Talk:Circumcision/Archive 23

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Jakew making the RACP quote POV...

First, note that the section heading is Policies of various national medical associations; and the RACP nations in question are Australia and New Zealand. Take note two critical statements removed by Jakew ... "without proven medical benefit," and "no evidence of benefit outweighing harm for circumcision as a routine procedure in the neonate." Here's my version, with few edits to original statement:

====Australia and New Zealand====

The Royal Australasian College of Physicians position is as follows:

The Paediatrics and Child Health Division, The Royal Australasian College of Physicians (RACP) has prepared this statement on routine circumcision of infants and boys to assist parents who are considering having this procedure undertaken on their male children and for doctors who are asked to advise on or undertake it. After extensive review of the literature the RACP reaffirms that there is no medical indication for routine neonatal circumcision.[emphasis in original statement]

Circumcision of males has been undertaken for religious and cultural reasons for many thousands of years. It remains an important ritual in some religious and cultural groups. …The best recognised medical indication for circumcision is phimosis.

In recent years there has been evidence of possible health benefits from routine male circumcision. The most important conditions where some benefit may result from circumcision are urinary tract infections, HIV and later cancer of the penis.
…

The possibility that routine circumcision may contravene human rights has been raised because circumcision is performed on a minor and is without proven medical benefit. Whether these legal concerns are valid will be known only if the matter is determined in a court of law.

If the operation is to be performed, the medical attendant should ensure this is done by a competent operator, using appropriate anaesthesia and in a safe child-friendly environment.

Review of the literature in relation to risks and benefits shows there is no evidence of benefit outweighing harm for circumcision as a routine procedure in the neonate.

— ROUTINE CIRCUMCISION OF MALE INFANTS AND BOYS - SUMMARY STATEMENT, Royal Australasian College of Physicians

And here's Jakew's reversion:

====Australasia====

The Royal Australasian College of Physicians position is as follows:

The Paediatrics and Child Health Division, The Royal Australasian College of Physicians (RACP) has prepared this statement on routine circumcision of infants and boys to assist parents who are considering having this procedure undertaken on their male children and for doctors who are asked to advise on or undertake it. After extensive review of the literature the RACP reaffirms that there is no medical indication for routine neonatal circumcision. (emphasis as in the original document)

If the operation is to be performed, the medical attendant should ensure this is done by a competent operator, using appropriate anaesthesia and in a safe child-friendly environment.

In all cases where parents request a circumcision for their child the medical attendant is obliged to provide accurate information on the risks and benefits of the procedure. Up-to-date, unbiased written material summarising the evidence should be widely available to parents.

— ROUTINE CIRCUMCISION OF MALE INFANTS AND BOYS - SUMMARY STATEMENT, Royal Australasian College of Physicians

TipPt 19:37, 3 February 2007 (UTC)

Already discussed at length in Talk:Circumcision/Archive 21. Jakew 17:31, 4 February 2007 (UTC)

Where Jakew basically says it needed condensing, that we can't violate copyright (a strange argument), and it meets editors needs. It's very pro-circ for Jakew to remove critical text from the CPS and RACP statements.TipPt 00:52, 5 February 2007 (UTC)

Why on earth do you consider avoiding copyright violations to be 'strange'? Jakew 10:44, 7 February 2007 (UTC)

I tried writing here at an earlier point but realize that Jakew may be what we call a troll that has a need to dominate this subject. Veffari 17:26, 13 February 2007 (UTC)

Taddio

Taddio's paper was very influential with Dr Greene [1] and of course with the AAP. Although Taddio described their paper as speculative, the paper had a great impact.Michael Glass 02:52, 5 February 2007 (UTC)

It seems rather pointless to estimate the impact of Taddio's paper, Michael. The AAP noted that "One report has noted that circumcised infants exhibit a stronger pain response to subsequent routine immunization than do uncircumcised infants." Let's not speculate about how meaningful that statement is. Jakew 10:11, 5 February 2007 (UTC)

It means what it says, Jake, and it is significant that the AAP changed its policy. Google Scholar reveals that Taddio's paper was cited by 257 others [2]. By comparison, the Auvert study has at this point been cited by 84 and Laumann's study was cited by 104. [3]. Michael Glass 12:55, 5 February 2007 (UTC)

We know that the AAP changed their policy, Michael, but we don't know why. Specifically, we cannot say whether it was due to Taddio's paper, another paper, or a combination of factors. The number of citations does not necessarily indicate acceptance - it could equally be criticism. Regardless, any use of the number of citations is original research by definition.

All I'm saying is let's stick to the known, published facts. Jakew 09:22, 6 February 2007 (UTC)

How is using the number of citations in Google Scholar "original research"? Referring to the number of citations - with a link to back it up - is simply a matter of publishing information that Google has gathered. Also, please note that the text as it stands does not say that the AAP's change in policy was due to Taddio's paper. It sticks to known facts: Taddio published her study, she said that it was speculative, nevertheless it was widely cited in scholarly literature, including in the AAP policy which, for the first time called for pain relief for infants. Now, if there are other factors in this change of policy, such as other papers by Taddio or others, then let us add that information to the article. Michael Glass 09:43, 6 February 2007 (UTC)

Michael, please think about this. Google Scholar is a database, not a publication. True, it can be queried, but a query is original research. Similarly, one can imagine a device that automatically counts stars of a certain magnitude in a specified section of the sky. If those results haven't been published, then using those is another example of original research, whether one specifies the methodology (parameters) or not.

Now, I'm not saying that the text does speculate about the cause the change in policy. I'm just saying that we shouldn't. Jakew 10:43, 7 February 2007 (UTC)

Jake, if querying Google is by definition "original research" then we might as well pack up and go home, because everything is original research. It wasn't a matter of counting the papers, it was simply a case of reading the screen! There's no difference between this and using Google to look up any other information. So I think your analogy with the stars falls down Michael Glass 12:31, 12 February 2007 (UTC)

Michael, there is a difference between the following:

• User:Jakew searched the Manchester library catalogue for 'circumcision' and found seventeen books listed.
• Encyclopaedia Britannica (1971 edition), in the article 'circumcision', states "(quotation)".

