This is an archive of past discussions about Circumcision. Do not edit the contents of this page. If you wish to start a new discussion or revive an old one, please do so on the current talk page.
From one of our External Links, under "circumcision promotion" (click on "No Clamps")[1]: The most commonly used clamps are the Gomco® and Mogen® type clamps. These clamps completely crush and sever the skin, the nerve endings and the blood vessels in a lengthy procedure causing extreme pain and trauma to the child. This may even cause the child to withdraw into a state of neurogenic shock in response to the sudden and massive pain. Great promotion of circumcision there. Should we move it to "circumcision opposition" or simply remove the link? Blackworm (talk) 20:56, 15 July 2008 (UTC)
Please, everyone, let's make this a pleasant editing environment for all participants, on the talk page and in edit summaries. ☺Coppertwig (talk) 21:26, 5 July 2008 (UTC)
It would be pleasant indeed if we did not edit each others comments. I have had to replace multiple post back to their relavant locations after being split incessantly. This goes against policy and threatens the sanctity of the page. Everyone makes mistakes, (I just split Blackworm's with my last one, sorry) but it's hard to assume good faith with such deliberations. Please respect each others comments. Garycompugeek (talk) 00:18, 12 July 2008 (UTC)
Blackworm, I apologize for editing your comment. After editing, I remembered this from WP:NPA: "for instance, stating "Your statement is a personal attack..." is not itself a personal attack."; therefore the words I removed were not a personal attack. Furthermore, Blackworm brought this part of WP:CIVIL to my attention: "Only in the most serious of circumstances should an editor replace or edit a comment made by another editor. Only in the event of something that can cause actual damage in the real world should this be the first step..." I hope this doesn't set us back too far in the process of moving towards resolution of existing problems. ☺Coppertwig (talk) 01:05, 12 July 2008 (UTC)
No problem, Coppertwig, I know you intended well. Garycompugeek, I think "sanctity" goes a bit far, but I agree that inserting comments in the middle of the discussion above previous replies to the exact same comment can easily be taken as disrespectful. Blackworm (talk) 01:46, 12 July 2008 (UTC)
To be honest, these days I don't much care what this page is named or whether it contains the word "surgical" or not, etc. What does concern me deeply is the level of discord: whether editors feel free to edit this page without finding themselves targets of what they perceive as uncomfortable or intolerable levels of incivility. I feel that I myself have been lucky to have very little of that sort of thing directed at me, but it pains me to see my fellow editors suffering. Of course, perceptions differ, and what to one person is an acceptable and relevant comment, to another is a personal attack. One pattern to try to avoid is mathematically equivalent to the following:
Editor A: "It was uncivil of you to say that."
Editor B: "It was uncivil of you to say that it was uncivil of me to say that."
Editor A: "It was uncivil of you to say that."
and so on, infinitely. This pattern can be difficult to recognize because of the many different words, actions and non-actions people use to express those messages, and because of the different perceptions. I'm thinking of three behaviours to try to avoid, behaviours which tend to contribute to that sort of infinite regress. I've made the mistake of doing at least two of these three things myself within the past few days:
Not using the most diplomatic possible manner when complaining about incivility.
Interpreting a complaint about incivility as itself being an incivility.
Failing to respond in a productive manner to a complaint about incivility.
A productive way to respond to a complaint about incivility could include:
apologizing
changing one's behaviour
clearing up a misunderstanding
possibly, arguing that what one did was OK might be a productive response, but possibly only if it's done in such a way that the other person is actually likely to respond productively
possibly, complaining about the way the other complaint was formulated might be a productive response, but possibly only if it's accompanied by a suggestion as to how the complaint could have been communicated acceptably, and possibly only if also accompanied by another productive response to the complaint itself.
I'd be interested in others' thoughts on this.
By the way, to Blackworm: thank you very much: I really appreciate the AGF. ☺Coppertwig (talk) 18:38, 16 July 2008 (UTC)
HIV
Can someone please link me to the discussion or consensus that justifies Twiggy's reversion of my sourced edit marked "NPOV". forestPIG02:33, 14 July 2008 (UTC)
I don't know where the discussion alluded to by Coppertwig is, but I'll chime in on the proposed addition. 1) The Van Howe paper was published in 1999, while the three RCT studies mentioned in this article were published in 2007. Therefore, the Van Howe citation does not support the claim that "the African studies [which, as written, implies the RCTs from '07] may be confounded by a variety of factors," since it pre-dates them by 8 years. Furthermore, both the circumstitions and MGMbill websites appear to be editorial in nature, and, therefore, do not provide sufficient support for claim that the African RCT studies were confounded or had flawed methodologies. There may also be questions regarding the reliability of these sources, but I will withold judgement at this time since I haven't fully reviewed their content. 2) The policy statement of the Australian Federation of Aids Organizations simply states that the "African data on circumcision is context-specific and cannot be extrapolated to the Australian epidemic in any way." It does not "appear to contradict the African Studies" as the proposed text indicates. While the AFAO policy statement does offer a critique of the use of circumcision to counter HIV transmission in Africa, all but one of these claims are unsupported by actual data or citations, and the one critique that is supported with citations (i.e. washing under the foreskin to prevent STD and HIV infections) has been contradicted elsewhere. I'm certainly not opposed to the inclusion of material which challenges the RCT results or the WHO interpretation, but I think a more robust set of references is needed to effectively support these claims. Kindest regards, AlphaEta04:07, 14 July 2008 (UTC)
I think as long as it's clear that we attribute claims made by the reliable sources, i.e. something to reflect The policy statement of the Australian Federation of Aids Organizations simply states that the "African data on circumcision is context-specific and cannot be extrapolated to the Australian epidemic in any way," then neutrality is served. That critique should be presented as a counterpoint to the WHO's and other media's extrapolation of the results to sitations outside Africa, as evident, introduced by the phrase in the article: In March 2007, WHO and the Joint United Nations Programme on HIV/AIDS (UNAIDS) stated that male circumcision is an effective intervention for HIV prevention, [...].Blackworm (talk) 04:44, 14 July 2008 (UTC)
The earlier discussion is archived here. The edit I reverted is here. Thank you everyone: for beginning this discussion, ForestPIG, for your thorough analysis, AlphaEta, and for your suggestion, Blackworm. I suggest the following modification to Blackworm's suggestion: as the second-last sentence in the 2nd paragraph of the HIV section, "The Australian Federation of Aids Organizations stated that the "African data on circumcision is context-specific and cannot be extrapolated to the Australian epidemic in any way." [2]" I don't see this briefing paper labelled as their "policy"; I don't know if there's another reference for that somewhere.
By the way, re keratin, I suggest replacing the McCoombe et al. ref, which is merely an abstract, with this one[1] which is a review study. Both McCoombe et al. and this study mention both the thinner keratin layer on the inner foreskin, and Langerhans' cells; currently the article does not mention Langerhans' cells. I suggest changing to "Szabo and Short suggest the inner surface of the foreskin as a probable viral entry point, stating that it lacks a keratin layer and is rich in Langerhans' cells, which contain receptors thought to be targets of the HIV virus."☺Coppertwig (talk) 00:57, 20 July 2008 (UTC)
Picture of a circumcised penis with a skin bridge
Why do they only have a picture of a circumcised penis with a skin bridge? This implies that all circumcised penis' have some problem. I have a circumcised penis and it does not have a skin bridge or anything else wrong with it. I see this as a biased view, having the uncircumcised penis as health, while the circumcised penis isn't.
I'm happy you believe there is nothing wrong with your circumcised penis, but are you aware that there is controversy over the "rightness" or "wrongness" of the genital cutting?
