Talk:Circumcision/Archive 74
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. |
Archive 70 | ← | Archive 72 | Archive 73 | Archive 74 | Archive 75 | Archive 76 | → | Archive 80 |
New "update" for death statistics
Neither new source meet WP:MEDRS; Thymos does not appear to be MEDLINE indexed, or even have any information which would help establish its reliability such as discussing its editorial board or policies. There is no indication this meets WP:RS, much less WP:MEDRS. In any event, this would be a primary study anyways, and would not qualify for MEDRS. Yobol (talk) 01:55, 2 September 2012 (UTC)
- Thank you for clarifying! Crimsoncorvid (talk) 02:19, 2 September 2012 (UTC)
This came up earlier and I provided an in-depth response about how the source is inappropriate here.
Zad68
12:53, 2 September 2012 (UTC)
loose circumcision
Does anyone know something more on loose circumsision? I can't seem to find it anywhere, i'm sure it exists... People think:"you are circumsised or not" but you can also be semi circumsised as far as i know --Arthurrovich (talk) 20:59, 1 September 2012 (UTC)
- In looking at all the medical literature, I've never run across such a thing. If you can find a reliable source that talks about it, let us know about it. It probably would not even be something added to this article because what you are describing does not appear to meet the medical definition that this article uses. It's possible such content could go into a different article.
Zad68
12:52, 4 September 2012 (UTC)
Possible content
There might be some WP:MEDRS compliant material at this version, which is currently a redirect here. Biosthmors (talk) 18:33, 5 September 2012 (UTC)
metzitzah b’peh
Perhaps something from this article could be used in the medical or legal sections. http://www.nypost.com/p/news/local/circumcisers_kiss_of_death_S20ek2gmCGjA5432IvveMI Gråbergs Gråa Sång (talk) 12:54, 6 September 2012 (UTC)
- This religious practice is not part of the medical procedure discussed in this article. It is already covered at Brit milah.
Zad68
13:11, 6 September 2012 (UTC)
Primary sources vs. secondary sources
I saw an edit which removed old citations to primary literature, which is good.[1] But a more recent primary source was also added. WP:MEDRS asks that we pretty much always cite secondary sources, like review articles. A good review might look at a study from 1973, 1999, and 2010 and then throw out 5 others and then draw conclusions from those three studies. We would then cite the conclusions of the review, as an example of how it might work in the big picture of things. Biosthmors (talk) 04:14, 7 September 2012 (UTC)
- Understood and I appreciate your high standards! Although it was not ideal, overall my edit was definitely a WP:MEDRS improvement to the article. I removed three very dated primary studies. Two were done in particular localities in England, and to be frank, their findings were misrepresented by the article, as the article content the sources were supporting implied a general, non-locality-specific overuse of circumcision for phimosis, and again they were published too long ago. The VanHowe article was useless as it was a 14-year-old cost-effectiveness study (and actually I have found a recently-published cost-effectiveness study I'll be using in the article when I get a chance to). But the overall point of the article content was that there are other treatments for phimosis besides circumcision. The source I added was indeed WP:PRIMARY but according to WP:MEDASSESS it's the best kind of primary source--a recent randomized placebo-controlled trial. Agree, not as good as a reputable secondary, but the best I could find at the time. If you or I find a good secondary to replace it, we'll do it, surely.
Zad68
13:02, 7 September 2012 (UTC)
I edited the article to re-present Esposito (2008)'s finding appropriately as a WP:PRIMARY according to WP:MEDMOS.
Zad68
13:06, 7 September 2012 (UTC)- Frankly, we should be removing wholesale any old material (>10 years). I would also prefer secondary sources; surely there are plenty of them on the topic of circumcision, so that we don't need to use a primary source. Yobol (talk) 21:55, 9 September 2012 (UTC)
- I'm working on it, both the removing of old sources, and adding and using new, secondary sources...
Zad68
02:44, 10 September 2012 (UTC)
- I'm working on it, both the removing of old sources, and adding and using new, secondary sources...
Proposed updates to "Further reading"
The current "Further reading" list is lopsided and contains many out-of-date books. I am proposing that we prune out the out-of-date stuff and reorganize the list a bit. As circumcision is a medical topic and information on it can get dated quickly, I am proposing that we remove advocacy books written before 2005. Applying this cut-off rule eliminates a number of books from non-academic publishers or those written by authors with no academic credentials. I am also suggesting that we remove the two books that are very specific to Judaism and its bris laws, which are not relevant to the general topic of medical circumcision (I'll move those Judaism books to an appropriate article), and also the books in German as not relevant to the audience of English Wikipedia.
Regarding the advocacy balance, we have done a good job of keeping an even pro vs. anti ratio in the External links section, but even with this pruning out of the outdated books, this still leaves more anti-circumcision advocacy books vs. pro, although it's better than before. We can add another "pro" book or two if they're found. I have a feeling there are more anti books written than pro, so it may be appropriate to have have the list be a little unbalanced anyway.
So, proposal is as follows:
Pro-circumcision advocacy
- Edgar J Schoen, M.D. Ed Schoen, MD on Circumcision. Berkeley, CA: RDR Books, 2005. (ISBN 978-1-57143-123-3)
Anti-circumcision advocacy
- George C. Denniston; Frederick M. Hodges; Marilyn Fayre Milos (2009). Circumcision and Human Rights. Springer. ISBN 978-1-4020-9166-7.
- Leonard B. Glick. Marked in Your Flesh: Circumcision from Ancient Judea to Modern America. New York: Oxford University Press, 2005. (ISBN 978-0-19-517674-2)
- Robert Darby. A surgical temptation: The demonization of the foreskin and the rise of circumcision in Britain. Chicago: University of Chicago Press, 2005. (ISBN 978-0-226-13645-5)
Of historical interest
- Peter Charles Remondino. History of Circumcision from the Earliest Times to the Present. Philadelphia and London; F. A. Davis; 1891.
We remove:
- Billy Ray Boyd. Circumcision Exposed: Rethinking a Medical and Cultural Tradition. Freedom, CA: The Crossing Press, 1998. (ISBN 978-0-89594-939-4)
- Outdated 1998, Boyd has no medical background, Crossing Press is not an academic publisher (it publishes Christian materials)
- Anne Briggs. Circumcision: What Every Parent Should Know. Charlottesville, VA: Birth & Parenting Publications, 1985. (ISBN 978-0-9615484-0-7)
- Outdated 1985, found no qualifications for Briggs
- Aaron J. Fink, M.D. Circumcision: A Parent's Decision for Life. Kavanah Publishing Company, Inc., 1988. (ISBN 978-0-9621347-0-8)
- Outdated 1988, reviews say book is dated
- Paul M. Fleiss, M.D. and Frederick Hodges, D. Phil. What Your Doctor May Not Tell You About Circumcision. New York: Warner Books, 2002. (ISBN 978-0-446-67880-3)
- Outdated 2002, Fleiss is described as having "unconventional medical views"
- Ronald Goldman, Ph.D. Circumcision: The Hidden Trauma. Boston: Vanguard, 1996. (ISBN 978-0-9644895-3-0)
- Outdated 1996, author is a psychologist but does not appear to have medical credentials
- Paysach J. Krohn, Rabbi. Bris Milah. Circumcision—The Covenant Of Abraham/A Compendium of Laws, Rituals, And Customs From Birth To Bris, Anthologized From Talmudic, And Traditional Sources. New York: Mesorah Publications, 1985, 2005.
