าสุหนัตปรับพฤติกรรมของพวกเขาเพื่อชดเชยการ ขาดของหนังหุ้มปลายลึงค์หรือปัจจัยอื่น ๆ อาจมีส่วนร่วมเช่นการปฏิบัติทางเพศทางวัฒนธรรม สิ่ง ที่มันไม่แสดงให้เห็นว่าการเพิ่มขึ้นของพฤติกรรมทางเพศที่ไม่ปลอดภัยมีผลต่อ การป้องกันกำจัดใด ๆ ที่อาจมีความชัดเจนในการทดลองทางคลินิกการตั้งค่า

할례가 : 임상 시험 현실과 대


왜 포경 임상 실험은 대부분의 아마 반드시 실제 효과로 번역되지 않습니다 많은 이유가 있습니다.

 
1. 임상 실험 효과는 50 %의 임상 효과가 낮은 인구 수준의 보호로 연결, 너무 낮은있다. 프 랑스어 연구원 Garenne하고, (임상 효과의 주된 이유가되는 크기) 임상 효과는 항상 인구 효과로 번역하지 않는 것이 입증되는 과거 연구 결과 50 %의 임상 효과가 없었습니다 예방 접종은 거의 제로 인구 효과가 있다고 표시했다.


 
2. 남자는 할례에 만들어 자신의 행동을 적응됩니다. 뭐든지 감각 남자 경험 손실, 행동의 적응에 대한 만들어되며 이것이 투기 비록 항문 성교의 가능성, 더 많은 섹스 파트너를 포함하여 더 다양한 섹스, 덜 콘돔도있을 수도, 더 자주 섹스, 더 활발한 섹스 수도있다는 뜻 사용 덜 안전한 섹스는 동작.
3. 시련은 초기 임상 효과를 과장 종료되었습니다.
4. 진짜 세상 못해 임상 지원, 임상 효능과 임상 시험을 가지고 있다고 교육의 동일한 레벨들을 가지고 있어요.
5. 상대적인 위험과 에피소드 보호 인생은 긴 보호, 또는 절대적인 보호되지 않습니다.
6. 여자는 할례를 남자와 섹스를 할 때 50% 높은 속도에서 감염된 것으로 나타납니다. 이것은 너무 일찍 상처는 포피의 손실에 대한 보상으로, 더 활발한 섹스 또는 자주 섹스 더 치료되기 전에 성관계를 재개가 원인일 수 있습니다.
7. 시련이지만, 높은 내부 안정성을 입증 인구 조사 때 매우 낮은 나타나는 외부 타당성, 작은 증거. Garenne 특정 아프리카 나라에 비 할례 인구보다 할례 남성의 특정 인구는 HIV 감염의 높은 속도를 가지고 것으로 나타났습니다.
8. 지금은 콘돔을 착용하고 안전한 섹스를 연습보다 circumcison의 큰 신뢰가있을 수 있습니다.
9. 아니 강조 즉 높은 인구 감염 속도, 높은 수준의 성행위, 섹스 파트너의 높은 숫자의 주요 원인을 해결해되었다, 그리고 그것은 거대한 문화의 변화를 필요로 behavioiural이 문화 현상이다.
10. 시련을 두 번하고, reserachers는 할례 그룹이 누구인지 눈을 멀게하지 않은 할례 그룹이 콘돔을 착용에 대한 더 많은 관심, 시간, 교육, 강조를 받았다.
11. 서쪽 세계에서 가장 높은 할례 속도를 가지고 미국, 및 HIV & STI는의 서쪽 세계에서 또한 가장 높은 요금. 차이를 조사 연구는 미국인들이 섹스 파트너 높은 숫자를 가지고하는 경향이 지적하고 유럽의 또래보다 콘돔을 사용. 이것은, 그들의 behaviours 적응 할례 미국 남자는 포피의 부족에 대한 보상가 될 수있는 다른 요소는 문화적인 성행위와 같은 공헌 수 있습니다. 무엇을 보여 않는 안전하지 않은 섹스 행위의 증가는 임상 실험 설정에 분명있을 수있는 보호 효과를 제거하는 것입니다.

割礼は:臨床試験実世界対


理由は、割礼の臨床試験は、おそらく、必ずしも実際の効果に変換されません多くの理由があります。

 
1。臨床試験への影響は50%の臨床効果が低い人口レベルの保護につながり、低すぎる。フランスの研究者ガレンヌ、および、(臨床効果の主な理由はされてサイズ)臨床効果は、常に人口の効果に変換しないことを示したことは過去の研究は、50%の臨床効果を持っていた予防接種が実質的にゼロ人口効果があったことを示していた。