Given the images I'm aware of that are currently available on Commons, I think the image we have is good. Ideally, I would like to replace it with two images: one of equal or better photographic quality showing a circumcised penis with no skin bridge or anything else unusual, both flaccid and erect; and a separate picture clearly showing a skin bridge. I find the skin bridge hard to see in the current picture. There was a website with a lot of pictures of clear examples of skin bridges, but I can't find it right now. ☺Coppertwig (talk) 12:13, 7 July 2008 (UTC)
The policy statement covering circumcision says there are pros and cons. We do not need to detail their position by stating each pro and con in the statement. Obviously lower transmission rate of STD's is a pro point and covered by initial statement. No need to illustrate this one pro point unless we balance out with con which gets cumbersome and unnecessary. Garycompugeek (talk) 14:18, 21 July 2008 (UTC)
What do you consider that quote to be: a pro or a con? I think it contains the important information that an American authority thinks the African data doesn't necessarily extrapolate to the U.S. Does that information appear anywhere else in the article? I think it's much more informative than simply saying there are risks and benefits – the reader could have guessed that already. ☺Coppertwig (talk) 00:56, 23 July 2008 (UTC)
I consider linking circumcision to STD/HIV transmission reduction a pro point. Bottom line is the AUA are sitting on the fence regarding circumcision. They do not recommend for or against, which is what we should be stating. They list many pros and cons of circumcision just like we have. The last paragraph talks about the 3 studies done in Africa. They note convincing evidence shows circumcision reduces HIV transmission rates but say the data may not extrapolate to US then go on to say circumcision should not be the only strategy offered to combat HIV. All of this is covered in the HIV section and to bring it up in the AUA policy section only clouds their position further. Garycompugeek (talk) 22:03, 23 July 2008 (UTC)
Prevalence map
Emilfaro: Attention! I uploaded the first version of the map on the 21st June. I am sure about this because I always upload and edit the page at the same time. My edit was: 16:45, 21 June 2008 Emilfaro (102,543 bytes). And now it looks like I added the image that DIDN NOT EVEN EXIST at that time. Can anyone explain that? (By the way my original colors were: Green=Yes, it's there; Red=No, it's not there. And they were inverted on the 23rd June image by RasterB. I am not RasterB.) —Preceding unsigned comment added by Emilfaro (talk • contribs) 10:27, 23 July 2008
Your original colors were terribly biased - they weren't green it's there, they were green it's good that it (the foreskin) is gone, and red = stop, go get it whacked off because it, the foreskin, is still there. They were reversed simply to make them logical - green = natural state, maroon = color of exposed glans. RasterB (talk) 00:49, 28 July 2008 (UTC)
File:Forbidden Knowledge.png I actually don't care about colours as you can see. I wonder how have you managed to remove my image and put your in place just in two days time :-)?Emilfaro
And finally i have the proof. The first version of the map that now says it's RasterB's is not created. Every other normal image says "edit this page" not "create this page". Emilfaro
I get it at last: to fake image you upload a similar copy with the inverted colours to Wikimedia Commons and then request a speedy deletion of my original image. Simple and effective. And explains, why the dates don't match... You are brilliant. My congradulations :-) Emilfaro —Preceding undated comment was added at 13:25, 30 July 2008 (UTC)
How to Fake an Image in Wikipedia
1. Find an image you want to fake (it must not be on Wikimedia Commons)
2. Upload an image you want to end up with on Wikimedia Commons (it must have the same name)
3. Upload a new version on Wikimedia Commons, which is actually the old one original you are faking
4. The image on wikipedia (original) is now going to fall the victim of speedy deletion
5. Now revert to the first version on Wikimedia Commons and end up with it :-)
Re this addition of a map: I think such a map can enhance the article. However, I'm doubtful about the copyright status. Also, the figure caption should probably explain the colour-coding. ☺Coppertwig (talk) 17:15, 21 June 2008 (UTC)
This map is somewhat confusing. Is it the current circumcision *rate* or *prevalence*? Because I'm pretty sure Canada's and Australia's circ rates are below 20% now, although obviously its prevalence is higher since the rate used to be much higher.Gimmethoseshoes (talk) 07:05, 23 June 2008 (UTC)
It also conveniently says "circumcision" everywhere instead of the phrase "male circumcision" used by its source. Good job, perfect timing; keep the fraud going. Blackworm (talk) 22:23, 23 June 2008 (UTC)
The source (pdf) given in the footnote from the map says "male circumcision" sometimes and "circumcision" sometimes. This article does the same. ☺Coppertwig (talk) 02:18, 24 June 2008 (UTC)
I stand corrected. It says it in its title, to disambiguate, and then uses it intermittently inside the article, reminding the reader of the sex of those people being circumcised. It repeats "male circumcision" more often than circumcision with no qualifier. I recommend we do the same here, especially with regard to the title. For some reason I haven't comprehended, you oppose the proposal with your "vote," while specifying that you actually support that change but are worried about other further changes not under discussion, which could not be enacted without further discussion. Is that an accurate summary of your position? Blackworm (talk) 02:34, 24 June 2008 (UTC)
No, I'm concerned about what seems to me a likely possibility that people might change a Circumcision redirect, if it existed, into a disambiguation page or short article with little or no prior discussion. To clarify: I'm not implying that anyone involved in the current discussion would do that. There is also the possibility that an article titled Circumcision would be found more easily by search engines; I'm not sure how search engines handle redirects. ☺Coppertwig (talk) 01:54, 25 June 2008 (UTC)
You say "no," but you effectively confirm that it is an accurate summary, since the potential subsequent change you are worried about would be impossible without consensus. You are effectively using an unrelated premise to support your sudden change of position on the move as it came to a vote. Not impressive. Similarly, putting worries about search engines over issues of neutrality and ambiguity in this encyclopedia also seems misguided. Blackworm (talk) 23:21, 26 June 2008 (UTC)
I am not happy with the colours used on the map. I think green has positive connotations whereas red has danger connotations. Being uncircumcised isn't dangerous. Also the prevalence varies from 1/6th to a 1/3 , according to which source you use so I think it is wrong that the higher amount is used. So I'm removing it. Tremello22 (talk) 17:19, 25 June 2008 (UTC)
Nijelj, red/maroon - it still signifies danger. so you needn't have bothered. Also the prevalence varies from 1/6th to a 1/3 so why should we use these particular stats?Tremello22 (talk) 21:46, 25 June 2008 (UTC)
I have just taken another look at the report UNAIDS/WHO FEB 2007 and it seems something has changed. I am pretty sure on page 14 of the pdf file where the map is it gave a ref for the "other sources" used to compile prevalence rates, but they has mysteriously disappeared. Now it just says "For other countries, estimates were made from other published sources" but it doesn't give what sources they were. Very strange - I remember seeing the sources at the bottom among the refs. So I vote to remove the map because the source cannot be verified. Tremello22 (talk) 23:52, 26 June 2008 (UTC)
As promised in this comment, I have revised the map to use more neutral colours. I chose blue and magenta, since as far as I'm aware these are free of connotations. I'm happy to change the colours again if a better choice of colours is suggested. Jakew (talk) 00:19, 27 June 2008 (UTC)
Who says "blue" is neutral at all? The colours are a hodgepodge and ridiculous. Use a grayscale instead, darker for areas of circumcision and lighter for areas of no circumcision. Right now the colours look ready to give a seizure. Revasser (talk) 00:28, 27 June 2008 (UTC)
Jakew, great work: I believe you are owed thanks for your hard work getting this map into this article. I think it should definitely read "Male Circumcision" however, especially since the source's title says Male Circumcision, and similar maps from other UN organizations also specify Male Circumcision in the captions of their figures [3], and yes, even in their Male Circumcision Prevalence Maps. This addition was JUST IN TIME to boost the image that "circumcision" without qualifier to describe male circumcision is common, normal, neutral, and has consensus -- at a time where this ambiguity is hotly disputed. Sorry, it cannot stand in its current form. It should read "Male Circumcision," as its source's title does, and as other sources paying attention to neutrality and lack of ambiguity do. Blackworm (talk) 04:33, 28 June 2008 (UTC)
No doubt footnote no.1 correctly ascribes the information on the map to the WHO but clearly the WHO is not the appropriate authority given that the UN as we all know deals with countries' self-reporting. May I point out that Malaysia and Indonesia, which are described as Muslim countries (as they officially indeed are), contain very substantial Christian, Buddhist and Hindu minorities. (See the CIA World Fact Book [4].) Moreover, many such minorities are considerably to be identified by region. North Borneo and New Guinea, for example, are very large geographical areas in Malaysia and Indonesia which only have a marginal Muslim presence; the Moluccas in Indonesia are at least 50% Christian; Bali is famously Hindu. Overall, Malaysia is some 60% Muslim and clearly does not belong in the plus-80% circumcised category as it appears on the map. But given the geographical spread of these countries and vast disparity of cultures and religions across the Indonesian Archipelago, it is surely meaningless to describe these countries in such a way. One is reminded of the generalisation in a former version of this article as to aboriginal Australians based, it seems, on certain academic studies of remote communities which did not at all constitute a valid observation as to aboriginal Australians as a whole. Masalai (talk) 07:39, 29 June 2008 (UTC)
I don't see the map anymore, but I had similar concerns about it. Mainly I wasn't sure if it was showing circumcision rates currently or percentage of extant males whose status is circumcised. Because obviously rates are much lower than they were in the past in some countries and vice versa for others.Gimmethoseshoes (talk) 04:44, 1 July 2008 (UTC)
I'm sorry if you won't have time to answer this question, but I wonder which version of the map you were looking at. More recent versions said "prevalence" in the figure caption, which I believe is meant to clarify that it's the percentage of extant males (see prevalence). I agree with you that if the map is present, the caption should clarify which quantity is being displayed. The map was removed in this edit. I support including the map if there are no copyright issues with it. I think it provides important information and significantly enhances the article. Blackworm, would you accept the inclusion of the map if the caption is edited to say "male circumcision"? ☺Coppertwig (talk) 23:05, 1 July 2008 (UTC)
If the caption, and the legend in the image are edited to say "male circumcision" that would remove my objection on that basis. Unfortunately though, I now notice that the source used says "DRAFT DOCUMENT," which as I pointed out long ago calls into question its reliability. I'd be inclined to reject that source on that basis, especially since it seems internally inconsistent (as I describe here). A draft is a document that is a 5 c: a preliminary sketch, outline, or version <the author's first draft> <a draft treaty>.[5] I presume the document is prominently marked as such precisely to warn the reader that it hasn't been properly reviewed and published, and may contain errors (as indeed it seems to). A better source would be UNAIDS 2007 [6], which although they seem to build on the WHO's estimates and silent, unexplained extrapolation of estimates from males 15+ to all males, at least it doesn't directly source a "DRAFT DOCUMENT." The map would need to be attributed to UNAIDS, however, not the "DHS and other sources" since that is the source we reference and rest on. Otherwise, if the consensus disagrees with me and decides to keep the WHO's "DRAFT DOCUMENT" as a reliable source, then the WHO should be cited as the source, not the DHS (as we are using the WHO's interpretation of DHS data). I would also prefer, in that case, that we make clear in the caption that the source is a "DRAFT DOCUMENT," letting the reader decide on the reliability of the source. Blackworm (talk) 19:37, 2 July 2008 (UTC)
Re this map: Image:Forbidden Knowledge.png which was added by Emilfaro: I think such a map can enhance the article. I don't know about copyright concerns, e.g. if it's too close a copy of a map by the WHO. Emilfaro seems to be raising some other copyright concerns: Emilfaro was the one contributing the map originally as far as I know, as mentioned in the first post in this section. Re readability: two of the colours look almost identical to me and the legend is too small to read easily. A figure caption might help. Thanks for your work in contributing this map, Emilfaro! ☺Coppertwig (talk) 00:45, 23 July 2008 (UTC)
Emilfaro, I am not a fan of edit warring. You still have yet to address my concerns. Why are the rates in the map from highest to lowest ? In the original map (which is a direct copy except different colours) the infobox has the rates from lowest to highest. That is not my only concern - I want you to explain to me where the WHO are getting there figures from - are they reliable? They say "DHO and other sources" . I have looked at the dhs website (there doesn't seem to be a page for male circumcision figures). Then I sent an email inquiring about the male circ figures used for this report, but the lady wasn't exactly helpful and she didn't provide me with any figures. So what does that tell you? Also - why do they neglect to name these "other sources" - who are these other sources - just random people in the street, asked to guess the amount? Finally, having said all that, why should we use these particular figures for a map? Why not other figures that put the circumcision rate lower?Tremello22 (talk) 01:11, 23 July 2008 (UTC)
Emilfaro, if you believe an image at Commons violates your copyright, may I suggest you first decide what you would like to be done, and then contact an administrator at Commons to help you? You might try commons:Commons:Administrators' noticeboard or commons:Commons:Help desk or commons:Commons:Deletion requests. Alternatively, it might work for you to edit the image page and put your name there, as apparently RasterB ought to have done. You could also state more clearly here whether you are claiming that an image violates your copyright, and ask us not to use a particular image or images for that reason. Do you also have another concern besides copyright? And are you sure your image doesn't violate the WHO's copyright? ☺Coppertwig (talk) 01:39, 24 July 2008 (UTC)
Thank you. But the point is I don't hold any copyright as I gave it away for anyone to do anything he wants with the image... Funny :-) The sad point is: there is someone, who can modify the Wikipedia archives. Emilfaro —Preceding undated comment was added at 09:27, 24 July 2008 (UTC)
I don't know what words exactly you used when you gave it away, but even if that means that you can't use the force of law to demand attribution, I see no reason why you can't ask for attribution as a courtesy, and I see no reason why Wikipedia wouldn't respect that. ☺Coppertwig (talk) 12:24, 24 July 2008 (UTC)
Unfortunately, that doesn't bring us to the real thing we need: the map on the page. Emilfaro
I introduced the first version of the map in this edit dated 21st. My original map was later somehow replaced with another one with inverted colors. Now it appears as if this image was created by RasterB on 23rd. How could I add image that didn't exist for two days? Later Jakew in this edit changed the image to grayscale version. And now I accidentally find out all this and make the indigo version. None of colors are recognised as neutral thus consensus is not possible at all. The map is being intentionally removed. I beg everyone who can to get out the word on this situation. Keep in mind that it is the one and only map on the subject. There is no alternative that I know of. This subject is very political. Emilfaro —Preceding undated comment was added at 16:33, 24 July 2008 (UTC)
I'm not sure what truth you are trying to show here but you must follow the rules and policies of Wikipedia. Specifically WP:Consensus is being ignored by you at the moment. All this is going to do is get you blocked. If you wish to pursue this either gain consensus here on talk or follow WP:Dispute resolution procedures. Garycompugeek (talk) 17:43, 24 July 2008 (UTC)
I think a map of circumcision rates can enhance the article, but I see the following problems with this particular map:
The colours are too similar to each other, so it's hard to interpret the map.