- Too specific to Judaism
- Brian J. Morris, Ph.D., D.Sc. In Favour of Circumcision. Sydney: UNSW Press, 1999. (ISBN 978-0-86840-537-7)
- Morris himself says his book is out-of-date and refers people to his website instead
- Holm Putzke, Ph.D. Die strafrechtliche Relevanz der Beschneidung von Knaben. Zugleich ein Beitrag über die Grenzen der Einwilligung in Fällen der Personensorge, in: H. Putzke u.a. (Hrsg.), Strafrecht zwischen System und Telos, Festschrift für Rolf Dietrich Herzberg zum siebzigsten Geburtstag am 14. Februar 2008, Mohr Siebeck: Tübingen 2008, p. 669–709 (ISBN 978-3161495700)
- In German
- Holm Putzke, Ph.D., Maximilian Stehr, Ph.D., and Hans-Georg Dietz, Ph.D. Liability to penalty for circumcision in boys. Medico-legal aspects of a controversial medical intervention, in: Monatsschrift Kinderheilkunde 8/2008, p. 783–788
- German
- Rosemary Romberg. Circumcision: The Painful Dilemma. South Hadley, MA Bergan & Garvey, 1985. (ISBN 978-0-89789-073-1)
- Outdated 1985, found no qualifications for Romberg
- Edward Wallerstein. Circumcision: An American Health Fallacy. New York: Springer, 1980 (ISBN 978-0-8261-3240-6)
- Outdated 1980, found no qualifications for Wallerstein
- Gerald N. Weiss M.D. and Andrea W Harter. Circumcision: Frankly Speaking. Wiser Publications, 1998. (ISBN 978-0-9667219-0-4)
- Outdated 1998
- Yosef David Weisberg, Rabbi. Otzar Habris. Encyclopedia of the laws and customs of Bris Milah and Pidyon Haben. Jerusalem: Hamoer, 2002.
- Too specific to Judaism
Feedback please... Zad68
17:24, 7 September 2012 (UTC)
- Agree broadly with the outline above. Old material should be removed, and we should really only be using good quality texts from academic publishers and from mainstream academic authors. Yobol (talk) 21:57, 9 September 2012 (UTC)
Another ref
Has this been used yet? Pinto, K (2012 Aug). "Circumcision controversies". Pediatric clinics of North America. 59 (4): 977–86. PMID 22857844. {{cite journal}}
: Check date values in: |date=
(help)
The Clinics publish well respect reviews. Doc James (talk · contribs · email) (if I write on your page reply on mine) 14:49, 12 September 2012 (UTC)
- No, not used yet, and I can't get more than the abstract. Can you help me get the full article text?? Wikipedia email is enabled for me.
Zad68
15:59, 12 September 2012 (UTC)
Ref does support
My addition was removed, apparently in part with the logic that the reference does not support the claim. Near the bottom of page 2 specifically states
Do not use EMLA Cream on the following areas:
• Cuts, grazes or wounds, excluding leg ulcers.
• Where there is a skin rash or eczema.
• In or near the eyes.
• Inside the nose, ear or mouth.
• In the back passage (anus).
• On the genitals of children.
This is a copy of the manufacturer-supplied information packet provided with the medication. While it is a primary source, it also is required to be factual as manufacturer-supplied drug information is regulated in the USA by the FDA. --Nouniquenames 18:40, 13 September 2012 (UTC)
- That same instruction sheet also says "When EMLA Cream is used on the genitals, a doctor or nurse should supervise its use." The instruction sheet you're linking to is for parents and not doctors. Regardless, reliable secondary sources like the AAP 2012 technical report say things like, "The analgesics used for newborn circumcision include nonpharmacologic and pharmacologic (topical and nerve blocks) techniques. The Task Force’s review included nonnutritive sucking, a pacifier dipped in sucrose, acetaminophen, topical 4% lidocaine (ie, LMX4 cream), a eutectic mixture of lidocaine-prilocaine local anesthetic (EMLA), subcutaneous ring block, and the dorsal penile nerve block (DPNB)." We don't use WP:PRIMARY to contradict WP:SECONDARY. Secondary sources say EMLA cream is used.
Zad68
18:53, 13 September 2012 (UTC)
POV?
We have section titles of "sexual effects" and "psychological effects" yet there aren't definitve effects established in either section. Biosthmors (talk) 17:47, 14 September 2012 (UTC)
- I'm getting there, I'm only doing one section at a time. As I'm purging out the old and primary sources and finding agreement in the newer secondary sources, I'm finding less content for these sections to justify having a whole section for each subject area anyway. What I might end up doing is eliminating the section headings and moving the small paragraphs into Complications. Any advice?
Zad68
17:51, 14 September 2012 (UTC)
- Sounds reasonable. Again, good work. =) Biosthmors (talk) 17:53, 14 September 2012 (UTC)
I've found some new sources with a Google Scholar search:
- Cansever, Gocke (1965). "Psychological effects of circumcision*". British Journal of Medical Psychology. 38 (4): 321–331. doi:10.1111/j.2044-8341.1965.tb01314.x. ISSN 0007-1129.
- Goldman, R. (2002). "The psychological impact of circumcision". BJU International. 83 (S1): 93–102. doi:10.1046/j.1464-410x.1999.0830s1093.x. ISSN 1464-4096.
- Boyle, G. J.; Goldman, R.; Svoboda, J. S.; Fernandez, E. (2002). "Male Circumcision: Pain, Trauma and Psychosexual Sequelae". Journal of Health Psychology. 7 (3): 329–343. doi:10.1177/135910530200700310. ISSN 1359-1053.
There are plenty more. Hopefully these could be used to help improve the article. - Stillwaterising (talk) 18:30, 14 September 2012 (UTC)
- Hi Stillwaterising, thanks for looking, but all those sources are too old to pass WP:MEDRS. In fact, Boyle 2002 was in the article and I just took it out as it was too old. Please look at WP:MEDRS for a description of the kind of sources we are looking for.
Zad68
19:44, 14 September 2012 (UTC)
- I would argue against removing Boyle 2002, especially in light that there does not seem to be a more recent review on this topic. If there's no newer equivalent study, then Boyle 2002 IS current medical information. Militant application of the "rule of thumb" guidelines for Use up-to-date evidence isn't even advised. It says: These instructions (Use up-to-date evidence) are appropriate for actively researched areas with many primary sources and several reviews and may need to be relaxed in areas where little progress is being made or few reviews are being published. - Stillwaterising (talk) 20:20, 14 September 2012 (UTC)
- We already have and are using two newer secondary sources.
Zad68
20:33, 14 September 2012 (UTC)
- Hiriji 2005 has only two paragraphs in the section named "Psychological effect" citing only 3 sources, none of which are comprehensive surveys of psychological effect of circumcision. To say that this article is superior to Boyle 2002, which has 40+ sources, is illogical. Hiriji2005 also has only two paragraphs in the section named "Sexual function and practice" with 6 cited sources. The argument that a newer review of sources ALWAYS supercedes one that was published 3 years (or 10 years) prior is misuse and misinterpretation of RS guidelines. - Stillwaterising (talk) 23:08, 14 September 2012 (UTC)
- I must agree with Stillwaterising. Until a source is found to give as in-depth coverage, there is no need to rush to delete this one. --Nouniquenames 00:53, 16 September 2012 (UTC)
- Except that there is the possibility that recent reviews do not cite the same literature because of evolving methodological standards, which is one of the reasons why we prefer recent reviews. Biosthmors (talk) 16:39, 16 September 2012 (UTC)
Removing very outdated secondary sources like Boyle 2002 and using newer secondary sources that cover the same topics is precisely the meaning and intent of the WP:MEDRS guideline. A newer secondary source has access to all the primary sources the older secondary source used, plus the older secondary sources themselves, plus newer sources the older source did section but will. not have--exactly this is true in the case here, and that is why, according to WP:MEDRS, we remove the outdated secondary sources and use the newer one. There is no rule that says that they have to list in the footnotes every source they used in their research, although they do almost always list the ones they mention specifically in the review. It's quite possible that they looked at a lot of primary sources and didn't find the evidence quality high enough to consider in their review or mention in their report.
Zad68
01:27, 16 September 2012 (UTC)- I disagree with your hypothesis that we should assume anything about the source in question and sources the source used. That would be OR. It may be best to start either a third opinion or an RFC. --Nouniquenames 06:38, 16 September 2012 (UTC)
- That the review sources do not list every source they came across is evident if you read the reviews. The hypothesis that the review articles list every such source is Stillwaterising's not mine, so it is him you disagree with. I'll be traveling for the next two days and may not be able to respond immediately, appreciate your patience.
Zad68
11:20, 16 September 2012 (UTC)- Agree with Zad if there is a newer ref that supports that content in question (ie one from the last 5 or at most 10 years) than we typically update it as he is doing. Doc James (talk · contribs · email) (if I write on your page reply on mine) 13:23, 16 September 2012 (UTC)
- That the review sources do not list every source they came across is evident if you read the reviews. The hypothesis that the review articles list every such source is Stillwaterising's not mine, so it is him you disagree with. I'll be traveling for the next two days and may not be able to respond immediately, appreciate your patience.