The first is original research. No verifiable, published source exists(*) to confirm my claim. The second is not, because it explicitly cites a single, published work. It doesn't matter how that material was found - whether you search a catalogue or chuck a grenade into a library and catch the first book that flies out, it's still the same book.

Similarly, if one uses Google to locate a specific published work, then that is fine. But Google searches themselves are original research - the emphasis is on what work others have done, not what you've done.

(*) - hypothetically, of course, someone may have published a paper on 'Google searches for circumcision' or 'library catalogue listings for circumcision'. In which case, quoting such a paper is not OR. But repeating the searches, or creating new ones, is OR. Jakew 13:15, 12 February 2007 (UTC)

Jake, if you counted up the books on circumcision in the catalogue of Manchester Library, that would be 'original research'. However, if the database already had a count of the books in the library, the work would have been done for you. Now in the case of Google Scholar, it's simply a case of looking up the information. It therefore fulfils your condition of someone having published the information already. Yes, it's done in a different way and in a different style, but it's been published nevertheless. It's just a matter of looking it up and quoting it! Even by your own argument, the citation count in Google Scholar is published material. In fact, the proof of that is that I can give a link to where it is published. It's the same as quoting from any other database, such as that for Medicare, Australia. The only difference is that quoting the number of citations to an article in Google Scholar is a darned sight easier! And that, I hope, is the end of it. Michael Glass 13:35, 13 February 2007 (UTC)

Michael, the Google search has not been published. It is a database query, generated in real time in response to the search criteria. The link just tells Google what to search for. In effect, it is a miniature computer program. It may be convenient, but it is still OR. Jakew 14:07, 13 February 2007 (UTC)

Avi claiming to know "undue weight"

His excuse for reverting is personal. He objects to facts being revealed to the reader.[4]

He now bears responsibility for readers not knowing circumcision is extremely painful and to request and expect a ring block.TipPt 13:23, 6 February 2007 (UTC)

Tip, you REALLY need a wikibreak. This article is consuming you beyond the point of logic. I'm serious, Tip, I'm getting a bit worried about you. At one point there seemed to be some type of rapport in which people could acheive the optimal article; now you seem to have turned this into a crusade, not to mention ad hominem personal attacks, which serves NO ones interest, especially yours. -- Avi 05:38, 6 February 2007 (UTC)

Avi, you and Jake do not own the circumcision article. Tip is trying to add relevant, cited information to the article. -- DanBlackham 08:59, 6 February 2007 (UTC)

When Tip or anyone else does so in a way that conforms to policy, rest assured that nobody will object, Dan. In the meantime, please note that policy notes that "Individual users thus enforce most policies and guidelines by editing pages, and discussing matters with each other." Jakew 09:36, 6 February 2007 (UTC)

Tip, you should really read Wikipedia is not a soapbox. We're not here to change the world; just to write an encyclopaedia. The fact that you're blaming other editors for infants' pain is a clue that instead of working towards the neutral point of view you want to advocate a specific point of view. Jakew 09:36, 6 February 2007 (UTC)

We are dealing with specific changes, and each should be considered individually. I presented them individually. Blanket reverts do not help.

An editor blocking the reader from reading that circumcision is extremely painful takes some responsibility for readers who then do not take actions to ensure that their child is provided proper pain control. It's THE basic Wiki precept to provide relevant fact. See above, I changed blame to shared responsibility.TipPt 13:59, 6 February 2007 (UTC)

Your soapbox is showing, Tip. -- Avi 07:38, 7 February 2007 (UTC)

You bias is evident:

Avi removes these two sentences.[5]

The first was taken out of Judiasm:

The original Brit milah consisted of excising the foreskin tissue which extended beyond the tip of the glans penis, while current practice (Brit periah) removes the foreskin to completely expose the glans.

Without a reliable and verifiable source, it is original research as well as WP:NPOV as its purpose is to cast aspersions on the process today. Tip, unfortunately, your history is painfully self-evident, and your claims of other editor's biases are completely negated by your own. Sad, but true. -- Avi 17:04, 9 February 2007 (UTC)

Will you leave the sentence in when it has a verifiable source? The sentence stands for itself, you do not judge it's purpose nor the readers interests or need to know.TipPt 17:16, 9 February 2007 (UTC)

The source you originally showed me was not a verifiable and reliable source. If you really wish to know what the procedure was, you have to look at the centuries (and millenia) old texts of the Talmud, Maimonides's Mishneh Torah, the Rosh, the Rif, the Beth Yosef and Shulchan Aruch in Yoreh Deah, and around twenty or so of the greatest responsa texts. Have you? I am certain you cannot even READ the original Aramaic or Hebrew. So how do you purport to know what the original procedure was? Some genital integrity site with NO idea of Jewish learning and tradition CANNOT be a reliable source for stating what the procedure was 500 years ago, let alone 2500 years ago. -- Avi 17:21, 9 February 2007 (UTC)

I am not qualified; thus defer to journal articles. Take your pick of references:[6][7][8]TipPt 18:19, 9 February 2007 (UTC)

David L. Gollaher (PhD in History of Science from Harvard, National Endowment for the Humanities Fellow) in his book Circumcision: A History of the World's Most Controversial Surgery (2000 New York: Basic) also discusses the institution of periah on pages 16-17. I think he rises to the standards of both reliability and verifiability.Zandrous 19:10, 9 February 2007 (UTC)

As a tertiary source, we must refer to such secondary texts. If any special, obscure knowledge were gained by any of us reading "the original Aramaic or Hebrew", as suggested by Avi, that clearly would be WP:OR. I think there is already rather too much quoting from primary medical sources in this article as it is. --Nigelj 23:30, 10 February 2007 (UTC)

(Outdenting)Please read WP:CITE. The Talmud et. al. is a realiable and verifiable source according any and all wiki standards. Secondly, sources in other languages are acceptable in wiki (see Mahmoud Ahmadinejad for example). Perhaps you should re-read WP:OR. Thanks. -- Avi 13:12, 11 February 2007 (UTC)