 
2。男性は割礼を補うために彼らの行動を適応させます。どのような感覚の男性の経験の喪失、行動の適応の交流行われる、これは投機が肛門性交の可能性は、より多くのセックスパートナーを含む、より多様性、以下のコンドームがあるかもしれない、より頻繁にセックス、より積極的なセックス、を意味するかもしれない使用する、より安全なセックスの動作。
3。試験は、初期の臨床効果を誇張して終了した。
4。現実の世界では文句を言わない臨床支援、臨床効果、臨床試験が持っていた教育と同じレベルを持っています。
5。相対リスクのエピソード保護は人生の長い保護、または絶対的な保護されていません。
6。女性が割礼を受けた男性とセックスをしたときは50%高いレートで感染していることが表示されます。これは、あまりにも早く傷が包皮の損失を補うために、より積極的な性別や頻繁にセックス以上に回復しました前にセックスを再開している可能性があります。
7。試験は、高い内部信頼性を実証人口を調べるときに非常に低いが表示されます外的妥当性の証拠はほとんど。ガレンヌは、特定のアフリカ諸国での非割礼人口よりも、割礼男性の特定の集団は、HIV感染の割合が高いことがあることが判明。
8。今すぐコンドームを着用し、安全なセックスの練習をよりcircumcisonの大きく依存があるかもしれません。
9。いいえ重点は、すなわち高い人口感染率、混乱の高レベルのセックスパートナーの高い数の主な原因に対処する上で作られた、それは、大規模な文化的変革を必要とするこの文化behavioiural現象です。
10。試験では、ダブル、reserachersは、割礼のグループにいたのか知って盲目にされていない割礼グループは、コンドームを着用などに注目し、時間、教育、と強調を受けた。
11。西部の世界で最高の割礼率を有する米国、HIV感染&STIの西部の世界にも最高速度。違いを調べた研究は、アメリカ人はセックスパートナーの数を増やす傾向にあったに留意し、その欧州ピア未満コンドームを使用していました。これは、自分たちの行動を適応させる割礼ているアメリカ人が包皮の不足を補うためにその可能性のある他の要因は、文化的な性行為などに貢献することができる。それは何を示すか危険な性行為の行動の増加は、臨床試験の設定で明らかになる可能性のある保護効果を排除するということです。

Обрезание: клинические испытания против Реальный мир


Есть много причин, почему обрезание клинических испытаний, скорее всего, не обязательно переводить в реальные эффекты мире.

 
1. Клинические эффекты суда являются слишком низкими, 50% клинический эффект приводит к низкому уровню защиты населения. Французский исследователь Garenne, показали, что клинический эффект не всегда перевод населению эффекты (главная причина быть размер клинического эффекта), и что предыдущие исследования показали, что прививки, которые 50% клинический эффект был практически нулевой эффект населения.


 
2. Люди будут адаптировать свое поведение, чтобы компенсировать обрезания. Независимо от потери опыта ощущения мужчины, будет состоять в адаптации поведения и это может означать, более частым сексом, более энергичные пола, хотя спекулятивных не может быть более разнообразным сексом в том числе возможность анального секса, больше сексуальных партнеров, меньше презервативов использования, менее безопасным сексом поведение.
3. Испытания были прекращены раннего преувеличиваю клинические эффекты.
4. Реальный мир не будет иметь такой же уровень поддержки клинических, клиническая эффективность, и образование, что клинические испытания.
5. Относительный риск и эпизодических защита не жизнь долго защиты, или абсолютной защиты.
6. Женщины по всей видимости, инфицированных на 50% выше ставки, когда секс с обрезанным мужчиной. Это может быть связано с возобновлением сексом слишком рано, прежде чем рана зажила, более энергичные пола или более частым сексом, чтобы компенсировать потери крайней плоти.
7. Испытания показали высокую надежность внутреннего, но мало доказательств внешней действительностью, которая выглядит весьма низкой при рассмотрении населения. Garenne обнаружили, что определенные группы населения из обрезанных мужчин имеют более высокий уровень ВИЧ-инфекции, чем необрезанных населения в некоторых африканских наций.
8. Там теперь можно больше уверенности circumcison чем носить презервативы и практики безопасного секса.
9. Нет акцент был сделан на решении основных причин высокой населения инфекции, а именно высокий уровень распущенности, большое число половых партнеров, и именно это культурное behavioiural явлений, которая требует, массивные изменения культуры.
10. Испытания не были ослеплены двойной reserachers знал, кто был в группе обрезанных, и обрезал группа получила больше внимания, времени, образования, и акцент на ношение презервативов.
11. США, который имеет самые высокие показатели обрезания в западном мире, а также высокие показатели ВИЧ-инфекции и ИППП в западном мире. Исследования, которые изучали различия отметил, американцы как правило, имеют большее количество сексуальных партнеров и используются меньше, презервативы, чем их европейские сверстники. Это может быть, что американские мужчины обрезаны адаптировать свое поведение, чтобы компенсировать отсутствие крайней плоти, или других факторов может способствовать, например, культурных сексуальной практики. Что она делает продемонстрировать, что распространение рискованных моделей поведения секс исключает защитный эффект, который может быть очевидным в условиях клинических испытаний.