The legend is too small and is not readable.
Per Blackworm, it should say "male circumcision" (if that's what it is), not just "circumcision", to avoid ambiguity.
I'm not convinced that this map doesn't violate the WHO's copyright.
The name of the file is not NPOV but is WP:SOAPBOXy.
The figure caption or image description file do not state clearly where the data is from. Although there is a link to a WHO document, it doesn't say why the link is there: the link could be marked "Reference" or "Data has been obtained from" or something to clarify this; it would be good to give complete citation information, not just the web link, since the web link might stop working at some point.
The figure caption should state where the data are from, in such a way as to give the reader some idea of the accuracy of the data.
The figure caption "Colour: neutral" seems meaningless to me. (Sorry.)
Please don't re-add the map before addressing these concerns.
Re your question, Emilfaro, about modifying Wikipedia's archives: I don't know what you're talking about: I don't think you've given enough detail for anyone to know what you mean. Apparently the image you originally uploaded to English Wikipedia was deleted on the grounds that a similar image (apparently based on it) existed at Commons. You said you had given away the rights to the map, so there's no basis for a complaint; and if you have a complaint or request then this page is probably not the place to take it up. I suggested some places at Commons where you could pursue the matter. ☺Coppertwig (talk) 17:32, 26 July 2008 (UTC)
Fine job. I would never find the log myself. But look carefully. My image is said to be deleted on the 26th: 08:35, 26 June 2008 Gonzo fan2007 (Talk | contribs) deleted "Image:Circumcision by Country.png" (I8: Image exists on Commons). But then RasterB image with the same name appeared on the 23rd:10:19, 23 June 2008. It is simply not possible :-) Emilfaro —Preceding unsigned comment added by 77.37.131.241 (talk)
I notice that my concerns about the reliability of these figures were ignored. To be expected I guess. Also the legend when you click on the map is poor. It says "circumcision by country". Considering that female circumcison is common in africa then I think in this case it should read "Male circumcision prevalence" and then it should cite the source - "according to DHO" or something like that. Otherwise it is absolutely pointless. In my opinion it doesn't enhance the article in any way. Tremello22 (talk) 00:23, 30 July 2008 (UTC)
Tremello22, I apologize for not paying more attention to your thoughtful, encyclopedic comments. We need editors who pay attention to these details of accuracy. There is a source given: the WHO document, which itself lists references, though I haven't had time to sort them out. I didn't understand what you said about 1/3 and 1/6: could you explain it? Maybe I don't know the background or context for what you're saying. ☺Coppertwig (talk) 14:31, 30 July 2008 (UTC)
Yes my problem was that the WHO document is a secondary source - it says its sources for producing the map were "DHS and other sources" which doesn't fill me with confidence. The 1/3 and the 1/6 are the estimated prevalence of circumcision according to the "prevalence of circumcison" section of the article. The estimate that a 1/6 of the population is circumcised is from the william and kapla study. So my problem was: why should we use the "1/3" figure to produce a map when there is a question over its reliability. On this basis, I wouldn't add the map as an unreliable map isn't enhancing the article - which should rely on accuracy, above all else.Tremello22 (talk) 22:45, 30 July 2008 (UTC)
Thanks for the explanation. It might be a good idea to add "approximate" or "estimated" or "estimated by..." (WHO? DHS?) to the figure caption. However, I think the WHO estimates seem more reliable than the 1993 Williams and Kapila study; the former, from a reputable organization, describes how the estimates were arrived at and lists references; the latter merely states in passing the one-sixth figure without saying, (as far as I can see), where it came from, and seems to be a study about complications etc., without (I think) a section discussing circumcision rates. WP:MEDRS suggests that secondary sources are preferred over primary sources. So I think it's OK to use the map based on the WHO data. ☺Coppertwig (talk) 01:56, 31 July 2008 (UTC)
This map is based on WHO data. This is the fifth edition. And it is designed to be absolutely newtral by expressing both viewpoints. Here are the first, the second, the third, and the fourth versions of the map that are considered not to be neutral. And thus censored.
The editorial comments about censorship, etc. in the image are unencyclopedic and do not belong in the article. Having a dual image is not the solution either. Please work out all issues here before restoring the the map. may I suggest using patterns instead of colors if anyone is particularly disturbed by the choices? Thank you. -- Avi (talk) 21:53, 6 August 2008 (UTC)
Agreed. Some neutral colour choices were also suggested here. As I understand it, it those are used, and the image caption references "prevalence of male circumcision" and the source (UNAIDS), I don't see any remaining objections from anyone. Blackworm (talk) 22:38, 6 August 2008 (UTC)
Map
Here's the neutral map I added using WHO figures. Was it really that difficult to add a map with neutral colours??? Signsolid (talk) 01:01, 7 August 2008 (UTC)
Circumcision rates around the world. Pale blue 0%-20%, medium blue 20%-80%, Dark blue 80%-100%
Beautiful colours, even mildly suggestive of the United Nations which may be entirely appropriate. Perhaps even a UN flag could be added. That would make the source clear at a glance. It lacks the required "no data" regions, however, and a colour legend. Who knows though, someone might again object that the areas in Africa are darker. I don't support that, but others can decide for themselves and chime in. Good work, seems close to a consensus and therefore a resolution to this somewhat heated conflict. (How many times has it been reverted? 10? It's odd that no one locked this article for "editwarring," but I applaud that, we're getting closer to a solution rather than arguing about whether a debate exists.) Blackworm (talk) 01:42, 7 August 2008 (UTC)
Unfortunately, "circumcision rate" seems ambiguous, leaning toward incidence of new circumcisions rather than prevalence, which is what the WHO is estimating. How about: Percentage of males over 15 who have been circumcised, according to United Nations (WHO/UNAIDS) estimates. (Pale blue, 0%-20%; medium blue, 20%-80%; dark blue, 80%-100%.) Still have to fix the "no data" regions, but otherwise that would seem to be a fine addition to the article. Blackworm (talk) 03:15, 7 August 2008 (UTC)
As an agnostic as to the pros and cons of circumcision, the colour debate is considerably irrelevant to me (green could be for Islam; red could be for liberal -- at least outside the USA where Republicans and Democrats latterly reverse the traditional red/blue identities -- whatever one's take on whether it is more liberal or conservative to be pro- or con- as to circumcision). The thing that bothers me about the map is the provenance of the statistics that inform it. As I previously mentioned, they are considerably open to question as to several of the countries that are on the map to have this or that incidence. Perhaps the discussion could move on from the significance of assorted colours to the surely more important question of where the statistics come from and what geographical areas they accurately refer to. Masalai (talk) 03:30, 7 August 2008 (UTC)
Presumably the source would be cited in the caption, satisfying WP:V. There may be an WP:NPOV argument to be made, as giving the source's data as a map gives it a lot of weight. By the way, I found this interesting document; it says: PRELIMINARY DRAFT – PLEASE DO NOT CITE OR DISTRIBUTE. I'm not citing for anything other than to make this point: it seems like draft documents aren't to be cited, and I seem to remember that one of the sources cited in these articles, and perhaps even for this map, is labeled "DRAFT DOCUMENT." In that light, doesn't it seem odd that we would cite such a document here? Blackworm (talk) 04:08, 7 August 2008 (UTC)
Image regarding circumcision rates worldwide
Recently User:Signsolid removed an image he had supplied (under the GFDL) and, when reverted, replaced it with another. It was again reverted, and then removed by a third party and now there is no image pending discussion. Since an image is not owned once it is licensed the provider cannot remove it on any grounds other than suitability, therefore it should be decided which is the best image for use in the article;
Circumcision rates by country. Pale blue 0%-20%, medium blue 20%-80%, Dark blue 80%-100%
or
Circumcision rates by country
Please note that either image may be manipulated under the terms of the GDFL, so it isn't a simple matter of colour preference or size. I throw this open to various opinions. LessHeard vanU (talk) 18:18, 7 August 2008 (UTC)
Or neither, since neither properly addressed the concerns raised in this discussion above (the "no data" region around Kashmir is relevant for image 2, and the caption has issues, and image 2's legend needs to say "male circumcision" per the source). Blackworm (talk) 18:24, 7 August 2008 (UTC)
Circumcision by Country
This page got too big and I say it is done on purpose. Why? Because this page is 35th (hubpages.com/hub/Top-100-Viewed-Wikipedia-Pages) most popular on Wikipedia. And Wikipedia is 8th most popular site. Giving this article audience of 200'000 people.