I'm perfectly familiar with the policies, thank you, Avi. From WP:OR: "Articles should only contain verifiable content from reliable sources without further analysis", "anyone—without specialist knowledge—who reads the primary source should be able to verify that the Wikipedia passage agrees with the primary source", "most articles should rely predominantly on secondary sources", etc. (my emphasis added here). Translation and interpretation of 500 - 2500 year-old texts in any language is a very skilled process - even current languages evolve. Adding references to such in the original language would be meaningless to the vast majority of readers and translating them yourself would be OR. What a tertiary source needs is reference to established academic translations and analyses of the texts, i.e. secondary sources. Trying to win your argument above with the point, "you cannot even READ the original Aramaic or Hebrew. So how do you purport to know..." is not acceptable as that would exonerate you from providing verifiable references to support your special knowledge - precisely the opposite of working with a team, by consensus. --Nigelj 21:55, 11 February 2007 (UTC)

The second is taken out of risks/anesthesia:

Fitzgerald et al conclude that early tissue trauma and pain in infants may “disrupt normal synaptic organization within the somatosensory system” that, though research was considered incomplete, “can have long-term consequences on sensory or pain behaviour that extend into childhood or beyond."[9]

Avi, please read fitzgerald. Multiple citations from other studies. Incomplete does not mean not relevant!TipPt 16:44, 9 February 2007 (UTC)

But being that this is a general article, and NOT a compendium of EVERY paper EVER written, we have to choose the best articles, not ones specifically designed to highlight ONE particular point-of-view by one particular editor on a crusade, I am afraid. -- Avi 17:04, 9 February 2007 (UTC)

Again, read fitzgerald. He brings unique facts to the reader specific to effects of pain which can be a risk of circumcision. Your denying the reader of fact is specific evidence of pro-circ bias.TipPt 17:13, 9 February 2007 (UTC)

As Avi has noted, we must select the best, most relevant articles, not just those that support one particular point of view. Furthermore, Fitzgerald made those quotes about pain in general, not circumcision in particular. To use them in this article is borderline OR, and definite cherry-picking. Jakew 18:41, 9 February 2007 (UTC)

There are only two points of view around here: pro and anti. They must both be represented in the selection of (duly referenced) points made, surely? These guys are not trying to give weight to some other, irritating, new or obscure viewpoint - just to balance pro with anti, as we are duty bound to do here. --Nigelj 23:30, 10 February 2007 (UTC)

There are doubtless points of view between the extremes, Nigel. Regardless, we cannot include every single argument ever made, because it would require an enormous amount of space. We must select. This is true regardless of whether the argument is "for" or "against." We don't include every paper investigating the relationship between circumcision and HIV, but instead we include literature reviews and the highest-quality, most notable RCTs. Similarly, we don't include every paper discussing pain management - especially speculative arguments based on incomplete research - but the highest quality information instead (and again, with a preference for literature reviews).

The difference between Wikipedia and an advocacy site is that we're not trying to hammer the reader with 'facts' until (s)he gives up and 'accepts' the arguments. We're just trying to give him/her a summary of the best, most reliable information available. There is no harm in representing views within reason, but that is not the point of the exercise. The point is to inform. And to do that, we must sort the wheat from the chaff.

We certainly must not include arguments that were not made about circumcision specifically, however relevant individual editors (or cirp.org) think they may be. Jakew 10:16, 11 February 2007 (UTC)

The topic is circumcision, which "removes some of all" of the foreskin. For Jews, for half of their history ... it used to be part, currently it's all and a frenectomy too for 20 - 30%. That's a very material change to practice and it thus belongs in the main topic.

Avi, how can you ignore half of Jewish history? You insisted on calling it a "religious requirement" of your faith. Requirement to do what exactly? I'll find a better reference.

As for Fitzgerald, I'll try to find a reference linking his work to circumcision. I bet some GI proponent...TipPt 21:45, 12 February 2007 (UTC)

Policies of various countries

I found the following introduction to this section:

The medical associations noted below find the current data insufficient to recommend neonatal circumcision. They agree that parental choice remains a legitimate reason to perform the procedure.

The problem with this introduction is that it directs attention to just two points, whether the current data is sufficient to recommend [routine] neonatal circumcision and the legitimacy of parental choice in this area. However, the policies, as quoted, showed a much wider range of concerns, including the significance of the various findings about disease such as UTIs and penile cancer, or the overprescribing of circumcision for conditions that can be treated in other ways. The policies speak well for themselves; they don't need an introduction that is pushing just two aspects of the various points they make.Michael Glass 03:10, 7 February 2007 (UTC)

I don't entirely agree with your reasoning - it seems to me that we must summarise sooner or later - but I'm inclined to agree that the policies can largely speak for themselves. I would eventually like to see some kind of introduction, but in the meantime I think removing this is probably a good choice. Jakew 10:48, 7 February 2007 (UTC)

We already know the content of that section introduction from the topic intro paragraphs.TipPt 15:12, 8 February 2007 (UTC)

RACP Policy

I have changed the introduction to the quotation to point out that it is only an excerpt. I have also quoted more from the policy because it does make several important points, about the need for a child-friendly environment, the comment about the review of the literature and the question of the legality of infant circumcision. I believe that the legal comment should be quoted in full, even though some may regard it as contentious. Michael Glass 04:34, 8 February 2007 (UTC)

Correction to procedures/anesthesia Jakew reverted away....[10]

The Cochrane review only looked at EMLA and DPNB; it did not study ring block. Jakew's version is incorrect.TipPt 15:50, 9 February 2007 (UTC)

It was a review of pain relief for circumcision, which included EMLA, DPNB, and other forms (eg sucrose). It reviewed other comparisons, but did not technically make a comparison itself. Jakew 18:46, 9 February 2007 (UTC)

Pain as a potential risk of circumcision

Lander’s, in researching neonatal circumcision without anesthesia, found that without exception, newborns in this study who did not receive an anesthetic suffered great distress during and following the circumcision, and they were exposed to unnecessary risk. Two of 11 newborns in the study who received no local anesthetic had potentially dangerous episodes within minutes of the procedure.[11][12] Fitzgerald et al conclude that early tissue trauma and pain in infants may “disrupt normal synaptic organization within the somatosensory system” that, though research was considered incomplete, “can have long-term consequences on sensory or pain behaviour that extend into childhood or beyond."[13] Razmus et al reported that newborns circumcised with the dorsal block and the ring block in combination with the concentrated oral sucrose had the lowest pain scores, and Ng et all found that EMLA cream, in addition to local anaesthetic, effectively reduces the sharp pain induced by needle puncture. Stang et al argues that "performing a circumcision on a newborn without using anesthesia is justified, only if one would be willing to perform a circumcision on an older child or adult without anesthesia."