Beschneidung: Klinische Studien vs Real World


Es gibt viele Gründe, warum die Beschneidung klinischen Studien wahrscheinlich nicht unbedingt auf reale Effekte zu übersetzen.

 
1. Die klinische Studie Effekte sind zu niedrig, eine 50% ige klinische Effekt führt zu einer niedrigen Ebene der Bevölkerung Schutz. Französisch Forscher Garenne, demonstriert, dass die klinischen Effekte nicht immer Bevölkerungszahl Auswirkungen übersetzen (Major Grund dafür ist eine Größe von klinischen Effekt), und dass die frühere Forschung habe gezeigt, dass Impfungen, die eine 50% ige klinische Wirkung hatte praktisch null Bevölkerung Auswirkungen hatte.


 
2. Die Menschen werden ihr Verhalten ein, um die Beschneidung. Was Verlust der Empfindung Männer erleben, wird dich für in der Anpassung von Verhalten gemacht werden, und dies könnte bedeuten, häufiger Sex, energischere Sex, obwohl spekulativ könnte abwechslungsreicher Sex einschließlich der Möglichkeit, Analverkehr, mehr Sex-Partner, weniger Kondom werden verwenden, weniger Safer Sex Verhalten.
3. Die Versuche wurden vorzeitig beendet übertreiben klinischen Effekte.
4. Die reale Welt gewohnt haben die gleichen Stufen der klinischen Unterstützung, die klinische Wirksamkeit und Bildung, dass die klinischen Studien hatte.
5. Relatives Risiko und episodischen Schutz ist nicht ein Leben lang Schutz oder absoluten Schutz.
6. Frauen scheinen bei 50% höhere infiziert, wenn man Sex mit einem beschnittenen Mann. Dies kann durch die Wiederaufnahme der Sex zu früh vor Wunde hat, energischere Geschlecht oder häufiger Sex geheilt zum Ausgleich der Vorhaut zu kompensieren.
7. Versuche zeigten eine hohe interne Zuverlässigkeit, aber wenig Hinweise auf externe Validität, die recht niedrig erscheint, wenn Populationen zu untersuchen. Garenne gefunden, dass bestimmte Populationen von beschnittenen Männern höhere Raten von HIV-Infektionen haben, als nicht beschnitten Populationen in bestimmten afrikanischen Nationen.
8. Es kann nun eine größere Abhängigkeit von circumcison als das Tragen von Kondomen und Safer Sex praktizieren werden.
9. Kein Schwerpunkt lag auf der Bewältigung der Hauptursachen für hohe Infektionsraten Bevölkerung, nämlich hohe Promiskuität, eine hohe Zahl von Sexualpartnern gemacht, und es ist diese kulturelle Phänomene, die behavioiural erfordert massive Kultur verändern.
10. Die Versuche wurden nicht doppelt verblindeten Die Forscher haben wusste, wer in der beschnittenen Gruppe und die beschnittenen Gruppe erhielt mehr Aufmerksamkeit, Zeit, Bildung und Betonung auf das Tragen von Kondomen.
11. Die USA, die höchsten Raten Beschneidung hat in der westlichen Welt, und auch die höchsten HIV & STI in der westlichen Welt. Studien, dass die Unterschiede untersucht festgestellt Amerikaner tendenziell eine höhere Zahl von Sexualpartnern haben und benutzt Kondome weniger als ihre europäischen Altersgenossen. Dies kann sein, dass amerikanische Männer, die beschnitten passen ihre Verhaltensweisen sind, um die fehlende Vorhaut zu kompensieren, oder andere Faktoren können beitragen, wie kulturelle Sexualpraktiken. Was es alles kann nachweisen, dass eine Erhöhung ungeschützten Sex Verhalten jedes protektiven Effekt, dass klar sein kann in einer klinischen Studie eliminiert.

La circoncision: Essais cliniques vs monde réel




Il ya plusieurs raisons pour lesquelles les essais cliniques circoncision sera très probablement se traduit pas nécessairement à des effets du monde réel.

 
1. Les effets des essais cliniques sont trop bas, un effet de 50% clinique conduit à la protection de la population de bas niveau. chercheur français Garenne, a démontré que les effets cliniques ne se traduisent pas toujours les effets de la population (taille des principales raisons d'être de l'effet clinique), et que des recherches antérieures avaient montré que la vaccination qui a eu un effet de 50% cliniques ont pratiquement nulle effets sur la population.