So why is the prevalence map banned? Several things.
First circumcision stops decease. They don't want you to know that.
Second USA and Israel have something too much in common with Arabs, with Muslims. And they don't want you even think about that.
Here I'll just list banned variants and welcome others to do so.
<gallery>
Image:Circumcision by Country.png|Original faked by RasterB
Image:Circumcision by Country 2.png|Grayscale by Jakew
Wild claims of censorship, conspiracy theories spamming images, and editwarring your image into the article rather than fixing the problems raised will get you nowhere. The objections are minor and fixable. If you feel that strongly about the map, do the work. Also, please try to contain discussion of this in ONE talk section. Thank you. Blackworm (talk) 18:46, 7 August 2008 (UTC)
Emilfaro, I didn't really edit your comment, I removed your new section heading since there were already TWO top-level sections devoted to this map on this page. Sorry if that upset you, but spam upsets me.
Gary, banning or blocking Emilfaro would just feed his "censorship" cries, as well as absolve him from the work of actually gaining consensus for his change. I don't support that. Blackworm (talk) 19:20, 7 August 2008 (UTC)
I'm with you Emilfaro there's nothing wrong with your map. Pro-circumcision US editors don't want the world to see that only the US, Israel, and Islamic world circumcise rountinely because the map shows most areas of the world and most of its population like China and India just don't circumcise. Signsolid (talk) 21:50, 7 August 2008 (UTC)
Emilfaro seems to be arguing the opposite of Signsolid, specifically that anti-circumcision editors are blocking the map ("First circumcision stops decease. They don't want you to know that."), thus seeming to make both your POV-related claims highly dubious, and the "consensus" between yourselves bewildering. Why not stop the pro- and anti- talk for two seconds and actually read what the editors opposing the map are saying about it? Let me summarize what I think of this map:
It lacks the correct "no data" areas, as noted above and you both seem to have ignored. Don't forget the one in Kashmir (India/Pakistan).
It quotes the wrong source, when a better source cite, for example, would be this.
The caption isn't appropriate. I suggest this caption: Map showing percentage of males who have been circumcised at a country level, according to estimates published by the United Nations (WHO/UNAIDS).
Okay, it's not quite the same file, as I had to search for the map when I went there, but I'm fine with that. The source quoted in the map should maybe also have a link to it at the end of the caption, but I can do that. Also maybe the "no data" colour could be even lighter (full white, or a pattern?), as I find it hard to distinguish between it and 0-20%. But again, I won't complain too much about that. The only thing left (and I'm sorry):
...is that the location of Kashmir seems wrong. If you compare the two maps, it looks like you grayed out parts of China instead and left Kashmir the same colour as India.
...And I really feel lousy at not being able to help you do this myself. I don't like appearing like I'm sitting back and barking orders, and please don't take my words that way. I really appreciate the job you're doing. Blackworm (talk) 23:58, 7 August 2008 (UTC)
I have corrected Kashmir for you. There are parts located in China as well. If you ever want to color a map it is very simple: you have to go to Wikipedia:Blank_maps and use MS Paint. Then go to Commons and that's about it. We can work out the details of the map later. If we have the consensus, please, add the map to the page :-) Emilfaro (talk) 00:06, 8 August 2008 (UTC)
It follows very logical sequence now, by the way 70,70,70; 120,120,120; 170,170,170 and 220,220,220. So the step is 50. Can't be better. And you cant make me do this again --- very boring to change from grey to grey... Emilfaro (talk) 23:30, 9 August 2008 (UTC)
I think we don't need to worry about violating the WHO's copyright, because just to be sure I asked here, and Commons administrator WilyD said "Data is not copyrightable. The map projection is different, the colour-scheme is different - there's no apparent problem."☺Coppertwig (talk) 02:11, 8 August 2008 (UTC)
Well, I'm no lawyer, but the reason I say it's a copy, is because the "data" it reflects seems to actually be the WHO map. At best, the source of the data isn't clear. If I mistaken on this point, please point me to the WHO table where all the countries are categorized as in the WHO map -- because it isn't on the page that our new map points to as a source. I shouldn't have to dig for the data, and in fact, now that I think of it, the source cite (link) should indeed point directly to it.
If no such table exists at the source site, then we must conclude that the WHO map itself is the source data. But the map is copyrighted. If "the map is the data," and "data is not copyrightable," and "the map is copyrighted," we seem to have a contradiction. A better explanation is that the WHO map is an interpretation of the non-copyrighted WHO data as interpretations are copyrightable, to my understanding. Blackworm (talk) 05:47, 8 August 2008 (UTC)
Or I guess one could argue that the non-copyrighted WHO data is implied by the WHO map. That makes sense, and all that would be needed would be a link directly to the WHO map in that case. Blackworm (talk) 06:33, 8 August 2008 (UTC)
I'm not crazy BTW about having the estimates of male circumcision prevalence published by male circumcision advocates displayed so prominently, and I could see someone raising undue weight issues, but they are a major source of information and if it's properly attributed to those advocates then there's no problem, I guess. Blackworm (talk) 06:36, 8 August 2008 (UTC)
If someone looks at what colour each country is in the WHO map and uses that information to decide how to colour another map, I think that's OK. If someone copies the shapes of the coastlines etc. from the WHO map, I guess that's probably a copyright violation, even if they apply a transformation to it to make it into a different map projection. I'm assuming it's the former; anyway, I figure that by asking at Commons like that enough has been done. ☺Coppertwig (talk) 14:05, 8 August 2008 (UTC)
Can I add a link in the "external links - circumcision opposition"
Can I add a link in the "external links" section to a new website that provides a forum/discussion board for opponents of circumcision under "Circumcision Opposition?" Spindled (talk) 04:25, 24 July 2008 (UTC)
Oh ok, although it seems that they are more so referring to general forums/discussion groups, this whole site is specifically made for discussions regarding circumcision. Right now it is very new and pretty empty, but in principle it seems like a nice place to discuss this topic. Duly noted tho. Spindled (talk) 05:37, 24 July 2008 (UTC)
Going down the list of things to avoid, I'd say this falls under 4. Links mainly intended to promote a website. See External link spamming.Blackworm (talk) 07:05, 24 July 2008 (UTC)
Male Genital Cutting
I think to keep this article neutral the term male genital cutting should be used in the introduction just as female circumcision is called female genital cutting. Both subjects are controversial and Wikipedia should treat both with the same neutrallity. Signsolid (talk) 00:57, 27 July 2008 (UTC)
A template at the top of this page says "discuss substantial changes here before making them". You may have felt that changing a few words was not "substantial": fair enough; however, once they were reverted, I think you should wait for discussion. Waiting 27 minutes is quite inadequate. I suggest several days. Some editors might argue that 24 hours is sufficient; I don't think one could justify any less than that.
I oppose the edit. I don't think the term is widely used. A Google scholar search turns up only 50 hits, and the first two actually say "fe- male genital cutting". Female genital cutting and male genital cutting are not the same thing, because the genitals are different, among other reasons. There's no need to try to artificially force the two concepts into the same mould. ☺Coppertwig (talk) 01:53, 27 July 2008 (UTC)
Substantial changes? No I don't think that is a fair description for adding 3 words to the article. If someone reverts my edits and tells me to take it to the Talk page I expect them to do so as well, hence I reverted the article back to my version due to them not taking the subject up on the Talk page. As for the term not being used it may very well not be as widely used as the term female genital cutting but this encyclopaedia is supposed to be neutral, and to be so it must treat both male and female circumcision with the same point of view, as both subjects are controversial. As for opposing the change because male and female genitals are different that's pretty obvious but in what way does it make the circumcision of either different? One is more widely accepted than the other? Or they are circumcised differently? As for being circumcised differently both have external skin on the genitals cut off so there's no major difference in how the circumcision is performed, only what parts of the genitalia they cut off due to the different shape of male and female genitalia. Signsolid (talk) 02:12, 27 July 2008 (UTC)
Again reverts are made to my edits without any discussion made on the Talk page. I think it's obvious that this is a plain case of pro-circumcsion editors dominating the article and preventing any criticism of circumcision. The reason why is most of these editors are usually American men who have been circumcised themselves and because there's nothing they can do about it now they vigoursly defend it as a good thing as so not to admit it's a bad thing that happened to them and they were operated on against their will as a baby for no medical benefit only because the US private medical health care system means medical companies make a lot money out of it, rather than in countries like the UK where health care is entirely goverment funded so non-beneficary operations are not carried out because no companies would make any money from them.
US medical companies would routinely circumcise girls too if it wasn't for the fact feminism in the US prevents them from doing so but no such movement protects boys as the US government states males are second class citizens to females, hence US government led affirmative action against them. US men wishing to ignore the fact their government sees them as second class citizens simply dismiss it rather than confront it because unlike women have the feminist movement to help them confront anti-female issues men have no such ally.