Jakew's revert looses a critical point ... that circumcision can be painful without anesthesia and may cause sensory harm. Here's all he wrote, and reverted back:TipPt 16:22, 9 February 2007 (UTC)

Razmus et al reported that newborns circumcised with the dorsal block and the ring block in combination with the concentrated oral sucrose had the lowest pain scores, and Ng et all found that EMLA cream, in addition to local anaesthetic, effectively reduces the sharp pain induced by needle puncture. Stang et al argues that "performing a circumcision on a newborn without using anesthesia is justified, only if one would be willing to perform a circumcision on an older child or adult without anesthesia." —Preceding unsigned comment added by TipPt (talk • contribs)

Another duplicate. Fitzgerald is discussed above. Jakew 18:50, 9 February 2007 (UTC)

Avi decides Fitzgerald is not relevant, and he removes a very critical sentence

Avi removes these two sentences.[14]

The first was taken out of Judiasm:

The original Brit milah consisted of excising the foreskin tissue which extended beyond the tip of the glans penis, while current practice (Brit periah) removes the foreskin to completely expose the glans.

The second is taken out of risks/anesthesia:

Fitzgerald et al conclude that early tissue trauma and pain in infants may “disrupt normal synaptic organization within the somatosensory system” that, though research was considered incomplete, “can have long-term consequences on sensory or pain behaviour that extend into childhood or beyond."[15]

Avi, please read fitzgerald. Multiple citations from other studies. Incomplete does not mean not relevant!—Preceding unsigned comment added by TipPt (talk • contribs)

Seems an entirely reasonable edit to me. The first lacks a cited, reliable source, and the second has been discussed in #Avi claiming to know "undue weight". I suggest that instead of complaining about other editors, you familiarise yourself with the important policies. Jakew 18:59, 9 February 2007 (UTC)

Here's a quote from a reliable, verifiable source to cite for the first sentence: "To discourage men from trying to restore their foreskins, the traditional operation was revised. Milah, as the first state of circumcision is called, simply meant cutting off a portion of an infant's foreskin. Still, enough of it usually remained to enable a surgeon to create something resembling an uncircumcised penis. To prevent this, probably around the middle of the second century, rabbis augmented milah with periah, a radical ablation of the foreskin that bared the glans entirely. Once established, periah was deemed essential to circumcision; if the mohel failed to cut away enough tissue, the operation was deemed insufficient to comply with God's covenant." from Circumcision: A History of the World's Most Controversial Surgery by David L. Gollaher. New York: Basic. P.17. Gollaher is well established as a scholarly writer and his book includes scrupulous references. Please discuss and feel free to make the appropriate change, or I will when I return after the weekend.Zandrous 11:33, 10 February 2007 (UTC)

Whether Gollaher is reliable or not I believe is irrelevant to THIS article. The above quote, and any corroborating and contradictory evidence, belongs in Brit Milah, not here. Why do you feel that periah needs to be discussed in the general circumcision article when we have a Judaism-specific one? -- Avi 14:01, 11 February 2007 (UTC)

Ah, forgive me, I missed you mentioning in the above discussion that you didn't believe the sentence to be appropriately located in this article, I only saw that you pointed out it's lack of an appropriate source, so I thought it would be helpful to provide one.Zandrous 14:33, 12 February 2007 (UTC)

Thank you. Perhaps I was not to clear either. While I personally believe that Gollaher is incorrect in his analysis, that would be pure WP:OR and unacceptable here in wiki. I think that I wold be able to find english sources that accurately encapsulate Orthodox Jewish tradition, and hold them up as superior references to the Jewish tradition than Gollaher is, which would address your point about "specialized research", although I am not 100% sure that Hebrew is any worse a language than French or Arabic for Wiki sources (cf. Mahmoud Ahmadinejad ), but I concur that Talmudic Aramaic may be (although there are english translations of the Talmud available to verify most sources). Regardless, in my opinion, Gollaher and those that have a different opinion as to periah needs to be discussed on Talk:Brit milah and, perhaps, eventually placed into the Bris Milah article, as that is specific and exclucive to the Jewish rite. -- Avi 14:58, 12 February 2007 (UTC)

The topic is circumcision, which "removes some or all" of the foreskin. For Jews, for half of their history ... it used to be part, currently it's all and a frenectomy too for 20 - 30%. Avi, how can you ignore half of Jewish history? You insisted on calling it a "religious requirement" of your faith. Requirement to do what exactly? I'll find a better reference.

The current text is inaccurate (saying only milah), and the change in practice is quite material; thus it will be in the main topic page.

As for Fitzgerald, I'll try to find a reference linking his work to circumcision. I bet some GI proponent...TipPt 22:04, 12 February 2007 (UTC)

Hey! Do not blank my comments from a talk page please!

What is this edit about? I am trying to engage in this problematic page in a constructive way in order to try to help improve its overall quality. I think I may be argued with, I may be proved wrong, but I think it is a grave contravention of some policy somewhere if my contributions are purposely blanked from discussions, whether I may have misremembered some unspecified thing or not. Please do not do that. --Nigelj 17:51, 11 February 2007 (UTC)

It was an accident; my apologies. -- Avi 20:43, 11 February 2007 (UTC)

Thanks for re-instating. Now we have a discussion - see above. --Nigelj 21:57, 11 February 2007 (UTC)

Margaret Somerville

I have added a reference to Margaret Somerville, the distinguished ethicist and Law Professor at McGill University, Canada. Her views have been quite influential, especially in Canada.Michael Glass 00:59, 12 February 2007 (UTC)

Michael, is there a need to start bringing indivivual people in the lead? It is clear in the lead that there is debate on the issue. Bringing indivisual doctors, professors, Rabbis, Imams, Priests, ethicists, accountants, or taxi drivers only serves to confuse and confound the prose. If there is a wiki article speifically about genital integritism and genital integritists, that is where she belongs, I believe. There are many respected people (doctors, lawyers, Rabbis, etc.) who support circumcision in the US and abroad. We don't bring THEM by name. -- Avi 05:18, 12 February 2007 (UTC)