 
2. Les hommes vont adapter leur comportement pour compenser la circoncision. Quelle que soit la perte de sensation des hommes d'expérience, sera constitué dans l'adaptation des comportements et cela pourrait signifier, le sexe plus fréquents, le sexe plus vigoureux, bien que la spéculation qu'il pourrait y avoir plus de sexe variées y compris la possibilité de relations sexuelles anales, plus de partenaires sexuels, moins de préservatifs l'utilisation, le comportement sexuel moins sûr.
3. Les essais ont été terminés début exagérer les effets cliniques.
4. Le monde réel n'aurez pas le même niveau de soutien clinique, l'efficacité clinique, et de l'éducation que les essais cliniques avaient.
5. Le risque relatif et la protection épisodique n'est pas une protection longue durée de vie, ou une protection absolue.
6. Les femmes semblent être infectés à 50% des taux plus élevés lors des rapports sexuels avec un homme circoncis. Cela peut être dû à la reprise des relations sexuelles trop tôt, avant la plaie s'est cicatrisée, le sexe plus vigoureux ou plus fréquemment le sexe pour compenser la perte du prépuce.
7. Les essais ont démontré une grande fiabilité interne, mais peu de preuves de la validité externe, qui apparaît très faible lorsque l'on examine les populations. Garenne a constaté que certaines populations d'hommes circoncis ont un taux plus élevé d'infections à VIH, que les populations non-circoncis dans certains pays d'Afrique.
8. Il peut maintenant être une plus grande dépendance des circumcison que de porter des préservatifs et des pratiques sexuelles sûres.
9. Aucun accent a été fait pour régler la principale cause de taux élevés d'infection de la population, à savoir des niveaux élevés de la promiscuité, le nombre élevé de partenaires sexuels, et c'est ce phénomène culturel behavioiural qui exige, changement de culture massive.
10. Les essais ne sont pas en double aveugle de la reserachers savait qui étaient dans le groupe circoncis, et le groupe circoncis reçu plus d'attention, de temps, de l'éducation, et l'accent mis sur le port de préservatifs.
11. Les Etats-Unis qui a le plus fort taux de circoncision dans le monde occidental, et aussi le plus haut taux de VIH et des IST dans le monde occidental. Les études qui ont examiné les différences constatées Américains ont tendance à avoir un plus grand nombre de partenaires sexuels et d'occasion moins les préservatifs que leurs homologues européens. C'est peut-être que les hommes américains qui sont circoncis adapter leurs comportements pour compenser l'absence de prépuce, ou d'autres facteurs contribuent peut-être, tels que la culture des pratiques sexuelles. Ce qu'il fait preuve, c'est que l'augmentation des comportements sexuels à risque élimine tout effet protecteur qui peut être évident dans un essai clinique.
Il ya plusieurs raisons pour lesquelles les essais cliniques circoncision sera très probablement se traduit pas nécessairement à des effets du monde réel.


Circuncisión: Ensayos Clínicos vs Real World

Circuncisión: Ensayos Clínicos vs Real World Hay muchas razones por qué la circuncisión ensayos clínicos no es muy probable que se traduce necesariamente a los efectos del mundo real.

 
1. Los efectos de ensayos clínicos son muy bajos, un efecto del 50% clínicos conduce a la protección de bajo nivel de la población. El investigador francés Garenne, demostró que los efectos clínicos no siempre se traduce en efectos de Población (tamaño mayor razón de ser del efecto clínico), y que investigaciones anteriores habían demostrado que las vacunas que tuvo un efecto clínico del 50% no tenía prácticamente cero efectos en la población.


 
2. Los hombres se adaptan su comportamiento para compensar la circuncisión. Cualquiera que sea la pérdida de la sensación experiencia de los hombres, será compensado en la adaptación de los comportamientos y esto podría significar, el sexo con mayor frecuencia, el sexo más fuerte, aunque especulativa que podría haber más sexo variado, que incluye la posibilidad de que el coito anal, más parejas sexuales, menos del condón uso, comportamiento sexual menos seguro.
3. Los ensayos se terminó a principios de exagerar los efectos clínicos.
4. El mundo real no tendrá el mismo nivel de apoyo clínico, la eficacia clínica y la educación que los ensayos clínicos tenían.
5. El riesgo relativo y la protección episódica no es una protección de larga duración, o una protección absoluta.
6. Las mujeres parecen estar infectados con tarifas un 50% superior al tener relaciones sexuales con un hombre circuncidado. Esto puede ser debido a la reanudación de relaciones sexuales demasiado pronto antes de la herida ha sanado, el sexo más fuerte o más frecuente del sexo para compensar la pérdida del prepucio.
7. Los ensayos demostraron la consistencia interna de alta, pero poca evidencia de la validez externa, que parece bastante bajo cuando se examina la población. Garenne encontrado que ciertas poblaciones de los hombres circuncidados tienen índices más altos de infecciones por el VIH, que las poblaciones no circuncidados en algunas naciones africanas.
8. Puede que ahora haya una mayor dependencia de circumcison que usar preservativos y practicar el sexo seguro.
9. No se hizo énfasis en abordar las principales causas de las altas tasas de infección de la población, es decir, un alto nivel de promiscuidad, un alto número de parejas sexuales, y es este fenómeno cultural behavioiural que requiere, el cambio de cultura masiva.
10. Los ensayos no fueron a doble ciego del reserachers sabía que estaban en el grupo circuncidado, y el grupo circuncidado recibido más atención, tiempo, educación, y el énfasis en usar condones.
11. Los EE.UU., que tiene los mayores índices de la circuncisión en el mundo occidental, y también las tasas más altas de VIH / ITS en el mundo occidental. Estudios que examinaron las diferencias observadas estadounidenses tendían a tener un mayor número de parejas sexuales y usan menos preservativos que sus pares europeos. Esto puede ser que los hombres americanos que están circuncidados adaptar sus comportamientos para compensar la falta de prepucio, u otros factores pueden estar contribuyendo, como culturales prácticas sexuales. Lo que sí demuestra es que un aumento de los comportamientos sexuales de riesgo se elimina cualquier efecto de protección que pueden ser evidentes en un entorno de ensayo clínico.

