Circumcision Information Network, Volume 3, Issue 19. Monday, 13 May 1996.
Introduction
This weekly bulletin is a project of CIN, the Circumcision Information Network (formerly CIN CompuBulletin). The purpose of this weekly bulletin is to educate the public about and to protect children and other non-consenting persons from genital mutilation. Readers are encouraged to copy and redistribute it, and to contribute written material.
--Rich Angell, Editor.
NEONATAL CIRCUMCISION DOES NOT PROTECT AGAINST CANCER Contributed by Frederick Hodges, typed by DYKS96A@prodigy.com (GEORGE HILL) BRITISH MEDICAL JOURNAL, (London) Vol. 312 no 7033 (March 23, 1996): pp. 779-780 Editor, - Although Morten Frisch and colleagues have made a valuable contribution to the study of penile cancer, they mistakenly repeat the myth that neonatal circumcision renders the subject immune to penile cancer.[1] The reference given for this statement is not an epidemiological study but an opinion article by the American circumcisionist Abraham L. Wolbarst in 1932.[2] Wolbarst invented this myth and was directly responsible for its proliferation; he based it on unverifiable anecdotes, ethnocentric stereotypes, a faulty understanding of human anatomy and physiology, a misunderstanding of the distinction between association and cause, and a unbridled missionary zeal. It was not based on valid scientific and epidemiological research. All subsequent repetions of this myth are traceable to Wolbarst's article, though Wolbarst himself advocated universal neonatal circumcision principally as a preventive for epilepsy, paralysis, and masturbation. Circumcisionists such as Wolbarst do not seem to have promoted this myth because they have a genuine interest in reducing penile cancer; they used it instead as a scare tactic to increase the rate of neonatal circumcision. It is surprising that sober scientists such as Frisk and colleagues could have relied on such a reference in their research. Edidemiological studies disproved Wolbarst's myth long ago. In North America the rate of penile cancer has been estimated to be 1 in 100,000[3] -- somewhat higher than the rate of 0.82 per 100,000 found by Frisch and colleagues. Maden et al reported penile cancer among a fifth of elderly patients form rural areas who had been circumcised neonatally and had been born at a time when the rate of neonatal circumcision was about 20% in rural populations.[4] Their study also shows that the rate of penile cancer among men circumcised neonatally has risen in the United States relative to the rise in the rate of neonatal circumcision. Science must look beyond normal human anatomy to discover the true risk factors for penile cancer. Current investigations into risks posed by infection with human papillomavirus (circumcised males have been shown to have an increased rate of such infection) and use of tobacco have been instructive.[5] Frisch and his colleagues have otherwise injected a welcome note of scientific rationalism into the debate over circumcision, which, despite the active participation of medical staff, is in essence an issue not of medical science but of human rights. PAUL M FLEISS Assistant clinical professor of pediatrics 8124 North Hillhurst Avenue Los Angeles, CA 90027 USA FREDERICK HODGES Medical Historian PO Box 5456 Berkeley, CA 94507 USA 1. Frisch M, Friis S, Kruger Kjaer S, Melbye M. Falling incidence oy penis cancer in an uncircumcised population. BMJ 1995; 311:1471 (2 December.) 2. Wolbarst, AL. Circumcision and penile cancer. Lancet 1932; 150-3. 3. Cutler SJ, Young JL Jr. Third national cancer survey: incidence data. Bethesda, Md. US Dept of Health, Education, and Welfare, Public Health Service, 1975. 4. Maden. C Sherman KJ, Beckman AM, Hislop TG, Teh CZ, Ashley RL, et al. History of circumcision, medical conditions, and sexual activity and risk of penile cancer. JNCI 1993;85:19-24. 5. Cook LS, Koutsky LA, Holmes KK. Clinical presentation of genital warts among circumcised and uncircumcised heterosexual men attending an urban STD clinic. Genitourin Med 1993;69:262-4. "THE FORESKIN IS NECESSARY" An article by Paul M. Fleiss. MD, MPH, and Frederick Hodges Townsend Letter for Doctors and Patients, April 1996. Contributed by typist DYKS96A@prodigy.com ( GEORGE HILL) Sixth of a multi-part series. Violation of Human Rights: Before introducing the policy of routine infant circumcision after World War II, circumcisers did not examine the human rights violation involved in the policy of forcing or even allowing unconsenting individuals to undergo surgery to amputate healthy penile tissue. More than just physical harm, circumcision causes political harm. Even if circumcision were physically harmless -- which it is not - it would still constitute a human rights violation. Furthermore, circumcisers have never shown that the stated public health goals could not have ben achieved by a less coercive policy than by foreskin amputation. The failure of the policy of mass circumcision to achieve the public health goals of reducing the rates of STDs, cancer, and genital infections is made more tragic in light of the harm, sexual dysfunction, morbidity, and risk of fatality unjustly inflicted on the past few generations of American males. Every male has the right to keep his birthright of an intact penis. Children have a right to expect parents or guardians to protect this right while they are still unable to protect it themselves. Parents and physicians have no right to remove health body parts from non-consenting individuals. In 1995, the American Academy of Pediatrics Committee on Bioethics agreed. According to their recent statement,(23) only a competent patient can give patient consent or informed consent. An infant is developmentally incompetent to consent to non-therapeutic surgery. The concept of informed parental permission does not apply to circumcision since the concept of informed parental permission allows only for medical intervention in cases of clear and immediate medical necessity, i. e., diseases, trauma or deformity; the natural human penis satisfies none of these conditions. Furthermore, since it is the infant and not the parent who must live with the consequences of this 'treatment' the individuals legal right to refuse treatment as well as the right to seek alternative treatment has been violated. Likewise the basic human right to autonomy, self-determination, and the right to an intact body as outlined in Article 5.1 of the American Convention on Human Rights(1969) and article 1.1 of the International Convention of Human, Civil, and Political Rights(1966) are violated by the performance of non-therapeutic circumcision. STUPID QUOTE OF THE WEEK "Is she, the mother, or father, are they really listening and submitting to the teaching of their religion or are they using their MIND and questioning things?" Majid Katme, President of the Muslim Medical Association, defending ritual circumcision in Victor Schonfeld's documentary "It's a Boy," which was aired in England, exposing the atrocities of ritual circumcision. FOR ADDITIONAL INFORMATION call NOCIRC, the National Organization of Circumcision Information Resource Centers at (415) 488-9883, fax (415) 488-9660. Ask about the resource provider nearest you. For written information, write NOCIRC, PO Box 2512, San Anselmo, CA 94979, with SASE and/or donation if possible. For further internet information, contact the Doctors Opposing Circumcision Web site at http://weber.u.washington.edu/~gcd/DOC.
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