Avi, why are you so dismissive of a Professor of Law and Medicine at one of Canada's greatest universities? Why do you compare her to a taxi-driver or an accountant as if her views on the ethics of circumcision account for nothing? Why do you want to dismiss her as a genital integritist? Did you really have to coin a new word so that you could name, brand, catalogue and dismiss her opinions? The reason for referring to Margaret Somerville and her position is to point out that a person of note has made a thoughtful and considered comment in this contentious area. Therefore I believe that it is totally appropriate to refer to her. I also believe that where well-known groups and distinguished and qualified individuals have made similar comments about circumcision then it is appropriate for the article to refer to their views or at least to provide a link to their views. The article refers specifically to Jewish and Muslim beliefs, and quoted extensively from the policies of medical associations in several countries. Similarly, it is appropriate to refer to Professor Somerville's views. Michael Glass 10:29, 12 February 2007 (UTC)

I have revised the text to make it more concise and restored the reference to Margaret Somerville to the text. I hope that the changes made will allay the concern expressed. Michael Glass 10:54, 12 February 2007 (UTC)

I am inclined to agree with Avi. It is quite clear that there is debate on the issue, and we do not need to include every single viewpoint that has ever been written in order to show this. Medical associations are clearly more notable than a single academic.

I'm not sure how important it is that Somerville is (or isn't) an intactivist, but for what it's worth, she has attended a NOCIRC symposium. Jakew 11:04, 12 February 2007 (UTC)

Please note that I have added the name of one person, not every single viewpoint. The arguments above appear to be of the straw man variety, or guilt by association. Michael Glass 11:56, 12 February 2007 (UTC)

Slippery slope would be closer. If we include Somerville, then that sets a precedent of including every Tom, Dick, and Harry's opinion, with the eventual result being unreadable chaos. It's better to set a fairly high standard of notability and apply it consistently. Jakew 13:22, 12 February 2007 (UTC)

If we are willing to back to Biblical days, I am sure I can list over 100 individually notable people who are proponents of circumcision, with around 20 from the late 80's and 90's alo with at least as much credibility in their fields as Sommerville has in hers. The article would then turn into a p*ssing contest, and with 3500 years of recorded history, Orthodox Judaism would likely have the longest list. That is rediculous. We mention the main camps in the lead. We give MORE than lip service to each in the text. This is neither the article for genital integrity, NOR the article for circumcsion advocacy. This is the article on the PROCESS. If there exists a genital integrity or "Anti-Circumcision" article on wikipedia, then Ms. Sommerville belongs there, but to add her here is 1) undue weight (why is she any more special than, let's say Rambam, rashi, Joseph Karo, Rama, Moses Feinstein, Yoel Teitelbaum, to name a handful spanning 1000 years of recorded, verifiable, and reliable history? Michael, let us build this article properly, without trying to surreptitiously and subtly add specific undue influences out-of-proportion to existing literature and history. Thanks. -- Avi 15:05, 12 February 2007 (UTC)

Avi, If you're so sure you have contemporary people of equal eminence to Margaret Somerville arguing a different point, why didn't you name them? Even if it is the dreaded undue weight to mention Margaret Somerville at this point in the text, why did you suppress the link? All you are doing is revert, revert, revert. The text is not neutral when it pits 'circumcision advocates' against 'the genital integrity movement'. It is more neutral to talk of 'those advocating' and 'those opposed' . The edit is not neutral when it suppresses the link as well as the name. As both of you have only argued against the name and neither of you has argued against the link, nor said a word against using more neutral language, I am going to restore the link and the the neutral language to the text and I expect you both to leave it alone. Michael Glass 19:48, 12 February 2007 (UTC)

I did . Moses Feinstein, Yoel Teitelbaum, and Shlomo Zalman Auerbach all lived within end of the twentieth century for starters. Regardless, it does not matter. The lead of this article should not have specific names, from any side. It should list the "camps" as it were, and that is all. Regarding your point about "naming" I can agree with that, and I will adjust the text accordingly. -- Avi 20:04, 12 February 2007 (UTC)

Further, unlike the dispute over the accuracy and dissemination of the translation of Mahmoud Ahmadinijead's fomous statement, no one disputes the veracity of either claim in that paragraph, so one source for each should suffice. I redid the Sommerville reference to accurately reflect that it is an excerpt from a book, as opposed to a website. -- Avi 20:21, 12 February 2007 (UTC)

Avi, I appreciate the changes that you made. However, the arguments of Margaret Somerville should not be confused with those of other groups. People's arguments against circumcision are not like identical blocks of Lego. I have changed the text and restored the links to make this point clear. Michael Glass 21:38, 12 February 2007 (UTC)

Perhaps that is true, but the Circumcision article is not the place for demonstrating fine differences in theoretical opposition, that information more properly belongs here: Genital integrity. For this article it is sufficient to know that the camps reliably and verifiably exist, and I agree for this purpose, using the Sommerville reference (although not by name in the text) is more than adequate to pass WP:RS and WP:V. -- Avi 21:42, 12 February 2007 (UTC)

Avi, I'm glad you see that there may be differences in the opinions of those opposing circumcision. Therefore you can appreciate that it is important to be precise, so that we don't attribute one person's views to another person. Michael Glass 21:58, 12 February 2007 (UTC)

Then the answer is to find a better source, not overload the wrong article. I'll do some hunting around, too. -- Avi 22:01, 12 February 2007 (UTC)

There was a good article summarizing legal arguments against circumcision which should cover most of the reasons you listed, what happened to it? History check time. -- Avi 22:06, 12 February 2007 (UTC)

FOUND IT! . The Van Howe/Svoboda article in BJU International. It covers the bulk of the causes and is more scholarly than a pack of websites. Michael, this article is not the place to discuss 'activist websites' , you are thinking of the Genital Integrity article. -- Avi 22:27, 12 February 2007 (UTC)

Good. Michael Glass 22:34, 12 February 2007 (UTC)

Hey, Why did you remove my discussion about Non-Surgical alternatives to Circumcision?