- I disagree with your hypothesis that we should assume anything about the source in question and sources the source used. That would be OR. It may be best to start either a third opinion or an RFC. --Nouniquenames 06:38, 16 September 2012 (UTC)
- I must agree with Stillwaterising. Until a source is found to give as in-depth coverage, there is no need to rush to delete this one. --Nouniquenames 00:53, 16 September 2012 (UTC)
- Hiriji 2005 has only two paragraphs in the section named "Psychological effect" citing only 3 sources, none of which are comprehensive surveys of psychological effect of circumcision. To say that this article is superior to Boyle 2002, which has 40+ sources, is illogical. Hiriji2005 also has only two paragraphs in the section named "Sexual function and practice" with 6 cited sources. The argument that a newer review of sources ALWAYS supercedes one that was published 3 years (or 10 years) prior is misuse and misinterpretation of RS guidelines. - Stillwaterising (talk) 23:08, 14 September 2012 (UTC)
- Stillwaterising could have a point, but I think they need to present an argument. Without knowing the literature, maybe recent reviews (what's the most recent one that reviews this, and where is a comprehensive list?) cite Boyle 2002 as a decent review and there is no difference in the kind of studies that were cited by Boyle in 2002 and those cited more recently. However, methodological expectations could have evolved rapidly. Also, I don't think saying "Boyle 2002 should be used" is very helpful to discussion unless it is tied to statements. What do people want to cite to Boyle 2002? And can that same information be identified in more recent reviews? If it can be cited to more recent reviews, this discussion is a waste of time. Biosthmors (talk) 16:39, 16 September 2012 (UTC)
- There have been significant changes in the primary literature since 2002 and a number of newer reviews are available. As mentioned by Bios we would need justification to continue using the Boyle paper. Doc James (talk · contribs · email) (if I write on your page reply on mine) 16:43, 16 September 2012 (UTC)
- Stillwaterising could have a point, but I think they need to present an argument. Without knowing the literature, maybe recent reviews (what's the most recent one that reviews this, and where is a comprehensive list?) cite Boyle 2002 as a decent review and there is no difference in the kind of studies that were cited by Boyle in 2002 and those cited more recently. However, methodological expectations could have evolved rapidly. Also, I don't think saying "Boyle 2002 should be used" is very helpful to discussion unless it is tied to statements. What do people want to cite to Boyle 2002? And can that same information be identified in more recent reviews? If it can be cited to more recent reviews, this discussion is a waste of time. Biosthmors (talk) 16:39, 16 September 2012 (UTC)
There may have been changes in the literature, but the title of this article is not "literature about circumcision." Unless the older literature has been refuted (an argument I have yet to see) or the technique has changed, the literature would still be reliable. --Nouniquenames 17:41, 16 September 2012 (UTC)
- Please listen to what is being said. Significant changes in the primary literature, and changes in the views of the older literature, are exactly the reasons why we remove the older secondaries and use the newer. Boyle mentioned the possibility of risks and anecdotal.evidence, that is what the BMA says. Hirji has access to newer studies than Boyle and mentions them. Boyle is unnecessary and outdated.
Zad68
18:26, 16 September 2012 (UTC) - Boyle himself said back in 2002 "evidence is starting to accumulate" and he makes no definitive statement regarding psychological effects. Since there have been more studies and newer reviews like Hirji make more definitive statements. FYI I will probably be offline until tomorrow night.
Zad68
18:48, 16 September 2012 (UTC)
- Also, please put forth what you actually want to cite from Boyle 2002 that can't be found in newer reviews. Arguing for the theoretical is not discussing changes to the article (WP:TPG), in my opinion. If you want to discuss changes to WP:MEDRS (which says articles should use recent sources, see Wikipedia talk:Identifying reliable sources (medicine). Biosthmors (talk) 00:22, 17 September 2012 (UTC)
Medical aspects
The section starts off with healthcare costs. That seems awkward. Could probably use an Economics section altogether, I would guess. Biosthmors (talk) 18:39, 19 September 2012 (UTC)
- I just finished re-sourcing and rewriting the pain section this morning, and I am at this very minute pulling the sources to rewrite the section on economics/cost-effectiveness. I'm seeing that this topic is very specific to individual populations based on national health systems and HIV risk levels. I may possibly move the whole section out of there and into a section on country-specific topics, it definitely does not belong in the medical topics area. I'm just not very fast! Doing this properly takes quite a while, at least it does for me, and I'm doing this work in between my real job and family stuff. I'm getting there, Biosthmors, I'm getting there...
Zad68
18:50, 19 September 2012 (UTC)
- I moved the economic info to its own section and then did some general restructuring, there were a lot of random bits of content stuck here and there that had to be moved together.
Zad68
20:03, 19 September 2012 (UTC)
- Of course! I've been doing a good article review of malaria for months. No rush. It just stuck out to me. Thanks again. Biosthmors (talk) 15:36, 20 September 2012 (UTC)
"Prevalence of circumcision by country"
Surely this map is misleading as to some countries and incorrect as to others. (1) The rate in Australia is now down well under 20%; higher overall incidence refers to older males born before the last few decades. (2) Malaysia is only slighter more than 50% Malay: Malays are al Muslim but pre-Malay aboriginals are largely not Muslim; substantial ethnically Chinese population is not Muslim at all and only a minority of ethnically Indian, who are substantially Hindu, Sikh and Christian. (3) Indonesia has a national population of 237,424,363 but Islam is far from universal and non-Muslim populations are the majority in various provinces: west New Guinea (though divided by the federal government into three provinces in recent years to accommodate Javanese takeovers in certain areas since Indonesia seized west New Guinea in 1961; Bali is substantially Hindu; there are large pockets of Christians in various other provinces, tending to predominate in certain regions. (4) Canada is down to under 30%, a proportion not at all indicated by the “30-80%” rate that is given in the table. Can the table not be replaced with one that is less misleading as to visual representation of table percentages? 121.222.204.247 (talk) 02:15, 18 September 2012 (UTC)
- The chart is pulled right out of the World Health Organization's report, and Wikipedia considers the WHO to be authoritative. You are correct in your point that if Australia or Canada continue at a lower rate, the prevalence will also move lower over time, but the chart is clearly labeled "prevalence" and not "rate," and the section it is in is called "prevalence." Your thoughts about what the rates should be for the other countries you mentioned based on assumptions about religion look like original research; Wikipedia requires reliable sources. If you have another source you'd like to see considered, please bring it.
Zad68
02:28, 18 September 2012 (UTC)- Not disputing the reliability of the World Health Organization's report, only the misleading indication that the near-zero in Australia and 30% in Canada is misrepresented by the "20-80%" indication. That indicates the living male population birth to death, not the rate.121.222.204.247 (talk) 03:03, 18 September 2012 (UTC)
- Again, the chart is clearly labelled "prevalence" and not "rate".
Zad68
03:16, 18 September 2012 (UTC)- The question is, does the average reader immediately understand the difference, or are you non-neutrally banking on the average reader confusing the two? I mean, we all know it's the latter, just wanted to point out the obvious for the benefit of sane people. --78.35.253.216 (talk) 18:55, 4 October 2012 (UTC)
- We need not assume the stupidity of the reader. If someone confounds "prevalence" (clearly labelled) as "rate", they might just well confuse circumcision with crucifixion. Carlossuarez46 (talk) 20:37, 4 October 2012 (UTC)
- The question is, does the average reader immediately understand the difference, or are you non-neutrally banking on the average reader confusing the two? I mean, we all know it's the latter, just wanted to point out the obvious for the benefit of sane people. --78.35.253.216 (talk) 18:55, 4 October 2012 (UTC)
- Again, the chart is clearly labelled "prevalence" and not "rate".
- Not disputing the reliability of the World Health Organization's report, only the misleading indication that the near-zero in Australia and 30% in Canada is misrepresented by the "20-80%" indication. That indicates the living male population birth to death, not the rate.121.222.204.247 (talk) 03:03, 18 September 2012 (UTC)
Parents offered the choice
Isn't it true that for parents offered the choice of whether to have their newborn sons circumcised, the vast majority choose to have their sons circumcised. The vast majority of geographies that have low circumcision rates they dont even present the parents with a choice. The low prevalence may be as much to do with nonavailibity or costs. Similarly one may infer that lamborghini is a very unwanted car brand because there are many more fords or fiats on the roads. So lack of prevalence has nothing to say about desirability which seems to be the implication of the article. — Preceding unsigned comment added by 67.166.158.16 (talk) 03:23, 27 September 2012 (UTC)
- Sounds interesting, do you have a reliable source we can use? We actually do have some information along this line, the new Johns Hopkins study mentions a decline in the circumcision rate after the cost of the procedure was no longer covered by third-party payers, causing the out-of-pocket costs to the parents to increase.