Sunday, February 20, 2011

Circumcision: Clinical Trials vs Real World

There are many reasons why the circumcision clinical trials will most probably not necessarily translate to real world effects.

 1.  The clinical trial effects are too low, a 50% clinical effect leads to low population level protection.  French researcher Garenne, demonstrated that clinical effects do not always translate to Population effects (Major reason being size of clinical effect), and that past research had shown that vaccinations that had a 50% clinical effect had virtually zero population effects.


 2.  Men will adapt their behaviour to make up for circumcision.  Whatever loss of sensation men experience, will be made up for in adaptation of behaviours and this could mean, more frequent sex, more vigorous sex, although speculative there could be more varied sex including the possibility of anal intercourse, more sex partners, less condom use, less safe sex behaviour.

3.  The trials were ended early exagerrating clinical effects.

4.  The real world wont have the same levels of clinical support, clinical efficacy, and education that the clinical trials had.

5.  Relative risk reduction and episodic protection is not life long protection, or absolute risk protection.

6. Women appear to be infected at 50% higher rates when having sex with a circumcised man.  This may be due to resuming sex too early before wound has healed, more vigourous sex or more frequent sex to compensate for loss of foreskin.

7. Trials demonstrated high internal reliability, but little evidence of external validity, which appears quite low when examining populations.  Garenne found that certain populations of circumcised men have higher rates of HIV infections, than non-circumcised populations in certain African Nations.

8.  There may now be a greater reliance of circumcison than wearing condoms and practising safe sex.

9.  No emphasis was made on addressing the major cause of high population infection rates, namely high levels of promiscuity, high numbers of sex partners, and it is this cultural behavioiural phenomena which requires, massive culture change.

10.  The trials were not double blinded the reserachers knew who were in the circumcised group, and the circumcised group received more attention, time, education, and emphasis on wearing condoms.

11. The USA  which has the highest circumcision rates in the western world, and also the highest rates of HIV & STI's in the western world.  Studies that examined the differences noted Americans tended to have a higher number of sex partners and used less condoms than their European peers.  This may be that American men who are circumcised adapt their behaviours to compensate for lack of foreskin, or other factors may be contributing, such as cultural sexual practices.  What it does demonstrate is that an increase in unsafe sex behaviours eliminates any protective effect that may be evident in a clinical trial setting.

Friday, February 18, 2011

Is Brian Morris of Circinfo.net a credible & unbiased source of information on infant male circumcision?


All latest critiques of Morris below:

When you have a Professor of Microbiology setting up a website (circinfo.net) which promotes male circumcision and is constantly in the media promoting circumcision, and even attacking the Royal Australasian College of Physicians for Refusing to Recommend infant male circumcision in Australia, it is important to ask whether this person has any credibility or authority in the area of circumcision.  However, when arguing or debating a topic it is important to not rely on Ad Homminem personal attacks as your sole argument.  I do believe that it is important to question someone's credibility when they claim expertise in an area, and particularly when this expertise is questionable.  IN this case I do not believe questioning someone's credibility is an Ad Homminem attack.   In the area of Molecular Biology Prof Brian Morris has legitimate qualifications and credibility, that is not in question here.  What is in question however, is whether a Professor of Molecular Biology has any authority to speak on Infant Child Health, in particular circumcision.

I will argue that it is legitimate to attack Brian Morris credibility as an authority on circumcision and child health, because of the biased claims he makes in favour of infant circumcision, and the lack of qualifications he has to make these claims. Firstly, He is a professor of Molecular Biology and not a Pediatrician, nor a Medical Doctor, nor a Urologist.  In Australia the leading authority on Child health matters is the Royal Australasian College of Physicians (RACP) and Prof Morris is not a member of the RACP.  For more than 2 Decades now the RACP has recommended against routine infant male circumcision and that it is not required in an Australain context.  Yet Brian Morris an Academic from the University of Sydney who's specialty is Molecular Biology continues to recommend routine infant circumcision, in spite of the RACP's recommendations against it. I would argue that he is neither a practitioner nor expert in the area of male genital health or child infant health, and therefore he is unqualified to make recommendations on infant male circumcision.

Historically, and well documented, Prof Morris's behaviour has been found to be totally in favor of circumcision and against anything that is anti-circumcision, and therefore I would argue he is not impartial.  Info below.