I contributed some serious personal ideas about circumcision yesterday that have today been removed. Just because some nut posted a crazy insulting response is no reason to wipe my contribution out. If Wikipedia wants to be a serious resource for would-be parents of newborn baby boys who are contemplating circumcision, they should have all the facts they need. As the WP page on circumcision now stands, it is very academic and quite far removed from today's reality. As always, anyone who talks about their own penis is quickly censored. I request that my serious argument be reinstated to this Talk Page. Thanks, ````Brian B, Florida 12 February 2007 —The preceding unsigned comment was added by 67.191.87.154 (talk) 22:18, 12 February 2007 (UTC). Neither the talk page nor the article is a forum for "personal" ideas. Please read WP:TALK as well as WP:NPOV for more background on the purpose of wikipedia. Thanks. -- Avi 22:25, 12 February 2007 (UTC)

With Avi being Jewish and Jakew having submitted to voluntary personal adult circumcision in 2003 (from reading their profiles) it is clear that this topic is now being controlled by biased pro-circumcision WP monitors. The Wikipedia circumcision page has become too academic and the reluctance to post a photo of a screaming baby boy being circumcised is further proof of this bias. Recognising that every effort has been made to be neutral on this highly controversial subject, I find it bizarre that in the 21st century WP is nonetheless tacitly promoting cruelty to babies for archaic historic reasons. Why not be similarly neutral on the Holocaust and post published information from old Nazis and the president of Iran to promote that genocide? Or refer to Ku Klux Klan publications on why they supported the lynching of blacks? Or quote the Pope of how homosexuality is an intrinsically moral disorder? Surely there comes a time when the world moves on to recognise essential human rights and stops providing the discredited so-called alternative view. Nobody would support the caning or beating of schoolchildren today yet only a few decades ago it was regarded as normal practice. Cutting the foreskin off newborn baby boys penises is similarly reprehensible today and WP should recognize its moral responsibility on this subject and stop hiding behind the we-are-just-an-encyclopedia-of-facts excuse. Thanks ```` Brian, Florida 13th February 2007

I'd suggest you re-read WP:CIVIL and WP:NPA. Please restrict your comments to content, and not editors. Thank you. -- Avi 20:01, 13 February 2007 (UTC)

Thank you - I read both these guides. Sorry if you think my comments were inappropriate. But it's hard not to think about the vast numbers of defenceless babies being cut each day and that nobody is caring about being civil to them or personally attacking them. The first para of the WP circumcision page still reads like "it's an ancient and venerable tradition of man" and then followed by a long list of so-called medical benefits. Please try to give more prominence to the babies' human rights view now that we are in the 21st century. Wikipedia is getting some bad press lately for editorial bias, don't exacerbate this. I've said enough on the subject now. Thank you for your understanding ```` Brian 13 Feb 07

Don't apologize to these people. They ARE BIASED. They want to stroke their own egoes and I don't blame them. If I was a man and I didnt have my entire penis, I might spend my days trying to justify this type of mutilation. You're right 100% and AVI is just insecure. Sorry but this is the truth. This article will not be controlled by the pro-circs for much longer.—Preceding unsigned comment added by 24.167.107.118 (talk • contribs)

Michael, now I think you are crossing the NPOV line

We discussed this months ago. Metzitzah discussions belong in Brit Milah and using any term like "lobbying" is specifically to cast aspersions on Orthodox Jews. This is completely irrelevant to THIS article, if not the Brit Milah one also. I will politely request that you self-revert that last edit. -- Avi 02:03, 13 February 2007 (UTC)

Avi, Please look at the link that I provided. The article [16] said, "The ultra-Orthodox community lobbied the mayor, saying freedom to practise their religion was guaranteed by the US constitution." What I have added to the article, I believe, is a fair summary of this quotation.

• As a person of Jewish descent, I find your accusation that I was casting aspersions on Jews or any Jewish group unwarranted, inaccurate, offensive and unfair.
• Secondly, it is perfectly respectable for people to lobby politicians. That is certainly the case in Australia. If lobbying politicians in America has different connotations, please let me know.
• Thirdly, my statement was backed up by a report in a reliable source, namely, the British Medical Journal.
• Finally, it is necessary to understand that there was lobbying about Metzizah to make it clear that there were political as well as religious and medical considerations affecting the decision-making process.

The fact that we discussed this matter months ago is irrelevant. I came across evidence in a reliable source that said that the ultra-Orthodox Jews lobbied the mayor and I added it to the article. Please do not try to bully me. The rules of Wikipedia advise you to assume good faith. Please adhere to that policy. As I said before, I am willing to work with you to put the material in a way that does not cause unnecessary offence. However, that does not extend to suppressing facts. Michael Glass 12:24, 13 February 2007 (UTC)

Here is a good reference Avi

http://www.jewishencyclopedia.com/view.jsp?artid=514&letter=C

[17]

You might also look into Wiki ... Circumcision in the Bible, and also Brit Milah.

NOT including the text "The original Brit milah consisted of excising the foreskin tissue which extended beyond the tip of the glans penis, while current practice (Brit periah) removes the foreskin to completely expose the glans" is misrepresentation by gross omission.TipPt 02:26, 13 February 2007 (UTC)

The 100 year-old Jewish Encyclopedia actually isn't a very good reference. Anyway, it's the wrong article, TipPt. Try Brit Milah. Jayjg ^(talk) 22:29, 13 February 2007 (UTC)

Since you don't seem to disagree with the content, why debate the citation. The sentence can be sourced several ways, and your observation is odd in itself because the paragraph is not otherwise sourced.

Omission misrepresents, plus your revert is an inaccurate description of the actual circumcision! Remember, circumcision is the Topic.TipPt 02:05, 14 February 2007 (UTC)

The content is a claim about alleged ancient practices from a dubious source. It's not relevant to this article, nor is it properly sourced. Since you've pointed out that the article is already "too long", it's astonishing you would even think of inserting dubious trivia. Try the Brit Milah article, and please bring better sources. Thanks. Jayjg ^(talk) 02:47, 14 February 2007 (UTC)

You call Emil G. Hirsch, (Ph.D., LL.D., Rabbi, Sinai Congregation; Professor of Rabbinical Literature and Philosophy, University of Chicago; Chicago, Ill.) 'et al' a dubious source? You are not credible.

You are a very poor judge of relevance. Again, the topic is circumcision. The current text is not accurate.