As for medical benefits 70%-80% of the world's men are not circumcised yet where are all these penile diseases they are supposed to have? I live in Europe where almost no men are circumcised yet any penile diseases are almost unheard of and HIV rates are lower in Europe than in the US. Part of the reason the US circumcises its males is because it doesn't wish to offend it Jewish population, which if much higher than in Europe. The other reason is the US has never fully lost the crazy 19th century biological hygene idiologies made by such likes as John Harvey Kellogg. Big companies kept those idiologies alive to make money. Strange that the founder of one of the largest US companies who makes breakfast cereals also started the process of circumcising all American men. You may think I'm being anti-American but actually politically I very much support US foreign policy and George Bush.
But hey circumcision's your problem not mine so support it all you want, I'm not the one who got a piece of my manhood cut off against my will at my most vulnerable as a baby for no other reason than to make some money for a company. Notice they only circumcise helpless babies, might be because they would tell them where to get off to if they tried it on when they're an adult and they would know the whole catching infections thing is about as likely as catching infections under your eyelids and having to have them cut off when you're a baby to stop it happening when you grow up. Signsolid (talk) 03:42, 27 July 2008 (UTC)
You might want to read WP:TALK. I realize statements like Coppertwig's Female genital cutting and male genital cutting are not the same thing, because the genitals are different, among other reasons may be incredibly frustrating and offensive to those who believe no one's genitals should be cut up without consent, but it is a common argument, similar to arguments about slavery 200 years ago (blacks and whites aren't the same thing), or women's right to vote 100 years ago (men's brains and women's aren't the same thing). Blackworm (talk) 06:57, 27 July 2008 (UTC)
SIgnsolid, please feel free to discuss the edits in question, but please immediately stop commenting on other editors' penises. Thanks in advance. Nandesuka (talk) 13:24, 27 July 2008 (UTC)
I'm sorry: I didn't intend any offense. If I were arguing, "Slavery is OK, because blacks and whites are not the same thing," that would be one thing. But if I were arguing, "Recommendations for sun-block lotion and vitamin D supplementation need to be individualized, because blacks and whites are not the same thing," that would be something else. Here, it's more like "Wikipedia articles are not supposed to assert, 'Slavery is not OK'". That doesn't mean that slavery is OK. It simply means that Wikipedia is not a soapbox. ☺Coppertwig (talk) 13:34, 27 July 2008 (UTC)
Exactly, but it can easily be used as a soapbox in subtle ways; for example, by calling male circumcision "circumcision," denying any mention of female circumcision under "circumcision," and calling female circumcision "female genital cutting." Blackworm (talk) 19:23, 27 July 2008 (UTC)
Any wording will be considered soapboxy by some people. The thing to do is to represent the various POVs with appropriate weight. If it's not possible to represent all the POVs because, for example, the page name needs to be reasonably concise, then the thing to do is to represent a median POV: one which minimizes the conceptual distance to the POVs in the sources, i.e. a most commmon or middle POV. I think the current wording does that reasonably well. ☺Coppertwig (talk) 23:07, 27 July 2008 (UTC)
"Removal" is inadequate to describe circumcision, which is the surgical removal of the foreskin. As anyone who has ever played with an uncircumcised penis knows, the foreskin is easily removed just by pushing on the skin of the penis - it slides back and forth like playing a slide trombone. It is way too much censorship to not include the very important element that circumcision involves surgery in the first sentence of the article. It also gets removed when you are having sex because of the vagina pushing against the foreskin. And you don't call that circumcision, do you? Yet it fits the definition of this badly censored article. RasterB (talk) 02:17, 29 July 2008 (UTC)
Seconded. "Removal" implies ease, like removing dirt from fingernails or cutting your hair. As a form of downplaying, it is often used in common speech to say something like "I am getting my wisdom teeth removed". However, it is often in fact, like circumcision, surgery. Revasser (talk) 06:14, 29 July 2008 (UTC)
I'm reverting: I'm removing the word "surgery" again, because it's my understanding that the re-addition of this word on June 27 did not gain consensus. See the previous discussion. ☺Coppertwig (talk) 14:30, 29 July 2008 (UTC)
I apologize: I neglected to read the above talk page comments before reverting. However, I still think the addition of the word "surgical" does not have consensus. RasterB, why didn't you leave the phrase "permanent removal"? (RasterB changed from "permanent removal" to "permanent surgical removal"; Blackworm responded by changing back to just "removal".) I think maybe that phrase could have gained consensus and would, in my opinion, have addressed the concern you raise. Since Revasser has also agreed with the same concern, and I haven't seen any objections to "permanent", I suggest that the word "permanent" be re-inserted. ☺Coppertwig (talk) 14:44, 29 July 2008 (UTC)
I'm quite tired of this discussion, as I really don't believe any significant number of native English speakers would understand "removal [...] from the penis" as anything but amputation. If you replace "removed" with "removed from the penis" in RasterB's argument above, it falls apart. The foreskin isn't "removed from the penis" during sex or at any other time other than when someone cuts it off of a person's penis. In any case, if "removal" could be taken to mean what RasterB says, then "permanent removal" is no better, as it could simply imply a permanent state of "removal." The best, clearest, most accurate word is "amputation," but I doubt that will meet with approval. There's also "cutting off," of course, which is even clearer, but again doesn't seem to have approval (for reasons I find to be completely invalid). If you want to talk about censorship, let's talk about why we can't say "cutting off" or "amputation" in this article. Plenty of sources define circumcision without using the words "surgical" and "permanent," [7] and I see no need for us to use them. Blackworm (talk) 21:52, 29 July 2008 (UTC)
After much discussion, the following sentence was retained in the lead in June, 2008 to address POV concerns:
The American Medical Association stated in 1999: "Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision, and support the provision of accurate and unbiased information to parents to inform their choice."[13]
Specifically, it was added to balance the WHO/CDC information regarding HIV:
The World Health Organisation (WHO; 2007), the Joint United Nations Programme on HIV/AIDS (UNAIDS; 2007), and the Centers for Disease Control and Prevention (CDC; 2008) state that evidence indicates that male circumcision significantly reduces the risk of HIV acquisition by men during penile-vaginal sex, but also state that circumcision only provides partial protection and should not replace other interventions to prevent transmission of HIV.[14][15]
Because the WHO/CDC was removed from the lead, it seemed appropriate that the AMA statement should also be removed to restore balance. This information still appears in the body of the article.
The question then becomes, should the AMA statement remain in the lead? We've made good progress toward streamlining the introduction, and re-adding the quotation will likely cause a new series of POV and notability issues. I vote to leave the AMA quote and information regarding HIV out of the lead. AlphaEta15:28, 26 July 2008 (UTC)
The AMA statement summarizes the views of medical organizations, and doesn't have anything to do with HIV. I think it should stay in the lead. If the current WHO advocacy is a contrast, we can summarize it with: The United Nations (World Health Organization, etc.) advocate mass male circumcision, stating that it reduces female to male transmission of HIV.[WHO 2007 ref] In Africa, mass male circumcision programs are now underway that have been described as "nominally voluntary."[BBC ref][8]Blackworm (talk) 19:03, 26 July 2008 (UTC)
I realize the two items are unrelated. As absurd as it seems in retrospect, one, the WHO paragraph, was used to support the inclusion of the other, the AMA policy statement, in the lead. I still think we should keep detailed information out of the lead, but if the AMA statement is deemed important enough to be summarized in the intro, the HIV information certainly also deserves mention. Again, I'm not saying the two are related, but each carries about the same gravity. If the AMA material stays, perhaps we could re-add the WHO material as follows?
The American Medical Association stated in 1999: "Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision, and support the provision of accurate and unbiased information to parents to inform their choice."[13] The United Nations (World Health Organization, etc.) advocate mass male circumcision, stating that it reduces female to male transmission of HIV.[WHO 2007 ref]
The second sentence of Blackworm's proposal appears to incorrectly attribute the actions of the Rwandan health ministry to the WHO, and is pertinent only to the Rwandan military, not Africa as a whole (according to the BBC reference). Regards, AlphaEta19:44, 26 July 2008 (UTC)
I would support the following -
"The American Medical Association stated in 1999: "Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision." in direct contrast to the World Health Organization's advocation of mass male circumcision to reduce transmission of HIV.[WHO 2007 ref]
1. I like the idea of condensing information in the lead, but I fear that this construct would link the AMA and WHO policies much more closely than they actually are. The AMA statement appears to refer to medical associations in industrialized nations, where HIV transmission occurs mainly via injection drug use and male homosexual encounters. The WHO policy refers to sub-Saharan Africa, where transmission occurs primarily via heterosexual contact, and where male circumcision would have a much greater impact on reducing the rate of infection. Therefore, these concepts may not be in "direct contrast" with one another since each is based on a separate set of unique circumstances.
The AMA statement summarizing the policies of various medical organizations and the WHO's stance on male circumcision and HIV are seperate, but equally notable, concepts, and they should be presented as such. Could we summarize the positions of these medical organizations even further? Would it be appropriate to paraphrase the AMA's findings rather than provide a quote?
In 1999, the American Medical Association stated that virtually all medical organizations and specialty societies do not recommend routine neotantal circumcision.[AMA ref] The World Health Organization, UNAIDS, [and other organizations that should be added to this list] support mass male circumcision, stating that it reduces female to male transmission of HIV.[WHO 2007 ref]
The AMA quote can be moved to the body of the text, because, as others have argued, it provides a nice summary of medical thinking in 1999 (and presumably today). Thanks, AlphaEta05:44, 30 July 2008 (UTC)
You right they are two sides of different coins best not to confuse them. Maybe this..
In 1999, the American Medical Association stated that virtually all medical organizations and specialty societies do not recommend routine neotantal circumcision,[AMA ref] however the World Health Organization and UNAIDS support mass male circumcision in Africa to reduce female to male transmission of HIV.[WHO 2007 ref]Garycompugeek (talk) 16:19, 31 July 2008 (UTC)
Your AMA quote is from 1999. At that time they said "Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child."