Latest critique in 2017:
http://www.circinfo.org/news_2017.html


The latest critique of Brian Morris 11/06/14 in the Skeptic :  http://www.skeptic.org.uk/magazine/onlinearticles/articlelist/711-infant-circumcision

Prof Pringle critique of Morris in 2014:
http://www.circinfo.org/news_2014.html#crazy
http://www.circinfo.org/news_2014.html#pbm




This is a critique of Morris published 02/05/14:
http://circwatch.org/circumcision-lies-and-fetishism-at-the-university-of-sydney/

Another Critique of Morris' work 11/04/14:  http://freethoughtblogs.com/pharyngula/2014/04/11/should-you-circumcise-your-child/

Read This 2013 critique of Brian Morris in the Journal of Medical Ethics: http://jme.bmj.com/content/early/2013/08/16/medethics-2013-101614.abstract/reply#medethics_el_16775

Sept 2013, the most recent and excellent critique of Morriss's qualifications and credibility: http://joseph4gi.blogspot.ca/2013/09/australia-circumcision-debate.html


In Aug 2013 Morris published a paper regarding circumcison and sexual satisfaction, read a critical review of that paper here: http://circleaks.blogspot.com.au/2013/08/does-male-circumcision-affect-sexual.html

Here is a critic of Morris's circumcision advocacy and his war on the foreskin: http://intactivistsofaustralasia.wordpress.com/2013/09/09/minority-reporter-how-brian-morris-fought-a-personal-war-against-the-human-foreskin-and-how-he-lost/


Most recently Morris was called a bully in response to a peer review journal criticism.  The reseach by Morten Frisk found circumcision harmful to both male & female sexuality and Morris tried to have this research banned from publication, and used bullying tactics to try and achieve this.   http://www.circinfo.org/Circumcision_and_sexual_function.html

Also Recently, Brian Morris, & colleagues Cooper & Wodek were found to have Mis-represented the circumcision rates in Australia, claiming in the Australian Medical Journal that current circumcision rates had reached 19% for Australia, when in fact Medicare statistics show current circumcision rates have never exceeded 13% for the whole of Australia.  The 19% figure comes from one state of Australia (NSW), how do 3 highly intelligent men make such a basic error of reporting? Makes one wonder when the obsession for infant circumcision is so strong, that maybe perceptions are skewed??? Below is a critique found on the Circumcstitions website, well worth a read, highlights mutiple episodes of mis-representation  for a man (a biochemist) who is not a pediatrician or urologist or medical doctor yet claims expertise in circumcision?

Again, recently in the Medical journal of Australia 8 letters were received which strongly criticised the proposal by Cooper, Morris, & Wodek that infant circumcision was akin to a surgical vaccine for HIV :  http://www.circinfo.org/MJA_Cooper_letters.html
http://www.circinfo.org/MJA_Cooper_letters.html