Wiki says the article is too long. I think it's full of repetition, full of irrelevant info, and fairly boring.TipPt 05:20, 14 February 2007 (UTC)

Ah, I see, you're familiar with the work of Emil G. Hirsch? In what way is the "current text not accurate"? How will describing alleged religious practices of 2,500 years ago fix that? Jayjg ^(talk) 16:46, 14 February 2007 (UTC)

Jayig, on what grounds do you say that the Jewish Encyclopedia isn't a good source of information? Michael Glass 13:49, 14 February 2007 (UTC)

I've said it many times in the past. It's a hundred year old encyclopedia, written from a certain dogmatic point of view. Old scholarship like that is almost inevitably supplanted by much newer and more accurate or balanced scholarship. Jayjg ^(talk) 16:46, 14 February 2007 (UTC)

Here, then, is a more up-to-date source of information:

Many Hellenistic Jews, particularly those who participated in athletics at the gymnasium, had an operation performed to conceal the fact of their circumcision (1 Maccabees 1.15). Similar action was taken during the Hadrianic persecution, in which period a prohibition against circumcision was issued. It was probably in order to prevent the possibility of obliterating the traces of circumcision that the rabbis added to the requirement of cutting the foreskin that of peri'ah (laying bare the glans).

(The Oxford Dictionary of the Jewish Religion, ed. R.J. Zwi Werblowsky and G. Wigoder. Oxford University Press, 1997, page 161.)

This source is only 10 years old and comes from a reputable publisher. Would you have any problem with a reference to the Oxford Dictionary of the Jewish Religion? Michael Glass 00:33, 15 February 2007 (UTC)

BIASED

If the sexual effects of circumcision belong on the Genital Integrity page, then all of this biased information about HIV belongs on a web page that should be called POTENTIAL BENEFITS TO CIRCUMCISION. This article is about the procedure. Not what some Jewish doctors in Africa say circumcision can prevent. That is just as out of place as any other biased information on this page. I'm so glad my husband is NOT circumcised. I can't have an orgasm with 'cut' men. Choosing a circumcised man would be like choosing a dildo over a vibrator (vibrating dildo) becuase it looks prettier. —The preceding unsigned comment was added by 24.167.107.118 (talk • contribs).

Yes the articles here are truly bizarre and defending toward child mutilation. I do think "Genital Integrity" is a bad label, easily used without further discussion. Most of the worlds loving parents choose not to mutilate their child boys, so the mutilation itself is out of the ordinary, not the other way around. After all, men are born with a foreskin. —151.202.74.4 17:34, 13 February 2007 (UTC)

Circumcision photo

How can we have a topic of circumcision without shopwing a picture of the actual procedure? Can we have a topic of heart operation without showing the procedure? Here is an excellent photo that I recommend be added to the topic. It is of course highly relevant as it shows the procedure quite well. http://www.emediawire.com/prfiles/2005/03/11/217505/screamingbaby.jpg Perhaps you have another photo that could serve this purpose (getting permission etc of course) Thanks – — … ° ≈ ≠ ≤ ≥ ± − × ÷ ← → · § Veffari 17:24, 13 February 2007 (UTC)

Even if it were not copyrighted (by the Saturday Evening Post, according to the right-hand side of this page), it would be inappropriate for inclusion. Such an image is merely an appeal to emotion, unsuitable for an encyclopaedia. Jakew 17:30, 13 February 2007 (UTC)

Again, Jakew comments are biased on the subject. An article on eye surgery is certainly enhanced by an image of the procedure. http://en.wikipedia.org/wiki/Image:Cataract_surgery.jpg It is obvious bias and violation of NPV if you don´t want a photo of the procedure. – — … ° ≈ ≠ ≤ ≥ ± − × ÷ ← → · § 151.202.74.4 17:41, 13 February 2007 (UTC) (my signing tool isn't working properly. veffari

A photo of the procedure is a possibility, provided that it is appropriate and available under a suitable license. Jakew 17:58, 13 February 2007 (UTC)

Moral quandary

There’s lots of research finding high rates of infection associated with ritual circumcisions. Just search Google for "Jewish circumcision infection." A few of the pubmed articles are quite good.

The infection rates make circ UTI "benefits" look silly.

We need to present this information, but I've a moral problem; since the medical establishment seeks to hospitalize circs. Unfortunately, the end result of hospital circs is generally more radical than ritual circs ... tighter shaft skin, less mucosa remaining, and the frenulum damaged or removed more frequently. No research to cite, just observations of technique.

If I had to circ my infant son, it would be done by a Mohel, not a DR in a hospital. Possible a specialist, but those seem very rare (micro surgery and all that). I hate to provide information that drives the procedure into hospitals.TipPt 20:57, 13 February 2007 (UTC)

Suggestions to shorten the topic length?

The article is too long. Here are my suggestions:

• I think the Assoc statements should be put in their own sub.

• The medical benefits (HIV ect) should go into the existing med analysis sub.

• History should be higher in the outline.

• Prevalence of circ should all be in it's sub.TipPt 21:30, 13 February 2007 (UTC)

Sounds OK to me. Michael Glass 03:07, 14 February 2007 (UTC)

LOL! I have a better idea.

• Ethical issues in their own stub.
• Risks in their own stub.
• History in its own stub. Jayjg ^(talk) 16:00, 14 February 2007 (UTC)

Once again, the idea was to complete this article, with th eproper sources, and then spin off the subsections. I'm afraid we may not get there anytime soon, however. -- Avi 22:45, 14 February 2007 (UTC)

Unfortunately there are two conflicting goals. One is to have a logical, clear organisation in which there is encyclopaedic coverage of all relevant issues, with little or no repetitive and redundant duplication and/or replication (;-)) between articles. Another, sadly, is propaganda, in which it is vital that the most visible article includes and promotes the "desired" information and excludes the "undesired" information.