The WHO recommendation is from 2007. Their recommendations are based on current feedback from the AMA, among other sources. BTW "mass male circumcision" was not their recommendation. Consider that the AMA published, in 2006 an article in JAMA titled "Routine Male Circumcision Could Prevent Millions of HIV Infections in Africa."[9] The AMA has not (as far as I know) said that they recommend routine neonatal circumcision in the U.S. -- yet. But, I expect that they are close to making that recommendation soon. Their opinion has changed since 1999. At that time it was extremely borderline.
What the WHO said was "Male circumcision should always be considered as part of a comprehensive HIV prevention package, which includes the provision of HIV testing and counselling services; treatment for sexually transmitted infections; the promotion of safer sex practices; and the provision of male and female condoms and promotion of their correct and consistent use."
AND
“Being able to recommend an additional HIV prevention method is a significant step towards getting ahead of this epidemic,” said Catherine Hankins, Associate Director, Department of Policy, Evidence and Partnerships at UNAIDS. “However, we must be clear: male circumcision does not provide complete protection against HIV. Men and women who consider male circumcision as an HIV preventive method must continue to use other forms of protection such as male and female condoms, delaying sexual debut and reducing the number of sexual partners.”
In summary, what the AMA said in 1999 is not indicative of how they feel today. They were borderline at best in 1999, and given research since that time, they may be close to recommending routine neonatal circumcision. One factor that may have slowed their decision is that a majority of males babies in the U.S. are commonly circumcised already. Atom (talk) 16:46, 31 July 2008 (UTC)
It is not for us to speculate their position. If they change their policy then they change their policy and will tell the world. You might take note that most medical organizations take little weight with WHO's circumcision's advocacy based on HIV prevention considering safe sex the best option. (Half measures that partly work seem lame when your life is on the line) Garycompugeek (talk) 18:39, 31 July 2008 (UTC)
Seriously, Atom's speculation is extremely irrelevant -- see WP:OR. The AMA paragraph belongs in the lead as the best summary of medical organizations' positions we have. I don't even mind including the opinion of major political organizations (e.g., UN/WHO) afterwards, but I oppose the removal of the paragraph. Blackworm (talk) 19:33, 31 July 2008 (UTC)
Ref for above: The WHO as a Political Organization: It is important to realize that the WHO is not a scientific institution but rather an agency of the United Nations, and, as such, is subject to the influence of governments of the G-7 countries—particularly those, like the United States, that fund large proportions of the WHO budget. Thus it is not uncommon for the agency to act as a transmitter of the conventional wisdom prevalent in the developed countries.[10] Extremely well said, in my opinion, and perfectly relevant to circumcision, where the "conventional wisdom" is at odds with the science. Blackworm (talk) 19:38, 31 July 2008 (UTC)
That quote is from 2000. There is a 2008 policy statement on hand published by the WHO that would be a better indicator of current opinions. Also, you have not heard me either support, nor attack the WHO, or other UN agencies, only cite various sources regarding them. Not being a fan of the Bush-Cheney administration, if I were to edit articles based on my political or philisophical preferences, they would look quite different. So, I am not supporting the WHO, only pointing out that what they said in 2000, and what they say in 2008 are pretty likely to be different, and the 2008 policy would be more accurate if we are discussing current eventsd, and not past history. Atom (talk) 21:30, 31 July 2008 (UTC)
My comments are intended as advice and opinion. I haven't supported a position, nor asked either of you or anyone else to take on my views. Of course speculation, or opinion not backed by citations should not be put in the article-- I haven't suggested otherwise. 1) My comment is intended to suggest that comparing a 1999 policy developed in 1997 to another agencies 2006 policy doesn't make much sense. 2) The 1999 policy is being seriously reconsidered, and has been in a state of flux since then. It is currently heavily influenced by recent research that was not available in 1997. (but nothing in the article should change until a citation stating a more current position can be supported.) I am not advocating any position in this article, only stating that the earlier comment putting an old AMA policy (that even at that time nearly advocated neonatal circumcision -- was borderline) in juxtaposition with a WHO policy (that was incorrectly quoted anyway) was not appropriate and meaningless.
If one were to discuss a more current position on the AMA, probably the 2006 JAMA article mentioned above, JAMA titled "Routine Male Circumcision Could Prevent Millions of HIV Infections in Africa."[11] would be more accurate and fair than the eight year old statement. If one were to discuss the WHO position, the 2008 Eliminating Female genital mutilation: An interagency statement might be a better resource than the year 2000 document mentioned. Atom (talk) 21:30, 31 July 2008 (UTC)
If you have a more recent summary of worldwide medical organizations' positions on circumcision from the AMA or another major reliable source, bring it. Otherwise, please stop the original research. Blackworm (talk) 21:47, 31 July 2008 (UTC)
Your unfriendly attitude isn't welcome. You should be concerned about accuracy, not pushing your view. At any rate, quoting two recent citations (both considered highly reliable) while not stating a personal position would probably not be called WP:OR by most people. Atom (talk) 21:54, 31 July 2008 (UTC)
Blackworm's OR accusation comes from your continued line of speculation that the AMA has changed their position on circumcision. It is irrelevant that thier policy statement is 8 years old. Garycompugeek (talk) 22:11, 31 July 2008 (UTC)
I did not claim that the AMA had officially changed their position. My speculation was that many of the Doctors in the AMA may have changed their position based on more recent research than their 1999 position. BTW, the position was developed in 1997, expressed in 1999, it is now 2008. The position is 9 to 11 years old. Atom (talk) 23:04, 31 July 2008 (UTC)
Hiya, just popping in as an uninvolved admin. For best results here, I recommend keeping discussions focused on the article, and not the editors. As an exercise, try avoiding the words "you" and "your" in any comments. Speaking only in the third person can have an excellent effect in de-escalating disputes. Thanks, --Elonka22:29, 31 July 2008 (UTC)
Precisely, Garycompugeek. Also, remember that for the lead section we are seeking a summary of medical organizations' positions, not the AMA's position; therefore even if the AMA had changed its position (and we have no evidence of that), that would also be irrelevant to the question. Finally, the suggestion that I am "pushing [my] view" is incivil (see WP:POVPUSH), and in violation of Wikipedia's civility policy. I'd ask that editors please refrain from repeating the suggestion. Blackworm (talk) 22:34, 31 July 2008 (UTC)
The title of this discussion is "AMA Quote in lead", which is why it became a topic. As I said earlier, I am not suggesting changing the lede section. I was commenting and discussing the topic on the talk page. Being talked down to in an unfriendly manner, and suggesting that neutral comments were OR is not particularly friendly. If I speculate that a particular organization may have changed their view in the last nine years, and base that on more recent research since that time, that is fair game on a talk page. If I were to suggest that the speculation procede to the lede article, then it is a problem. By point in speculating, of course, is that if there is some probability or liklihood that one or more of the organizations in the paragraph in question might have changed their views in the light of more recent research, that our research to determine of there is any offical change in posture by different organizations might be fruitful.
My criticism (intentionally light) was that relying on old research, or comparing a position that was formed in 1997 with another organization from a quote in 2000 (when there is a more recent position on the latter from this current year) did not seem to be working toward presenting the most accurate information. As it turns out, the AMA has not officially changed their position on the matter as of this writing. My provision of a recent and related paper published in the JAMA, although Africa specific, could potentially offer useful information for the lede -- maybe not. I don't see how a discussion on a talk page about the topic of the article should be so controversial. If one ore more editors disagrees, they may merely say so without making it personal, or being uncivil and then charging the editor they have been uncivil to with being uncivil themselves. Atom (talk) 23:04, 31 July 2008 (UTC)
I found these (2007-2008 references) to be interesting:
[http://pediatrics.aappublications.org/cgi/reprint/119/5/1006 Circumcision in the Time of HIV: When Is There
Enough Evidence to Revise the American Academy
of Pediatrics’ Policy on Circumcision?] "Reviews of the literature have concluded that there is substantial evidence to support the conclusion that circumcision significantly reduces the rate of HIV infection, and one review concluded
that “male circumcision is the most compelling evidence-based preventive strategy to emerge since the results of mother-to-child transmission clinical trials.”
Rebuttal: Should newborns be circumcised? YES "The protective effects of circumcision against other serious disorders have been well documented in major medical journals in recent years.1-4 These include lowering the risks of human papillomavirus, penile cancer, cervical cancer in female sexual partners, Chlamydia infection, syphilis and chancroid, phimosis, local infection, and genital dermatoses. Circumcised men have
easier lifetime genital hygiene. Depending on how you lump these, there are 7 to 11 proven preventive health benefits of circumcision versus the single risk of surgical complications, which the American Academy of Pediatrics lists as occuring in 0.3% to 0.5% of cases and as usually minor. That is at least a 7:1 benefit-to-risk ratio."
Male Circumcision for Prevention of HIV and Other Sexually Transmitted Diseases "A recent commentary in Pediatrics reviewed documented medical benefits of newborn circumcision, including protection against balanoposthitis, phimosis, infections of the urinary tract in and protection against human papillomavirus–associated genital cancers and HIV and Chlamydia adolescents and adults.1 Low rates of minor complications (0.2%–0.6%) and safety and local anesthesia were noted. The ability circumcision to protect against sexually transmitted diseases(STDs) was also shown in a recently cohort study from New Zealand.2 Recent large randomized clinical trials in South Africa, Kenya, demonstrated reduction of HIV-acquisition circumcision performed outside the newborn showing the role of adult male circumcision prevention of STDs in adolescents and adults." "Editor’s note: The American Academy of Pediatrics is presently reviewing its 1999 Circumcision Policy Statement"
CDC HIV/AIDS Science Facts:Male Circumcision and Risk for HIV Transmission and Other Health Conditions: Implications for the United StatesMale circumcision has been associated with a lower risk for HIV infection in international observational studies and in three randomized controlled clinical trials. It is possible, but not
yet adequately assessed, that male circumcision could reduce male-to-female transmission of HIV, although probably to a lesser extent than female-to-male transmission. Male circumcision has also been associated with a number of other health benefits. Although there are risks to male circumcision, serious complications are rare. Accordingly, male circumcision, together with other prevention interventions, could play an important role in HIV prevention in settings similar to those of the clinical trials"
Yes, and what do these have to do with the AMA's summary of worldwide medical organizations' positions on circumcision? Blackworm (talk) 23:00, 31 July 2008 (UTC)
Nothing. Atom I ask that you revert yourself and remove the above material. It has no bearing on our discussion. I could paste plenty of anti-circumcision material all over the page but what would that have to do with our discussion of the AMA source quote in the lead? Garycompugeek (talk) 02:26, 1 August 2008 (UTC)
This is the AMA's recommendation: "The AMA supports the general principles of the 1999 Circumcision Policy Statement of the American Academy of Pediatrics, which reads as follows: Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided."