His hobby-traveling to mass circumcision rituals to view and film:
Quotes from “personal” website of Brian Morris:
“I have some wonderful photographs of a group of Masai boys in their early teens that I met in Kenya in 1989 dressed in their dark circumcision robes, with white feathers as headwear, and white painted facial decoration that stood out against their very black skin.
Each wore a pendant that was the razor blade used for their own circumcision. The ceremony that they had gone through is a special part of their tribal culture and was very important to these boys, who were proud to show that they were now ‘men’. In other cultures it is associated with preparation for marriage and as a sign of entry into manhood.”
And his site links to proven circumfetish sites (and vice-versa).. and the usual testimonials present in all fetishist sites.
Reviews of his book which contains info from his site–including one from the Jam and from some of his fellow Austs..
Brian Morris is a professor of Molecular Biology and hypertension-field of study at the Univ Of Sidney, Aust HE is NOT a MD nor a circumcision expert.
The Journal of Australian Medicine (1999, vol.11, no.11, p.18), which has no apparent interest in either defending or condemning circumcision, has reviewed Dr. Morris’ book and given it a thumbs down. Here’s an excerpt from that very sensible review:
“In those with a normal bladder and kidneys the argument for circumcision may be akin to suggesting prophylactic removal of the tonsils or the appendix; the latter are obviously as silly as taking seriously any study supposedly concluding that either version of the penis ‘looks better’.
Also, is the author really serious in suggesting that routine circumcision is needed to prevent zipper injury? Unfortunately, once again, a presentation on the subject of circumcision has not advanced the development of a scientific approach.”
Reviewer: A reader from Bond University Men’s Health Research Center, Gold Coast, Queensland, Australia September 2, 1999 This book was reviewed (above) in “glowing terms” by a physician, who openly admits to having circumcised a large number of unconsenting minors (who happen to be boys). Consequently, he has a vested interest in promoting genital reduction surgery (erogenous foreskin amputation). Are physicians now to take their medical advice from obsessive genital cutters, rather than from recognized professional bodies? Not one national medical association anywhere in the world recommends unnecessary circumcision!
This book selectively cites outdated studies many of which have been thoroughly discredited in the scientific medical literature for decades. For example, this book states that penile cancer is reduced by circumcision. Nothing could be further from the truth.
Representatives of the American Cancer Society (Feb 16, 1996) stated that infant circumcision is not a valid or effective measure to prevent penile cancer which affects only one in 100,000 males.
The Australasian Association of Paediatric Surgeons stated (April, 1996) that “neonatal circumcision has no medical indication.”
The Queensland Law Reform Commission (Dec, 1993) stated that “routine circumcision could be regarded as a criminal act.”
The primary dictum of ethical medical practice is “First do no harm.” Yet there is now overwhelming evidence that infant circumcision causes irreparable harm physically, sexually, and psychologically.
Much of the life-long harm caused by imposed genital cutting (on unconsenting minors) is documented in the British Journal of Urology, 1999 (Vol 83, Supplement 1). Also see website: http://www.cirp.org/ <http://www.cirp.org/>  listed by the British Medical Association.
Gregory J. Boyle, Ph.D Professor of Psychology and Director, Men’s Health Research Centre Bond University, Gold Coast 4229 Australia BOOK LACKS SCIENTIFIC EVIDENCE AUSTRALIAN MEDICINE, 1999, Vol. 11 (No. 11), p. 18. by Professor Paddy Dewan Extract — “….[The author] understates the nature of the procedure, omits several potential complications and downplays the importance of circumcision to the income of American doctors. Also, Dr Morris omits to mention the medical treatment of phimosis, and he overstates the adverse events associated with phimosis when he states that “as a result of phimosis, males will be unable to urinate. The bladder fills up and urinary retention becomes a painful, alarming and dangerous experience”. This is a marked variance to the many boys who usually present with minimal symptoms with phimosis, which is easily treated by the application of steroid cream for four to six weeks.
“The increased risk of urinary tract infection in uncircumcised boys is probably real, but it remains arguable if the data used to support circumcision is analysed more critically. Even so, circumcision for boys with renal anomalies, that is, those having intermittent catheterisation or with immune deficiencies, is probably appropriate–these arguments are not presented in Dr Morris’ book. In those with a normal bladder and kidneys the argument for circumcision may be akin to suggesting prophylactic removal of the tonsils or the appendix; the latter are obviously as silly as taking seriously any study supposedly concluding that either version of the penis “looks better”. Also, is the author really serious in suggesting that routine circumcision is needed to prevent zipper injury?
Furthermore, he chooses to select penile cancer figures that support his argument, then proceeds to accuse the anti-circumcision group, NOCIRC, of “distortions, anecdotes and testimonials”, and Dr. Paul Fleiss of “off the wall statements” to support his case to keep the foreskin. Dr Morris then concludes, “if anything, circumcision by freeing the penis of the encumbrance of a foreskin can only serve to enhance penis size”.
“In quoting a Forum magazine study, referring to the opinion of a “Seinfeld” character and stating that “the uncircumcised man may need several showers per day”, further undermines Dr Morris’ efforts to have us take seriously the data otherwise collected. Unfortunately, once again, a presentation on the subject of circumcision has not advanced the development of a scientific approach….”
Professor Paddy Dewan is a Paediatric Urologist from the Royal Children’s Hospital, Melbourne.
Dr. James Powell from Chicago, Illinois , October 28, 1999 A book without emotions…..or FACTS! I find it totally ridiculous that such a book exists in which the author makes his claims on completely anecdotal grounds. There are few facts presented in this book. You will not find the information you need to educate yourself about this topic in this book. If you want GOOD information from people that know what they are talking about, refer to the vast multitude of anti-circumcision facts that are on the internet, or the vast amount of more factual books available. And please avoid Mr. Morris’s own website as you will find nothing but the same delusions on it as in his book.
Dr Morris recently wrote a letter to the Medical Journal of Australia to promote circumcision.
Here is the response by the authors:
“The letter by Morris is more difficult to discuss as it relates, on the whole, to the use of routine circumcision, which was not the focus of our article. The issues raised by Morris seem to be at complete odds with the 2002 Policy Statement on Circumcision by the RACP — which is also consistent with the recommendations of the Canadian Paediatric Society and the American Academy of Paediatrics.4 The RACP Policy Statement reviewed most of the points raised by Morris, including urinary tract infections, STDs, human papillomavirus and carcinomas of the cervix and penis. In each case, after an extensive review of the literature, the RACP reaffirmed that there is no medical indication for routine circumcision. Morris’s view on the reduction of risk of sexual problems is at odds with the article by Darby,9 published in the same issue of the Journal as our article, and is beyond the scope of our study. His claim that circumcision improves appearance is highly subjective and unsubstantiated, and should not be used to justify the surgical removal of tissue that may have a benefit to the individual later in life”
His deceits:
Dr. Brian J. Morris, Ph.D. is a biochemist at the University of Sydney.
He has written a very pro-circumcision page on the Internet.
His page is full of errors. He frequently misrepresents his sources. Many of his sources are on the CIRP so one should go there and read them to see what they really say.
For example, Dr. Morris writes”
“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 [6]. In this document medical practitioners are now urged to fully inform parents of the benefits of having their male children circumcised.”
In reality, the Australian College of Paediatrics states:
“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. Up-to-date, unbiased written material summarising the evidence in plain English should be widely available to parents.”
Dr. Morris omitted risks. See
Dr. Morris originally had his pages on the departmental board at the U. of Sydney. He was forced to move his pages to the personal pages section because of professional criticism of his diatribe.
For commentary on Dr. Morris’ work please go here:
The essay “Medical Benefits From Circumcision” by Brian Morris is a case study in misinformation! For example … Morris – “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. In this document medical practitioners are now urged to fully inform parents of the benefits of having their male children circumcised.”
Australian College of Paediatrics – “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.”
Morris says that the ACP urged that parents be fully informed of the benefits, but he totally ignores their recommendation that parents also be fully informed of the risks.
Morris – “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.”
Canadian Paediatric Society – “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.”
In 1982 the CPS took a position against routine infant circumcision because “there are no valid medical indications for circumcision in the neonatal period.” The CPS did not change their position against RIC in 1996. Morris conveniently ignores the Canadian Paediatric Society’s opposition to routine infant circumcision.
Morris – “The American College of Pediatrics has moved far closer to an advocacy position …”
The Department of Pediatrics at Johns Hopkins University has a web page that lists many pediatric organization. There is no organization called the “American College of Pediatrics”. The following are among the many organizations they list – American Academy of Pediatrics, American Pediatric Society, and American Pediatric Surgery Association.
“Pediatric Points of Interest” compiled by the Department of Pediatrics at Johns Hopkins University http://www.med.jhu.edu/peds/neonatology/organ.html#Organizations <http://www.med.jhu.edu/peds/neonatology/organ.html#Organizations>
Also “American College of Pediatrics” is not listed in online phone directories.
Morris has probably confused the American College of Pediatrics with the American Academy of Pediatrics. Assuming that is what he did, let’s look at the statement, “The American Academy of Pediatrics has moved far closer to an advocacy position …”
The American Academy of Pediatrics (AAP) issued statements on routine infant circumcision in 1971, 1975, 1983, and 1989.
AAP (1971) – “there are no valid medical indications for circumcision in the neonatal period.”
AAP (1975) – “there is no absolute medical indication for routine circumcision of the newborn.”
The AAP reiterated their 1975 position again in 1983.
AAP (1989) – “Newborn circumcision has potential medical benefits and advantages as well as disadvantages and risks. When circumcision is being considered, the benefits and risks should be explained to the parents and informed consent obtained.”
While it may be “technically” correct to say that the AAP has “moved closer to” an advocacy position, the statement by Morris is misleading because the AAP has *not* taken an advocacy position in favor of routine infant circumcision. A more correct statement would be, “The American Academy of Pediatrics has softened its opposition to routine intact circumcision.” Softening one’s opposition to a policy is not the same thing as advocating that policy.
Later in the article Morris again misrepresents the position of the American Academy of Pediatrics (AAP).
Morris – “The trend not to circumcise started in the mid to late 1970s, after the American Academy of Paediatrics Committee for the Newborn stated, in 1971, that there are ‘no valid medical indications for circumcision’. In 1975 this was modified to ‘no absolute valid … ‘, which remained in the 1983 statement, but in 1989 it changed significantly to ‘New evidence has suggested possible medical benefits …’”
The sentence that Morris quotes from the 1989 AAP report is in the introduction, not the conclusion. The conclusion of the report states clearly that there are both potential medical benefits and risks. Morris does not mention the disadvantages and risk of infant circumcision. He leaves the impression that the AAP only mentions benefits.
AAP – “Newborn circumcision has potential medical benefits and advantages as well as disadvantages and risks. When circumcision is being considered, the benefits and risks should be explained to the parents and informed consent obtained.”
Actual statements by Aust Ped societies:
Australasian Association of Paediatric Surgeons. Guidelines for Circumcision. http://www.cirp.org/library/statements/aaps/ <http://www.cirp.org/library/statements/aaps/>
“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.”
“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.”
“Neonatal male circumcision has no medical indication. It is a traumatic procedure performed without anaesthesia to remove a normal functional and protective prepuce. At birth, the prepuce has not separated from the underlying glans and must be forcibly torn apart to deliver the glans, prior to removal of the prepuce distal to the coronal groove.”
AMA (Aust):
The AMA will discourage circumcision of baby boys in line with the Australian College of Paediatrics’ Position Statement on Routine Circumcision of Normal Male Infants and Boys.
The statement, released in June and supported by the AMA’s November Federal Council meeting, includes: The Australian College of Paediatrics should continue to discourage the practice of circumcision in newborns.



Now if you think this man has any credibility as an unbiased objective commentator on infant circumcision–you need to think again.