As many of us know all too well, such a situation makes changing a punctuation mark something of a challenge. Jakew 10:54, 15 February 2007 (UTC)

If we build it, they will come? I believe there is a consensus away for a parallel version, which then replaces the existing mess.TipPt 15:09, 15 February 2007 (UTC)

Sorry, I don't understand what you mean. Would you mind clarifying? Jakew 15:11, 15 February 2007 (UTC)

I believe what he means is that he has been trying for 9 months now to replace this well-written article, which quotes high-quality sources in a neutral way, with a pamphlet warning parents of the horrors of circumcision, how they expose their sons to mortal danger and in all likelihood permanently destroy their sons' only chance for happiness if they circumcise them. Jayjg ^(talk) 21:08, 16 February 2007 (UTC)

I suggest we create a new version. I'm guessing it would be avi, jakew, michael, and me. It's the only way to achieve sweeping change. It will be easy to get concensus to swap, given the current state of the article.TipPt 15:50, 15 February 2007 (UTC)

I suggest we finalize given portions of this article, and then copy it lock-stock-and-barrel to the spin offs, and write a summary here. -- Avi 17:42, 15 February 2007 (UTC)

Finalizing could take years, though most of what I wanted included is done. Lock-stock-and-barrel is a huge waste of work ... most of the summary writing is already done. We need a concise condensed Topic.TipPt 01:41, 17 February 2007 (UTC)

Controversy and Bias

Before the readers go on reading too much more, there needs to be a statement that all information given COULD BE BIASED. —The preceding unsigned comment was added by Woodstock2010 (talk • contribs) 06:08, 14 February 2007 (UTC).

It's probably only needed for stuff that you add to the article, and that usually doesn't last long, for obvious reasons. Jayjg ^(talk) 16:00, 14 February 2007 (UTC)

and the fact that no single person can dominate an article if others have valuable info is something that people like JAYJG or blue jay jay-z or whatever are JUST GOING TO HAVE TO LEARN TO LIVE WITH.—Preceding unsigned comment added by 24.167.107.118 (talk • contribs)

Metzitzah to clean the wound

It was traditionally believed that oral suction was needed to clean the wound. I have changed the wording to make clear that this was a tradional belief. The previous wording could be taken to imply that metzitzah actually cleans the wound. I have also removed other weasel wording about metzitzah. I know the subject is a sensitive one, so if others don't feel I got the balance right, please let's discuss how to say it better. Michael Glass 12:22, 14 February 2007 (UTC)

Do we really need to discuss this at all in this article? It is an aspect of (some) brit milah, but not of circumcision in general. It seems to me that anyone specifically interested in detailed aspects of a bris will be reading that article instead... Jakew 13:01, 14 February 2007 (UTC)

Firstly, the wording needed to be changed because the former wording could be misleading to some readers. Secondly, because of the public health implications of this practice, it needs to be at least touched on in a general article. Michael Glass 13:45, 14 February 2007 (UTC)

Are you certain? it is not part of a standard circumcision, only a Brit Milah. So it is likely out of scope. We are not discussing typhoid, even though that also is a health risk. -- Avi 22:46, 14 February 2007 (UTC)

Avi, I believe that it's well accepted that Metzizah b'peh has risks. However, that is not at issue in my change of wording. 'To clean the wound' implies that metzizah b'peh does indeed clean the wound. This is not a fact, but a traditional belief, and it is a belief that would be rejected by most doctors. Therefore the wording needs to be changed to something that does not carry this implication. Your point about metzitzah not being part of a standard circumcision is well taken, but it is a part of ritual circumcision for some Jews. As there are health concerns about this practice, I believe that it comes into the scope of this article. Michael Glass 23:14, 14 February 2007 (UTC)

And details about "ritual circumcision for some Jews" belongs in the article about "ritual circumcision for some Jews", or Brit Milah, no? -- Avi 23:42, 14 February 2007 (UTC)

Avi, as I understand you, your concern is not about the change of wording, but whether metzitzah should be discussed in a general article about circumcision. I believe it should be touched on because the article is not limited to medical circumcisions but is about circumcision in general. Therefore it also touches on circumcision practices in other groups. Michael Glass 00:12, 15 February 2007 (UTC)

The question is, should "touch on" include discussion of fairly obscure details of a "rare" practice that is advocated by a "a small number of Orthodox rabbis" (according to WebMD)?

To use an analogy, would you expect a general article on monotremes to include a discussion about the pharmaceutical treatment of a rare condition affecting echidnas, or would you expect to find such information in a more specific article?

I would say that the appropriate article should include details of the pros and cons of metzitzah, but that we should stick to more general facts about circumcision in this article. Jakew 10:42, 15 February 2007 (UTC)

Jake, I'm not trying to have a whole thesis on metzitzah in the circumcision article, but to have concise and accurate information on metzitzah expressed in a way that is not open to misunderstanding. Michael Glass 10:54, 15 February 2007 (UTC)

FWIW, I think some mention of metzitzah and the controversies in New York are worth mentioning here, as this story got some coverage in the New York Times and is the sort of thing that people hearing about in the major media might turn to Wikipedia for information on. Just a thought.Zandrous 13:49, 15 February 2007 (UTC)

Mordechai Halperin…

…is the Chief Officer of Medical Ethics, the Ministry of Health, Israel. As reliable and notable as anyone else in this article. -- Avi 05:34, 15 February 2007 (UTC)

I've just created an article on him too -- Avi 06:28, 15 February 2007 (UTC)

OK, but how does that mean you can distort the original covenant (in terms of actual practice)?TipPt 15:52, 15 February 2007 (UTC)

Its original purpose was to help healing. "Clean the wound" is a bit of a simplification/misstatement. I would rather take the words of a world-renknown physician, bioethicist, and Talmudic authority over New York Times beat-writer in this case. One has an inordiante expertise in both the physical and religious matters relating to this case, the other most probably did not know the difference between metzitza and mezuza before his article. I think the scholarly, reliable, and verifiable choice is obvious. Who is more of an expert on the orginal covenantm Halperin or Newman? -- Avi 15:59, 15 February 2007 (UTC)

The covenant

I don't really have a clue what Avi's talking about, sorry.

I do know that the original covenant is to remove just the tip of the foreskin … that procedure met religious requirements for half of Jewish history. The current text misrepresents both by omitting historical fact, and by it's grossly incomplete description of current practice. It misleads, by leaving the reader thinking that a radical circumcision is the covenant. Radical became a strong cultural ritual, but it's not God's requirement. Such omission is fraudulant.

We need something like... "The original Brit milah consisted of excising the foreskin tissue which extended beyond the tip of the glans penis, while current practice (Brit periah) removes the foreskin to completely expose the glans."http://www.jewishencyclopedia.com/view.jsp?artid=514&letter=C ...in the Topic.TipPt 17:20, 15 February 2007 (UTC)