Zad68
02:15, 28 September 2012 (UTC)
Undue emphasis on single source?
Hi all. I just want to throw something out there for consideration.
I've noticed that one particular source – the American Academy of Pediatrics Circumcision Policy Statement – is currently referenced 29 times (see reference number six in the version current at time of writing) – twice as many times as the next most cited source. This is the policy statement of one particular US medical organisation and is referenced in the following sections/sub-sections:
- Lead – four times (pain reduction and psychological stress, impact on sexual function, UTIs and cancer, ethical questions)
- Modern procedure:Removal of the foreskin – twice
- Modern procedure: Aftercare – one of the only two reference sources
- Modern procedure: Pain management – five times in the space of three short paragraphs, effectively dominating the entire sub-section
- Modern procedure: Complications and risks – twice, and dominates the entire first (and largest) paragraph of the section, exclusively
- Effects: Urinary tract infections – five out of the six references over the two paragraphs of the entire sub-section.
- Effects: Cancers – four out of the 18 references, which is over one fifth of the total
- Society and culture: Ethical issues: Consent – one reference; the very first one
- Society and culture: Economic considerations – two references
- Positions of medical associations: United States – two references
(Please feel free to correct any mistakes in my observations above)
So, excluding the Positions of medical associations section – where use of this source in the relevant sub-section is obviously non-contentious – this single AAP source appears in eight out of the 16 subsections in the article. Bearing in mind that the authorship (the AAP Task Force on Circumcision), apparently consists of just eight individuals, representing just one nation, could it be possible that there are NPOV and undue emphasis issues here? Isn't this suspiciously US-centric, and doesn't it allow the views of a small number of individuals representing a single organisation to dominate the article in many respects? And crucially, can this be justified with respect to Wikipedia policies? Beejaypii (talk) 11:59, 11 October 2012 (UTC)
- Beejaypii makes and excellent point and I agree this article has always been way to US centric. Being that the majority of the world is not circumcised should we really rely so heavily on one organization in the US? How do we compensate for this bias? Perhaps more European and Asian refs? Garycompugeek (talk) 13:40, 11 October 2012 (UTC)
Hi BJP, on the surface it might appear to be undue use if you're just counting the number of cites, but the AAP's 2012 technical report is 30 pages long and provides a tremendous amount of technical detail reflecting the most up-to-date evidence regarding a wide range of circumcision-related topics. The other secondary sources we're using don't cover as many topics in as much detail. The meta-analyses and the systematic reviews provide in-depth analysis of the primary sources, but only in one specific topic area. Using a few of the examples you cited:
- Regarding pain management, AAP 2012 is used alongside Lonngvist 2010, BMA 2006, CPSBC 2009, Shockley 2011, and Wolter 2008
- Regarding complications and risks, AAP 2012 is used alongside AAFP 2007, AUA 2007, Weiss 2010, KNMG 2010, Sadeghi-Nejad 2010, Perera 2010, Doyle 2010, BMA 2006, and Hirji 2005
- Regarding cancer, AAP 2012 is used alongside Mayo Clinic, Larke 2011, Hayahsi 2011, Rehmeyer 2011 and Bosch 2009.
- Regarding UTIs, AAP 2012 is used alongside Jagannath 2011... if you have more WP:MEDRS-compliant sourcing, please bring it.
- In many cases the other refs used alongside AAP 2012 are not from the USA. So I understand your concern but if you take a closer look at the sourcing on a topic-by-topic basis, I don't think the article actually exhibits a problem with undue use of AAP 2012. Also, be careful not to simply count the number of footnote superscripts, in many cases a single source can be used to provide support for multiple medical claims. Cheers...
Zad68
13:45, 11 October 2012 (UTC) - Adding, I also looked into the concern that the sources are too USA-centric. For the sources I listed above, I pulled their countries of origin:
- AAP 2012 - USA
- AAFP 2007 - USA
- AUA 2007 - USA
- BMA 2006 - Britain
- Bosch 2009 - Spain
- CPSBC 2009 - Canada
- Doyle 2010 - USA
- Hayahsi 2011 - Japan
- Hirji 2005 - Britain
- Jagannath 2011 - Bahrain
- KNMG 2010 - The Netherlands
- Larke 2011 - Britain
- Lonngvist 2010 - Sweden
- Mayo Clinic - USA
- Perera 2010 - Australia
- Rehmeyer 2011 - USA
- Sadeghi-Nejad 2010 - USA
- Shockley 2011 - USA
- Weiss 2010 - Britain
- So 8 of the 19 sources, less than half, come from teams based in the USA, and Europe and Asia (Gary's concern) are indeed represented in the sourcing. Also, keep in mind that in general, the systematic reviews pull their primary sources they analyze from all over the world with no language restriction. So, even if the reviewers are based in the USA, the underlying data they are looking at will be from all over the world and from many languages (I didn't go this deep down in my look at the locations of the sourcing to see if this was the case for this list).
Zad68
14:23, 11 October 2012 (UTC)
Paul on Gentile Conversion
I am surprised to find that Paul's insistence that Jewish law, including the necessity of circumcision, did not bind gentiles who wished to become Christians is not mentioned in the article regarding circumcision. Jim Lacey (talk) 16:13, 29 October 2012 (UTC)
- You are right, it's a serious omission. I recognized I missed including that and have plans to add it to the history section soon.
Zad68
17:12, 29 October 2012 (UTC)- You may consider adding it to controversies section instead: see Circumcision controversy in early Christianity. Carlossuarez46 (talk) 07:13, 31 October 2012 (UTC)
- It's covered there but it needed a mention here, in due weight.
Zad68
19:12, 5 November 2012 (UTC)
- It's covered there but it needed a mention here, in due weight.
Done Content about circumcision and Christianity added.
Zad68
19:12, 5 November 2012 (UTC)
- You may consider adding it to controversies section instead: see Circumcision controversy in early Christianity. Carlossuarez46 (talk) 07:13, 31 October 2012 (UTC)
Circumcision may have a negative impact on sexual function.
This sentence needs to be changed- Circumcision does not appear to have a negative impact on sexual function.[6][8][9][10]
This is what the above sentence needs to be changed to. Circumcision does appear to have a negative impact on sexual function. [1][2][3][4] GothHick49 (talk) 19:13, 30 October 2012 (UTC)
or the sentence should be removed as it is a controversial statement.GothHick49 (talk) 19:13, 30 October 2012 (UTC)
- When articles deal with medical issues like sexual function after a medical procedure, they must reflect highly reliable sources, which is guidance you should review to understand the criteria. The references you suggest do not satisfy those criteria. Our article must reflect mainstream opinion regarding sexual function, and avoid giving weight to opinions that are outside the mainstream. We do have an article that addresses a variety of Circumcision controversies, which might be of interest to you. -- Scray (talk) 16:28, 30 October 2012 (UTC)
I would suggest that both be reported; there are credible studies emerging that indicate circumcised men do indeed suffer more sexual complications than intact men: for example. This would better reflect the disagreements between medical camps (the no-effect proponents largely being localised to the United States anyway, so as the article stands it is biased towards that area) than a clear-cut statement in either direction. Noodlemaz (talk) 20:29, 30 October 2012 (UTC)
The sentence should be removed as it is a controversial statement.GothHick49 (talk) 19:13, 30 October 2012 (UTC)
You could just take the whole article about Circumcision down as it is a controversial subject as a whole. GothHick49 (talk) 19:16, 30 October 2012 (UTC)
- There is no Wikipedia policy that discourages creating articles on controversial topics. Wikipedia articles on medical topics reflect what the best, most up-to-date reliable secondary sources say. The sources that you mention in your suggested edit are not considered by Wikipedia standards to be reliable sources and will not be used to support article content. For Wikipedia's guidelines on sourcing for medical articles, please see WP:MEDRS
Zad68
19:57, 30 October 2012 (UTC)
Maybe it's Mr. Jake Waskett's involvement, his conflict of interest, having co-authored with Mr. Brian Morris. How do you have an objective article when you have conflict of interest? GothHick49 (talk) 20:25, 30 October 2012 (UTC)
So, why not take the sentence out? GothHick49 (talk) 20:27, 30 October 2012 (UTC)
- The sentence should not come out because it is very, very well-sourced according to Wikipedia standards. Not one of the four sources cited in support of the sentence is authored or co-authored by either Mr. Waskett or Mr. Morris, so I am not sure why you bring those individuals up. If you feel there is a conflict of interest, please raise your concerns at Wikipedia:Conflict of interest/Noticeboard.