Gary, your sentence represents a nice compromise. Any minor tweaks can be addressed on the talk page, but overall I think it is a step in the right direction. Thanks for your help, AlphaEta22:38, 1 August 2008 (UTC)
Given the major criticisms of the AIDS studies and the fact that most agree that there is little evidence to suggest circumcision has any effect on HIV contraction then why should this particular topic be put in the lead? Why not penile cancer or sexual effects? It just seems very arbitrary to me. This isn't an AIDS article, it is a circumcision article. The position of ALL medical associations basically saying that it shouldn't be recommended seems relevant and should be included. The point of it being added initially to balance something else is irrelevant.Tremello22 (talk) 23:19, 1 August 2008 (UTC)
I think your premise, that "the fact that most agree that there is little evidence to suggest circumcision has any effect on HIV contraction " is incorrect. There is a great deal of evidence that circumcision affects HIV. Your point that there are a number of other factors that circumcision advocates consider beneficial is also worth mentioning. Atom (talk) 23:27, 1 August 2008 (UTC)
I mentioned earlier in these comments that the "mass circumcision" text was not accurate. I changed that to be consistent with what the citation did say in its recommendations. "Since neonatal circumcision is a less complicated and risky procedure than circumcision performed in young boys, adolescents or adults, such countries should consider how to promote neonatal circumcision in a safe, culturally acceptable and sustainable manner."
There are a few other possible ways to say what the WHO recommended, as the paper has 43 recommendations in various areas. The sentence could represent the WHO view in a variety ways. As it is the intro, it needed to be succinct.
Male circumcision should now be recognized as an efficacious intervention for HIV prevention.
Promoting male circumcision should be recognized as an additional, important strategy for the prevention of heterosexually acquired HIV infection in men.
Countries should ensure that male circumcision is provided with full adherence to medical ethics and human rights principles. Informed consent, confidentiality and absence of coercion should be assured.
Before policy makers and programme developers promote male circumcision for specific population groups, they should justify the reasons after conducting an analysis of the ethical and gender implications; this analysis should be conducted in consultation with members of such population groups, stakeholders and other critical decision makers.
Male circumcision service provision should be used as an opportunity to address the sexual health needs of men, and such services should actively counsel and promote safer and responsible sexual behaviour.
Such countries should consider scaling up access to
priority for adolescents, young men, and as indicated by
considerations, older men at particularly high risk of HIV.
Male circumcision services should not be delivered in isolation, but as part of a recommended minimum package which includes information about the risks and benefits of the procedure, counselling about the need to adopt and maintain safer sex practices, access to HIV testing, condom promotion and provision, and the management of sexually transmitted infections.
Bilateral and multilateral donors should consider male circumcision as an important, evidence-based intervention for HIV prevention and allocate resources accordingly.
If medically indicated, male circumcision should be provided to all men irrespective of HIV status.
HIV testing should be recommended for all men seeking male circumcision, but should not be mandatory.
Since neonatal circumcision is a less complicated and risky procedure than circumcision performed in young boys, adolescents or adults, such countries should consider how to promote neonatal circumcision in a safe, culturally acceptable and sustainable manner.
I chose the last one, primarily because the first part of the sentence was about the AMA's view on neo-natal circumcision, and the chosen paaragraph was the only place the WHO document discussed recommendations for neo-natal circumcision.
In order to be succinct, (rare for me) I edited the sentence to read "...promote neonatal circumcision in a safe, culturally acceptable and sustainable manner"
I felt that the word "promote" was a key verb, as that is the way the WHO expressed it, not in some stronger, or weaker fashion.
I could not find the previous wording "mass male circumcision" in the document at all.
I can see how one could make a case for Adding "Africa" to the quote, in order to give a better context for statement. For instance, " within Africa, the World Health Organization and UNAIDS promote neonatal circumcision in a safe, culturally acceptable and sustainable manner" or "the World Health Organization and UNAIDS promote neonatal circumcision, within Africa, in a safe, culturally acceptable and sustainable manner" Or "the World Health Organization and UNAIDS promote neonatal circumcision in a safe, culturally acceptable and sustainable manner. Their recommendations are for Africa, not globally." Atom (talk) 23:27, 1 August 2008 (UTC)
Yes, and what do these have to do with the AMA's summary of worldwide medical organizations' positions on circumcision? Blackworm (talk) 01:42, 2 August 2008 (UTC)
The WHO policy is/was in the lede paragraph starting with the AMA's policy. This secion is discussing that paragraph, I believe. Atom (talk) 18:46, 3 August 2008 (UTC)
My initial reason for voting to take it out was partly because having looked at the studies myself and noted the criticisms of the studies: here, here,here, and herefor example and also the number of studies showing no affect means that you can't conclusively say that it prevents anything. So having it in the introduction is wrong. Also, you haven't addressed the more salient fact that it seems arbitrary. Why include info about HIV and not anything else? Why not include the American cancer society statement that circumcision should not be used to prevent penile cancer? Do you see what I mean? It is arbitrary and doesn't belong in the lead section. This article is about circumcision, not specifically about the link between circumcision and AIDS - which is why the paragraph that states that no medical association in the world recommends RIC, is relevant.Tremello22 (talk) 01:58, 2 August 2008 (UTC)
WHO perspective in lede
I think it is appropriate that if we choose to characterize the opinion of the AMA and the WHO in the lede in an abbreviate form that it be done accurately, according to reliable sources.
An editor has characterized this position as "However, the United Nations (World Health Organization/UNAIDS) support mass male circumcision to reduce female to male transmission of HIV" and points us to a source | UN Urges Mass Circumcision which is the newspaper "The Guardian". As it turns out, the Guardian citation [12] is a news story offering the opinion of the health editor, Sarah Bosley. REading the article thoroughly, although a good article, it is apparent that this is her opinion of their view, and not a quote of the actual UN or WHO policy, or even a quote of what a spokesperson for either organization has actually said.
I think a cite of this type could be useable in the Wikipedia article, somewhere other than the lede, in epxressing, perhaps, how some people have interpreted the WHO's position or recommendations.
What should be in the lede, however, is actually what the WHO has recommended, rather than someone opinion of what they think they heard, or what they think the WHO might have said. As I said in a previous section, pointing at the actual WHO document, and all of their broad recommendations (43 in all) we discuss what the AMA's official documented position is (although old, from 1999 -- but the last official position) which is displayed in the context of neonatal circumcision, and so we offer balance and NPOV by offering the WHO's official position regarding neonatal circumcision.
Just as it would not be appropriate to cite an article that suggested that the AMA now unofficially favors neo-natal circumcision (instead citing their most recent official position), it is approriate to cite the WHO's official position on neo-natal circumcision (rather than citing an article suggesting that they advocate "mass circumcision".) Perhaps they do -- I don't know and I don't care. Their official policy and recommendations is clearly stated in the cited reference. That should stand, and not someone else's opinion about what their position may be. Atom (talk) 15:31, 2 August 2008 (UTC)
I think the current wording is good. Well done, wiki-editors. "In 1999, the American Medical Association stated that virtually all medical organizations and specialty societies do not recommend routine neotantal circumcision [13]. The World Health Organization and UNAIDS promote neonatal circumcision in a safe, culturally acceptable and sustainable manner."☺Coppertwig (talk) 15:37, 2 August 2008 (UTC)
Gary, when you changed the statement from "The World Health Organization and UNAIDS promote neonatal circumcision in a safe, culturally acceptable and sustainable manner", which was a direct quote, to "The World Health Organization and UNAIDS recommended promotion of neonatal circumcision to combat the transmission of HIV when in a safe, culturally acceptable and sustainable manner." Essentially adding the observation/coment/opinion/text "to combat the transmission of HIV". I think it changes the basic nature of the statement. Okay, I can live with your version, I don't mean to quibble. My concern is that summarizing the complex set of concerns expressed by the WHO in that report, as well as previous statements by that organization, it oversimplifies. In my personal opinion, I think primarily that (what you added) may be the primary factor. In the abscence of the HIV concern, they very well may not have been willing to make that recommendation. That is speculation though. There are a variety of other factors they considered, including all of the things mentioned in the article (balancing the low risk of neo-natal complications from the procedure with/against the health benefits of reducing HIV, Penile Cancer, transmittion of STI's, etc.) Now that is my opinion. The statment you added, I think, may be your opinion too. Would it not be safer to either just stick with the exact quote of their recommendation -- or explain in more detail (an issue in the lede -- appropriate for later in the article)? Atom (talk) 17:16, 2 August 2008 (UTC)
The title of the source is "New Data on Male Circumcision and HIV Prevention: Policy and Programme Implications". From that alone we can infer a linkage in policy reasoning to recommend circumcision. This is also evident in the policy's conclusions and recommendations. It does mention other benefits and risks but the opening lead should only summarize. Garycompugeek (talk) 18:23, 2 August 2008 (UTC)
If it says "to combat the transmission of HIV" in the lead, I suggest changing this to "to combat female-to-male transmission of HIV" to avoid accidentally giving the wrong impression.☺Coppertwig (talk) 22:49, 2 August 2008 (UTC)
I've significantly changed the summary of the WHO/UNAIDS recommendations. Firstly, it is male circumcision which is recommended, not neonatal circumcision exclusively. Furthermore, the procedure is recommended as an additional strategy only; the source document contains the recommendation that "men opting for the procedure and their partners" should be informed that "male circumcision is not a 'magic bullet' for HIV prevention but is complementary to other ways of reducing risk of HIV infection." I think we should reflect that in the lead. Beejaypii (talk) 14:35, 3 August 2008 (UTC)
Having reviewed my last edit and the two sources used in the paragraph, I've made further changes to try to improve balance and accuracy. Beejaypii (talk) 17:43, 3 August 2008 (UTC)
I made some changes as well. The one that is most notable, Beejaypii, is a copyedit to make the whole section trimmer, including removing that art about female to male transmission. I had two reasons: FIRST because the UN/WHO document does not use that wording anywhere. I agree with you that clearly the pertinent research used by the WHO does not indicate that either male to female HIV transmission, nor male to male HIV transmission is reduced, that throughout the 34 recommendations they do not specify anyplace that it is to reduce only female to male HIV transmission. I am of the opinion that they did that intentionally. They do summarize the research in that respect, but make no recommendations based on that. I feel that they believe that male to female and male to male HIV transmission is reduced -- but know there is no research supporting that yet. Other documents indicate that they want to determine if this is the case. Regardless of my speculation, whether the WHO does or does not feel that way, they clearly did not specify in their recommendations "to reduce female to male HIV transmission". Which is why I don't think it should be stated that they said/recommended that. SECOND, this is the lede intro paragraph. It should be short and concise and is already to wieldy, even after my copyedit. Later in the article the fact that the existing research only shows a reduction in female to male HIV should be addressed. In the lede, we are contrasting the AMA's vew with the WHO's view. Initially it was restricted to their respective views on neonatal circumcision, not all of circumcision in general.