Zad68
20:35, 30 October 2012 (UTC)
Just because a subject is well sourced, doesn't mean it should be published as the truth. The article should only state what circumcision is and not what it is thought to do or not do. The article should not lean one way or the other, pro or con. GothHick49 (talk) 20:45, 30 October 2012 (UTC)
- The article reflect the various sources that discuss this issue. If you wish to correct this 'lean', either explain why the sources used are inappropriate, or provide additional reliable sources expressing a contrary view - and by reliable, I mean not an advocacy website. Ankh.Morpork 20:51, 30 October 2012 (UTC)
A statement as well-sourced as this one will be presented in Wikipedia's narrative voice. This is covered at WP:MEDRS. You have been directed to WP:MEDRS several times now. Have you read it yet?
Zad68
20:53, 30 October 2012 (UTC)
WIKIPEDIA DOES NOT GIVE MEDICAL ADVICE Wikipedia contains articles on many medical topics; however, no warranty whatsoever is made that any of the articles are accurate. There is absolutely no assurance that any statement contained or cited in an article touching on medical matters is true, correct, precise, or up-to-date. The overwhelming majority of such articles are written, in part or in whole, by nonprofessionals. Even if a statement made about medicine is accurate, it may not apply to you or your symptoms. The medical information provided on Wikipedia is, at best, of a general nature and cannot substitute for the advice of a medical professional (for instance, a qualified doctor/physician, nurse, pharmacist/chemist, and so on). Wikipedia is not a doctor. None of the individual contributors, system operators, developers, sponsors of Wikipedia nor anyone else connected to Wikipedia can take any responsibility for the results or consequences of any attempt to use or adopt any of the information presented on this web site. Nothing on Wikipedia.org or included as part of any project of Wikimedia Foundation, Inc., should be construed as an attempt to offer or render a medical opinion or otherwise engage in the practice of medicine. GothHick49 (talk) 21:13, 30 October 2012 (UTC)
This sentence is advising people that circumcision does no harm- Circumcision does not appear to have a negative impact on sexual function. GothHick49 (talk) 21:19, 30 October 2012 (UTC)
- The sentence under discussion does not provide medical advice.
Zad68
22:31, 30 October 2012 (UTC)
Wikipedia should be written from a neutral point of view. The sentence under discussion is not neutral. GothHick49 (talk) 22:38, 30 October 2012 (UTC)
Wikipedia does not have firm rules. Rules in Wikipedia are not carved in stone, as their wording and interpretation are likely to change over time. The principles and spirit of Wikipedia's rules matter more than their literal wording, and sometimes improving Wikipedia requires making an exception to a rule. Be bold (but not reckless) in updating articles and do not worry about making mistakes. Prior versions of pages are saved, so any mistakes can be corrected. GothHick49 (talk) 22:40, 30 October 2012 (UTC)
- Ok, I've left you a Welcome message at your talk page, pointing you to Wikipedia's policies and guidelines, and also an invitation to visit the Tea House, where you can ask general questions. After you have done that, we can pick up this discussion again. Cheers...
Zad68
22:48, 30 October 2012 (UTC)
What? GothHick49 (talk) 22:52, 30 October 2012 (UTC)
"...sometimes improving Wikipedia requires making an exception to a rule." GothHick49 (talk) 22:58, 30 October 2012 (UTC)
The sentence under discussion is advocating advice and support of circumcision. GothHick49 (talk) 23:08, 30 October 2012 (UTC) The sentence under discussion is misleading. GothHick49 (talk) 23:08, 30 October 2012 (UTC)
These sentences do not seem to agree with the sources. Summaries of the views of professional associations of physicians state that none recommend routine circumcision,[26][27] and that none recommend prohibiting the practice.[27] This is what the first source says. Non-therapeutic circumcision of male minors (2010) The official viewpoint of KNMG and other related medical/scientific organizations is that non-therapeutic circumcision of male minors is a violation of children’s rights to autonomy and physical integrity. Contrary to popular belief, circumcision can cause complications – bleeding, infection, urethral stricture and panic attacks are particularly common. KNMG is therefore urging a strong policy of deterrence. KNMG is calling upon doctors to actively and insistently inform parents who are considering the procedure of the absence of medical benefits and the danger of complications.
I cite these sources for being against circumcision, www.doctorsopposingcircumcision.org [5] arclaw.org [6] http://www.nocirc.org/ [7]http://www.intactamerica.org/ [8] GothHick49 (talk) 03:59, 31 October 2012 (UTC)
- I've taken a look at the sources you're suggesting, but (as you've been told by more than one editor here) those sources are not acceptable in this context (and we've explained why above); I realize that this may be frustrating, but an encyclopedia must have standards for sourcing. Your responses above don't demonstrate that you've seriously considered the suggestions others have made and the policies & guidelines that have been highlighted above - have you read them? Also, just so that you're aware in future discussions, the section headings of Talk pages should state the topic without indicating a particular point of view. I hope you'll familiarize yourself with WP's policies - otherwise, you'll have a hard time contributing here. The teahouse is a great place to discuss the policies. -- Scray (talk) 11:45, 31 October 2012 (UTC)
I have read this from a source that is cited on the article, "The prepuce may protect the glans by acting as a barrier against contamination and maintaining a moist environment for the glans, and its complex innervation suggests that it may also enhance sexual pleasure." [9] GothHick49 (talk) 15:04, 31 October 2012 (UTC)
- It is great that you are now looking to use WP:MEDRS-compliant sources. The sentence you mention is pulled from the introduction, and is one of the things the systematic review will investigate. What we use are the results of the systematic review: "The evidence suggests that adult circumcision does not affect sexual satisfaction and function," and in the discussion of the results, "The evidence did not show a decrease in sexual satisfaction and function after circumcision."
Zad68
15:17, 31 October 2012 (UTC)
That is a good point. Maybe it's the paragraph that's the problem. If the infant section and the adult section were separated into two paragraphs, it wouldn't seem to be misleading. GothHick49 (talk) 16:21, 31 October 2012 (UTC)
- AAP 2012 does indeed include studies comparing men circumcised neonatally vs. uncircumcised men, and the source is clear: "The literature review does not support the belief that male circumcision adversely affects penile sexual function or sensitivity, or sexual satisfaction, regardless of how these factors are defined." Do you not agree the sentence reflects the best available WP:MEDRS-compliant reliable secondary sources accurately?
Zad68
17:59, 31 October 2012 (UTC)
I'm unclear how the AAP can be used as a source and not the D.O.C.[10] both are organizations of physicians. GothHick49 (talk) 21:38, 31 October 2012 (UTC)
JOURNAL OF MEN'S HEALTH AND GENDER, Volume 4, Number 3: Page 361, September 2007. Does circumcision improve couple’s sexual life? I. Solinis Department of Urology, General Hospital of Didimoticho, Didimoticho, Greece A. Yiannaki Department of Urology, General Hospital of Didimoticho, Didimoticho, Greece Background: The aim of the study was to compare sexual life and enjoyment of men (and their partner) that were circumcised as adults before and after their circumcision. Methods: The study included 123 sexually active men that were circumcised two years before or more. The mean age was 36 years (22– 64). All the men filled a questionnaire about the quality of their sexual life and the sexual enjoyment before and after circumcision. Also, there were questions about partner’s sexual life improvement. The results are presented below. Results: 16% answered that their sex life was improved, while 35% reported a worse sex life after circumcision. There were no significant differences in erection and ejaculation. 65% reported that the ejaculation latency time increased significantly after circumcision but only 10% of them reported that this fact improved sexual life. 46% of men reported that their partner’s sexual life worsened after circumcision, 33% reported that their partner’s sexual life improved and 21% reported no significant difference. Conclusion: There was a decrease in couple’s sexual life after circumcision indicating that adult circumcision adversely affects sexual function in many men or/and their partners, possibly because of complications of surgery and loss of nerve endings. The results support the view that physicians and parents should be informed of the potential benefits and risks before newborns are circumcised. GothHick49 (talk) 21:44, 31 October 2012 (UTC)
I can not find where the AAP says that circumcision has no negative impact on sexual function. This is all I can find. SEXUAL PRACTICE, SENSATION, AND CIRCUMCISION STATUS A survey of adult males using self-report suggests more varied sexual practice and less sexual dysfunction in circumcised adult men.13 There are anecdotal reports that penile sensation and sexual satisfaction are decreased for circumcised males. Masters and Johnson noted no difference in exteroceptive and light tactile discrimination on the ventral or dorsal surfaces of the glans penis between circumcised and uncircumcised men.31 [11] GothHick49 (talk) 22:12, 31 October 2012 (UTC)
- I see part of the problem--you are still looking at the old 1999 policy. You need to see the new 2012 policy. At the link you gave, at the top, it says, " This policy has been revised by the policy on 130 (3): 585." Click on that. I or somebody else will address your other points regarding sources later, but the gist is that those sources you are bringing aren't even in the same ballpark in terms of source reliability as compared to the sources the article currently uses.
Zad68
00:00, 1 November 2012 (UTC) Regarding your previous suggested sources, again, WP:MEDRS is your guide. You've read it by now, haven't you? Regarding the American Academy of Pediatrics vs. Doctors Opposing Circumcision, please see Wikipedia:MEDRS#Medical_and_scientific_organizations for the kinds of organization Wikipedia recognizes as authoritative. D.O.C. is an advocacy group, not a medical organization like the AAP. The Journal of Men's Health and Gender is not a MEDLINE-indexed journal and so fails to meet even the bare minimum requirement for a journal for medical sourcing. Even if it were, the study you mention is a primary study, and Wikipedia strongly prefers secondary sources like systematic reviews, as the article currently has. And, the study is too old by WP:MEDRS standards. You would have known this if you had read through WP:MEDRS first.
Zad68
04:17, 1 November 2012 (UTC)
Zad68, thank you for being patient and understanding as this newbie is learning the ropes about Wikipedia. I can't seem to find a study of the affects of circumcision on infant boys in latter life as adults. Do you know of any? Maybe I'm just over looking it in the article. GothHick49 (talk) 18:08, 1 November 2012 (UTC)
- Did you find it or not? I saw you said you did but you removed that message?
Zad68
18:26, 1 November 2012 (UTC)
Oh, sorry, I didn't find it. GothHick49 (talk) 18:41, 1 November 2012 (UTC)
- Your question actually had me make a correction to the sourcing in the article. The article only had the citation for the AAP 2012 Policy but not the Technical Report. I have updated the article so that the AAP 2012 reference includes cites for both the AAP Policy and the Technical report, so thank you for that. Here are the links to the:
- The individual studies can be found in the Technical Report, give that a look-through.
Zad68
19:10, 1 November 2012 (UTC)
- You posted a bit from Perera 2010 ("Safety and Efficacy..."). Why?
Zad68
19:14, 1 November 2012 (UTC)
I'm wondering why myself. I'll remove it. GothHick49 (talk) 19:20, 1 November 2012 (UTC)
The AAP used the results from a Australian telephone survey as a source, really? GothHick49 (talk) 20:08, 1 November 2012 (UTC)
The AAP cites several sources of the same study, why would they do that? GothHick49 (talk) 20:27, 1 November 2012 (UTC)
- Re AAP using Australian survey: Apparently so. Note that there are also three other journal articles in use at that sentence. The AAP also says the quality of the evidence of the four reports cited in that sentence is "good and fair", although they don't tell you which ones are "good" and which ones are "fair".
Zad68
20:35, 1 November 2012 (UTC)
Here's one of the AAP's sources studies [12] OBJECTIVE To prospectively study, using a questionnaire, the sexuality of men circumcised as adults compared to uncircumcised men, and to compare their sex lives before and after circumcision. SUBJECTS AND METHODS The study included 373 sexually active men, of whom 255 were circumcised and 118 were not. Of the 255 circumcised men, 138 had been sexually active before circumcision, and all were circumcised at >20 years of age. As the Brief Male Sexual Function Inventory does not specifically address the quality of sex life, questions were added to compare sexual and masturbatory pleasure before and after circumcision. RESULTS There were no significant differences in sexual drive, erection, ejaculation, and ejaculation latency time between circumcised and uncircumcised men. Masturbatory pleasure decreased after circumcision in 48% of the respondents, while 8% reported increased pleasure. Masturbatory difficulty increased after circumcision in 63% of the respondents but was easier in 37%. About 6% answered that their sex lives improved, while 20% reported a worse sex life after circumcision. CONCLUSION There was a decrease in masturbatory pleasure and sexual enjoyment after circumcision, indicating that adult circumcision adversely affects sexual function in many men, possibly because of complications of the surgery and a loss of nerve endings.
I'm wondering how the AAP came to the conclusion that circumcision didn't affect sexual function? How ironic, while reviewing some of these studies the advertisement at the top of the page was for Viagra. GothHick49 (talk) 20:49, 1 November 2012 (UTC)
I didn't see your post until after I posted the above. "Good and fair" GothHick49 (talk) 20:52, 1 November 2012 (UTC)
- Re Viagra... LOL! That's quite ironic. :)
Re your general questioning of whether we can trust the AAP as an authoritative source: I can tell you that the community of experienced Wikipedia medical article editors does indeed trust the AAP as an authoritative source. If you'd like to raise the general question of whether Wikipedia editors should or should not consider AAP technical reports as authoritative, reliable secondary sources you can raise the question at WP:RSN, but I bet you can already guess what the answer is going to be.
Zad68
20:56, 1 November 2012 (UTC)
My main concern now is the confusing term of "male circumcision" vs. "infant circumcision". Even in the AAP report it was quite confusing whether they were referring to adult male or infant male. GothHick49 (talk) 22:14, 1 November 2012 (UTC)
I wonder why the AAP removed it's sources from their Circumcision Policy Statement? Are they monitoring this page? hmm? GothHick49 (talk) 00:47, 2 November 2012 (UTC)
That doesn't seem like a very reliable source? GothHick49 (talk) 01:02, 2 November 2012 (UTC)
- Re "male circumcision" vs. "infant circumcision", in my read of the Technical Report I am not experiencing confusion. The wording the AAP chose is "Male circumcision does not appear to adversely affect penile sexual function/sensitivity or sexual satisfaction." If they meant "adult" or "infant" circumcision only they would have said so.
Re "I wonder why the AAP removed it's sources... Are they monitoring this page"... what are you talking about? I truly don't understand. The AAP did not remove any sources from anywhere, and the idea that the AAP is "monitoring" this page is a WP:REDFLAG.
Zad68
02:29, 2 November 2012 (UTC)
They were here [13] now they're not. GothHick49 (talk) 03:08, 2 November 2012 (UTC)
- You're looking at the Abstract view. In the vertical gray bar in the middle of the page, click on "Full Text (PDF)".
Zad68
03:12, 2 November 2012 (UTC)
already. Carlossuarez46 (talk) 07:20, 2 November 2012 (UTC)
I'm no troll. GothHick49 (talk) 14:27, 2 November 2012 (UTC)
It's not there. Not even in the pdf. GothHick49 (talk) 14:27, 2 November 2012 (UTC)
What about this as a source? [14] GothHick49 (talk) 14:27, 2 November 2012 (UTC)
- 1) They are there on pages e779 to e785 of the Technical Report PDF. I am sorry I am unable to help you any more with this, try the Wikipedia:Reference_desk. 2) We already use it.
Zad68
14:35, 2 November 2012 (UTC)
But it DOES sometimes have a negitive impact on sexual function. If too much skin is removed it can cause painful or possibly bleeding erections, entrapped penis, lots of things
spend like 2 seconds on google gives you points to look for on more scholarly databases somewhere http://answers.yahoo.com/question/index?qid=20120525044949AAnIN9P http://www.healthboards.com/boards/mens-health/898256-circumcision-painful-erections.html http://www.dukehealth.org/health_library/health_articles/buried-penis-disorder-q-a-with-detlev-erdmann-md-phd ect. these are just top 3 results when searched
trapped penis, painful erections and hairy shaft(too much skin taken scrotal skin pulled onto penis(irritates female organ, need to shave it) are "Circumcision may have a negative impact on sexual function" [[User:|27.30.317.816]] (talk) 03:06, 6 November 2012 (UTC)
- You need to read WP:RS and also WP:MEDRS. Chat boards are never reliable sources for anything. The dukehealth.org page discusses buried penis from improperly-performed circumcisions, not properly-performed ones, and is not a useful source for the subject of sexual effects of circumcision. Also, the dukehealth.org page is all the way at the bottom of WP:MEDASSESS, please read up on Wikipedia's requirements for reliable sources using the links I have provided here.