Atomaton, I'm not sure if you've written "male to female" when you meant "female to male", but in any case, the cited WHO document (last footnote in lead) lists as its second recommendation "Promoting male cirumcision should be recognized as an additional, important strategy for the prevention of heterosexually acquired HIV infection in men." I think if the lead mentions HIV reduction, it should specify "in men" or "female to male" or equivalent, to avoid giving a mistaken impression that there is any evidence that cirumcision reduces male to female transmission. I still suggest inserting "female to male": would you please clarify, Atomaton, whether you oppose my suggested edit and why? ☺Coppertwig (talk) 22:54, 3 August 2008 (UTC)
Sorry if I have mistated someplace. I think, reviewing my comments that I got it right. "the WHO does not indicate that either male to female HIV transmission, nor male to male HIV transmission is reduced" That would be correct. They indicate that research shows female to male HIV transmission is reduced by circumcision of men. I'd have no opposition to it if it were stated as you did "Promoting male cirumcision should be recognized as an additional, important strategy for the prevention of heterosexually acquired HIV infection in men." At one point I would have objected it being in the lede (as the lede had focused n neonatal polices of the AMA and the WHO -- now changed), but that para has expanded so much now, I am not sure that it matters. The latter thing I said was that the recommendation did not specifically use the term "female to male", but the expression "prevention of heterosexually acquired HIV infection in men" would be true to the cite. Atom (talk) 01:00, 4 August 2008 (UTC)
HIV in lead
In reply to some of the above: the reason HIV was in the lead was that the WHO is recommending circumcision as a means to reduce HIV occurrence. Given the WHO's importance as a leader of world health policy, this makes that fact notable. If a major international organization were recommending circumcision to combat some other disease, maybe it should be in the lead too. ☺Coppertwig (talk) 02:50, 2 August 2008 (UTC)
Everyone who replied to the RFC disagreed that it belongs in the lead. Which is why I removed it. Now its back. Blackworm has replaced it. Why? Garycompugeek (talk) 23:00, 6 August 2008 (UTC)
I did not know there was a consensus to remove it -- I merely restored both pre-June paragraphs (AMA and WHO) that were removed as they seemed to be treated as one issue in Talk, with one balancing the other. My objection is mainly to the removal of the AMA paragraph, although I do believe the WHO's HIV-related advocacy is relevant for the lead too. Additionally, as I've said, I think it's valid and informative note the real-world impact of that advocacy (mass male circumcision on a nominally voluntary basis in Africa).[13]Blackworm (talk) 23:07, 6 August 2008 (UTC)
AMA Quote 2
There is dispute again about the wording in the AMA quote. I prefer the accurated quote, cited asl closely as possible. In this case the discussion is which quote (if one wished to be concise) should dominate the lead on the AMA's opinion.
The two quotes, accurate from the citation are:
"Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision, and support the provision of accurate and unbiased information to parents to inform their choice." which is found in the "Summary and Comments section". I think the comment is relavent, and important.
The other quote:
"The AMA supports the general principles of the 1999 Circumcision Policy Statement of the American Academy of Pediatrics, which reads as follows: Existing scientific evidence demonstrates potential medical benefits of newborn male circumcision; however, these data are not sufficient to recommend routine neonatal circumcision. In circumstances in which there are potential benefits and risks, yet the procedure is not essential to the child's current well-being, parents should determine what is in the best interest of the child. To make an informed choice, parents of all male infants should be given accurate and unbiased information and be provided the opportunity to discuss this decision. If a decision for circumcision is made, procedural analgesia should be provided." Of which, only the first portion is provided. (See italized, above). This is from the Recommendations section, and recommendation two, of three recommendations given.
From looking at the document, it is my opinion that clearly the recommendation should prevail, as it is one of the recommendations given as the outcome of the report. It clearly states what the AMA recommends. The previous, summary and comments, is a portion of a number of comments (one of four paragraphs of comments). As I said, I feel that the comments are important, but that they are just a portion of the comments that explain the AMA recommendations. To clearly state the AMA's position, one needs to give their official recommendations, and not trump those recommendations with a portion of comments explaining the recommendations.
As an attempt to keep the balance of the article, and to satisfy editors who are likely to be up in arms, I included BOTH of these, giving the recommendations of the AMA first, for obvious reasons, and then the comment.
I know that the result is likely to be that someone will say that the lede is already too long, and this section needs to be shorter. I agree. But, to do that, one would have to point to the recommendations, and omit the comments. I welcome others input on this, but strongly feel that omitting the recommendations of the AMA, in favor of a small portion of the comments that cooincidentally seem to support on particular POV would not be the fair and balanced approach. Atom (talk) 01:23, 4 August 2008 (UTC)
Here's my take on the issue:
Policy statement by a single organization (AMA) that basically says they support another organization's policy (AAP) - Not notable enough for the lead. We could probably find 20 policy statements from separate medical organizations, and it would be hard to argue that some should be included in the lead, while others should be excluded.
Statement by the AMA which summarizes the policies of "virtually all" medical organizations - Notable enough for inclusion in the lead. It is the most concise way we can make this point.
It's not clear the 1999 AMA statement belongs in the lede at all; it almost certainly doesn't, given that it's just one national organization (not even the only U.S. one), and is now representing the medical view as of 10 years ago, not today. I've NPOVd it for now, but if I don't see any serious statements in support of its inclusion, I'm going to have to remove it. And serious statements would have to explain why 10 year old medical views from an organization representing only part of one country's doctors would belong in the lede. Jayjg (talk)03:13, 4 August 2008 (UTC)
But the Statement (comments) by the AMA says "Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision..." could very well be talking about virtually all specialty societies and medical organizations under the purview of the AMA. (American Context) They would probably not be speaking for the BMA (British) (although their policy is consistent with that) or the AMA (Australian) (non-medical circumcision is a breach of human rights) the Indian Medical Association ("the Indian medical fraternity seems to have come to accept the significance of circumcision in prevention of the deadly disease") or the Chinese Medial Associaiton (?). Why not briefly mention these organizations and their policies, rather than trying to get the AMA statement quote to cover it? Jayjg's position seems to have some merit in my opinion. Atom (talk) 03:32, 4 August 2008 (UTC)
I agree that the AMA statement's weakness is that it does not specify which medical association policies were assessed. AlphaEta04:20, 4 August 2008 (UTC)
This is nonsensical. If the AMA said that virtually all medical organizations recommended circumcision, it would be in bold in the first paragraph. As it was, the paragraph was put there as a summary of medical organizations' opinions, and it's still a valid one. The UN political view (WHO, UNAIDS, etc.) was a notable contrast and so it was there too. NPOV was served. There is no consensus to remove the AMA's summary, and no source has been brought to challenge that source. Blackworm (talk) 16:03, 4 August 2008 (UTC)
I perceive the consensus as being a group of editors removing the controversial, and non-essential text during a period of discussion about what to do with that text. Although I could live with it being permanently removed, I don;t believe that this has been decided, or a consensus formed. I believe it is still under discussion. I see these editors as participating in this consensus to excise the text, determine what to do with it, and what wording to use if it is returned, and then returning it (if there is no consensus for removal): AlphaEta, Atomaton, Jayjg. Also, you returned the wrong version of the text. The version that says the AMA follows the AAP policy is the latest, and cited directly form the AMA recommendations. See other discussions above. The very reasons the text was temporarily pulled was because of a disagreement on that wording. Atom (talk) 23:23, 5 August 2008 (UTC)
Maps and images
The editorial comments about censorship, etc. in the image are unencyclopedic and do not belong in the article. Having a dual image is not the solution either. Please work out all issues here before restoring the the map. may I suggest using patterns instead of colors if anyone is particularly disturbed by the choices? Thank you. -- Avi (talk) 21:53, 6 August 2008 (UTC)
Agreed. Some neutral colour choices were also suggested here. As I understand it, it those are used, and the image caption references "prevalence of male circumcision" and the source (UNAIDS), I don't see any remaining objections from anyone. Blackworm (talk) 22:38, 6 August 2008 (UTC)
Relevant discussion at