Zad68
03:27, 6 November 2012 (UTC)
International Response to the AAP Report to be published in Pediatrics in early 2013
The statement of German pediatric society BVKJ for the upcoming (Nov 26) hearing of the Bundestag's legal committee contains the English abstract, list of authors and their affiliations (at the end) of the response to this year's AAP report that is going to be published in AAP's Pediatrics in early 2013. Perhaps this has some place in this or one of the related articles. — 188.194.78.200 (talk) 00:48, 22 November 2012 (UTC)
- I read the English abstract and pieces of the document using Google Translate. Reading through the translated German, the point of the document seems to be arguing against currently-proposed legislation in Germany to make religious non-therapeutic circumcision explicitly legal. It makes its own medical case against circumcision and then, based on that, argues against the legislation.
I was not able to determine exactly which particular medical effects will be addressed in the Pediatrics publication this document pre-announces, or to what degree the conclusions in the Pediatrics publication will be different from what the current secondary sources say. In the current article, AAP 2012 is used nearly exclusively as a source for medical complications and effects. The document mentioned argues against the AAP's position that the medical benefits outweigh the risks, and that part of AAP 2012 isn't really used here.
The document makes the usual ethical and legal arguments (bodily integrity, consent), and those are already covered in the article. One thing I saw, it seems odd to me that in Section 4, the worldwide body of data used in the systematic reviews regarding complications seems to be being ignored, and instead "an Internet-based survey" of German institutions is being used to determine complication rates. (It's possible this isn't clear because of the translation.)
I am wondering how this will be published in Pediatrics--Will it be published as a review article? Or as a large "letter to the editor" or as a position statement alongside a number of other articles with differing views, as part of a debate that journals sometimes host? Until something gets published, it's not possible to tell exactly how or where it will be useful.
Zad68
05:03, 22 November 2012 (UTC)
- I haven't read that PDF in its entirety because I stopped reading early on when I saw this:
Die immer wieder zitierte Stellungnahme der AAP (DOI: 10.1542/peds.2012-1989 Pediatrics; originally published online August 27, 2012) widerspricht früheren Stellungnahmen der gleichen Organisation, ohne sich auf neue Forschungsergebnisse berufen zu können. Diese Stellungnahme der AAP wird inzwischen von nahezu allen anderen pädiatrischen Gesellschaften und Verbänden der Welt als wissenschaftlich nicht haltbar eingestuft.
(My translation:) The position statement from the AAP which has been cited again and again (DOI: 10.1542/peds.2012-1989 Pediatrics; originally published online August 27, 2012) contradicts earlier position statements from the same organization without being able to rely on new research. Nearly all other pediatric societies and associations worldwide by now have assessed this AAP position statement as scientifically untenable.
- However, no evidence is offered for the claims that
- -- the AAP's Policy Statement "contradicts" earlier AAP Policy Statements
- -- the AAP Technical Report (2012) is unable to rely on new research
- -- nearly all other pediatric societies and associations worldwide have assessed the AAP's Policy Statement or Technical Report as scientifically untenable.
- Thus I decided not to read any further. One more point, the proposed new German law (made necessary by the decision of a regional court in May of this year which created legal uncertainty) will not "make religious non-therapeutic circumcision explicitly legal", it will make all non-therapeutic circumcision explicitly legal, provided that the best interests of the boy are safeguarded. Generally circumcisions will have to be performed by medical doctors, with an exemption for religious or traditional circumcisers within the first six months of a boy's life. It also appears clear that the law will protect older boys from being circumcised against their expressed wishes. Some issues, in particular regarding anesthesia, remain to be worked out. And needless to say (?), no physician will be compelled to perform non-therapeutic circumisions if she or he objects on ethical grounds. — Preceding unsigned comment added by 82.113.121.34 (talk) 16:13, 22 November 2012 (UTC)
UMMMMMMM?
Sugery (noun) The branch of medicine concerned with treatment of injuries or disorders of the body by incision or manipulation, esp. with instruments
Foreskin is not an injury or disorder, therefore circumcision is not a SURGICAL procedure. It is a procedure, but not surgical. It is technically mutilation but I know certain circumcised editors here don't want to use that word. However, it is not "surgical" even if performed by a surgeon. That's like saying beheading is a surgical procedure. Is anyone going to correct this or should I? 75.1.53.13 (talk) 08:51, 22 November 2012 (UTC)
- Please review the Wikipedia policy regarding no original research.
Zad68
12:40, 22 November 2012 (UTC) - If what 75. says were true, then cosmetic surgery would not be surgery. That makes no sense. — Preceding unsigned comment added by 82.113.121.34 (talk) 14:34, 22 November 2012 (UTC)
- Whether or not it is therapeutic or even at all beneficial, it certainly is surgery, just like any cosmetic surgery.Mattmatt1987 (talk) —Preceding undated comment added 05:50, 23 November 2012 (UTC)
Circumcisions can be performed by Mohels and religious leaders...and in third world countries...by the local religious leader. It is not always a "surgical" procedure. Sometimes, people circumcise themselves. If you cut off one of your body parts...or someone else's...it's not "surgical". It is technically mutilation. And "cosmetic surgery" is actually synonymous with "mutilation." You have to put cosmetic in front. If you put COSMETIC SURGICAL PROCEDURE for circumcision...that would be accurate. But "surgical" is not accurate. 75.1.53.13 (talk) 03:56, 23 November 2012 (UTC)
And by that same logic...female genital mutilation is a "surgical procedure". We need to use accurate terms. Cutting off a body part is not technically a surgical procedure unless there is an illness or injury. Mutilation, COSMETIC SURGERY, partial amputation...all of these are accurate. "Surgery" is not accurate by definition. Please look up the word "Surgery". 75.1.53.13 (talk) 04:01, 23 November 2012 (UTC)
Wording in Effects
Currently, the article states that: There is strong evidence that circumcision reduces the risk of...' I changed "strong" to "possible" despite the source use of the term "strong" and was reverted. I suggest that, due to the note in the joint WHO/UNAIDS recommendation that circumcision only provides partial protection from HIV and should never replace known methods of HIV prevention and based on the historical dispute over this idea (see Circumcision and HIV, from the lead: Over forty epidemiological studies have been conducted to investigate the relationship between male circumcision and HIV infection.[1] Reviews of these studies have reached differing conclusions about whether circumcision could be used as a prevention method against HIV). To suggest that there is strong evidence is very misleading. --Nouniquenames 16:22, 28 November 2012 (UTC)
- I should really shut up; this is not my squabble, but... I suggest that this argument is beside the point; at cross purposes in fact. The evidence certainly is strong; people have looked and seen and argued a bit about the figures, but if there has been any evidence that there is no protective effect, I have missed it. What is weak is not the evidence, but the effect. 20% or 50% or 90% protection might be good news for the epidemiologists, but it is cold comfort for the heroic screw who discovers the next day that he had got drunk with the wrong girl. Unless of course he likes finding that he may just have attached an expiry date to his lifeline. IMO, 99% would be too little. Do you think I would play Russian roulette with a 100-shot pistol (or equivalent) just for a silly screw? Would you? And frankly, I reckon that the Risk of AIDS is worse; it is a baaaad way to go, guys! So anyway, whatever your tastes in these matters, don't quibble about the strong evidence, point out the weak protection! JonRichfield (talk) 16:40, 28 November 2012 (UTC)
- LOL Jon, it's a cheeky way of putting it but you're dead on. I think Nouniquenames just had an honest mistaken reading of what the article is saying, and a careful re-read should clear it up. Sources state the evidence is strong for the effectiveness against FTM transmission circumcision does provide; sources don't state the effectiveness is enough to make circumcision by itself a recommended HIV prevention strategy. The article aready does indeed include content making it clear that our sources state that circumcision by itself is no magic bullet solution to HIV: The lead states that the WHO "recommends considering it as part of a comprehensive HIV program in areas with high endemic rates of HIV." and the body of the article has "The joint WHO/UNAIDS recommendation also notes that circumcision only provides partial protection from HIV and should never replace known methods of HIV prevention." and states that the Male Circumcision Clearinghouse describes circumcision as "one component of comprehensive HIV prevention services."
Zad68
17:27, 28 November 2012 (UTC)
- LOL Jon, it's a cheeky way of putting it but you're dead on. I think Nouniquenames just had an honest mistaken reading of what the article is saying, and a careful re-read should clear it up. Sources state the evidence is strong for the effectiveness against FTM transmission circumcision does provide; sources don't state the effectiveness is enough to make circumcision by itself a recommended HIV prevention strategy. The article aready does indeed include content making it clear that our sources state that circumcision by itself is no magic bullet solution to HIV: The lead states that the WHO "recommends considering it as part of a comprehensive HIV program in areas with high endemic rates of HIV." and the body of the article has "The joint WHO/UNAIDS recommendation also notes that circumcision only provides partial protection from HIV and should never replace known methods of HIV prevention." and states that the Male Circumcision Clearinghouse describes circumcision as "one component of comprehensive HIV prevention services."
- Thanks Zad, nice of you to say that. These good-faith arguments often get hung up on cross-purposes and end up with folks at each other's throats. Let's hope this one now settles down to cooperation instead. Cheers, JonRichfield (talk) 17:42, 28 November 2012 (UTC)
Discussion of effects on sexual function almost completely excluded from this article
First, take note that I am familair with WP:MEDRS and that I have read the above discussion. I know that "it is vital that the biomedical information in articles be based on reliable, third-party, published sources and accurately reflect current medical knowledge." My problem with the almost complete exclusion of information on sexual effects (minus sexually transmitted diseases of course) of circumscision regarding this article is that it is not scientific consensus that circumcision does not affect penile sexual function/sensitivity or sexual satisfaction. By that, I mean that although recent medical sources state/support the notion that circumcision "does not appear to adversely affect penile sexual function/sensitivity or sexual satisfaction," the words "does not appear" and "adverse effects" are different than if the sources used the words "does not" and "effects" instead. The fact that there is no scientific consensus on whether or not circumscision affects penile sexual function/sensitivity or sexual satisfaction is apparent by the fact that this has been a widely debated aspect of circumcision (meaning by more than just anti-circumcision camps). And even if there were scientific consensus in this regard, it doesn't mean that a bit of the debate cannot be mentioned; it could be mentioned without giving WP:UNDUE weight to the it "affect[s] penile sexual function/sensitivity or sexual satisfaction" side, as this article once did. Wikipedia medical articles being bound to generally go by the most up-to-date sources for medical information does not mean that conflicting medical views from a few or several years ago cannot be mentioned, as shown by this article mentioning position statements from a few or several years ago in the Positions of medical associations section. I would understand this drastic exclusion if these conflicting sources on sexual function/sensitivity and satisfaction had been proven wrong and the medical community are mostly in agreement that circumcision causes no sexual effects, but they are not. Further, the 2012 American Academy of Pediatrics source does not speak for all of the medical community. The fact that this topic is so debated is why we had an article on it called Sexual effects of circumcision. This version of that article shows that even The American Academy of Family Physicians stated in 2007 the following: "The effect of circumcision on penile sensation or sexual satisfaction is unknown. Because the epithelium of a circumcised glans becomes cornified, and because some feel nerve over-stimulation leads to desensitization, many believe that the glans of a circumcised penis is less sensitive. [...] No valid evidence to date, however, supports the notion that being circumcised affects sexual sensation or satisfaction."
They clearly used the word "unknown." No evidence showing without a doubt that circumcision affects sexual sensation or satisfaction does not mean that it doesn't. Per the Talk:Sexual effects of circumcision#Is this page needed anymore? It should be redirected to Circumcision discussion, it was decided that the topic of sexual effects of circumcision should be redirected to this article because this article sufficiently covers it. But that is no longer the case. The topic in this article has been whittled down to these two sentences: "The American Academy of Pediatrics stated (2012) that 'circumcision does not appear to adversely affect penile sexual function/sensitivity or sexual satisfaction,'[6] and this finding is supported by other reviews.[8][9][10] The Royal Dutch Medical Association's 2010 Viewpoint mentions that 'complications in the area of sexuality' have been reported." That information isn't even in the Effects section, but rather in the Complications and risks section.
So, basically, I feel that this article should give decent weight to conflicting views on this topic, like it did before. Because right now it does not and that's a disservice to this article/readers in that regard. If the Foreskin article can cover this topic beyond a sentence or two, as it should and does, then this article certainly can and should. And if none of you are willing to offer more space to this topic in this article, then at least recreate the Sexual effects of circumcision article and tweak it as necessary.
I'll ask WP:MED to comment on this, and Sugarcube73 for more balanced weight in the discussion. I may not comment on this anymore beyond what I have on this talk page. I just wanted to state my thoughts on this and seek attention about it from others outside of this article. At least then, serious WP:CONSENSUS can be achieved on the issue. 108.60.139.170 (talk) 20:46, 9 November 2012 (UTC)
- Information should be included if sources are identified. What sources are there? A good start would be to list the best ones here. Commentary is not necessary. Blue Rasberry (talk) 21:09, 9 November 2012 (UTC)
- I'll be stepping away from the keyboard soon, but as always, you need to bring, per WP:MEDRS, the best, most up-to-date reliable sources, and propose a specific change you'd like to see in the article so we can discuss it. What are the sources and proposed content? From what I could find, the best, most up-to-date sources--the AAP and recent review articles and systematic reviews--have a consensus that circumcision doesn't appear have a negative effect, but maybe I missed a source.
Zad68
21:10, 9 November 2012 (UTC)
- And, please do not WP:CANVASS.
Zad68
21:10, 9 November 2012 (UTC)- I don't mean to offend, but I feel that neither of you read all of what I stated above. Not only did I state that I am familiar with WP:MEDRS (so I don't need to be pointed to it), I also mentioned how the words "does not appear" and "adverse effects" differ from saying that there are no effects or no adverse effects, that "medical articles being bound to generally go by the most up-to-date sources for medical information does not mean that conflicting medical views from a few or several years ago cannot be mentioned, as shown by this article mentioning position statements from a few or several years ago in the Positions of medical associations section," and I pointed to a version of what was the Sexual effects of circumcision article showing a variety of conflicting views about whether or not circumcision has any effects on penile sexual function/sensitivity or sexual satisfaction. In the example above, I cited a statement by the American Academy of Family Physicians. Just because that statement is from 2007 does not mean that it cannot or should not be cited, especially since position statements from several years ago are included in this article. In fact, it being from 2007 makes it within the "last five years or so, preferably in the last two or three years" WP:MEDRS recommendation for sources. I also mentioned that the 2012 American Academy of Pediatrics source does not speak for all or the majority of the medical community. It certainly does not stop the fact that whether or not circumcision has any negative effects on sexual function/sensitivity and satisfaction is widely debated, as evidenced by the article that, you, Zad68 had redirected to this article only to then eventually delete almost all of the information on it from this article. Those sources are the most up-to-date sources for those particular viewpoints, and some of them in the Foreskin article are from 2007...while that article also has dates for sources from 2008, 2009 and 2010. One from 2010 relays that the Royal Australasian College of Physicians states that the foreskin protects the glans, and that "the foreskin is a primary sensory part of the penis, containing some of the most sensitive areas of the penis. The effects of circumcision on sexual sensation however are not clear, with reports of both enhanced and diminished sexual pleasure following the procedure in adults and little awareness of advantage or disadvantage in those circumcised in infancy."[2] The other one from 2010 is from the Royal Dutch Medical Association and states that many sexologists view the foreskin as "a complex, erotogenic structure that plays an important role ‘in the mechanical function of the penis during sexual acts, such as penetrative intercourse and masturbation’."[3]. The fact is that there is debate on this topic and you are suppressing it by having wrongly deleted (yes, the Sexual effects of circumcision article is more of a deletion than a redirect at this point) an article on it and now seemingly asserting that since this debate among the medical community isn't actively happening right now, as in very recently, it can't be covered in this article. It's covered in the Foreskin article, as it should be, and it should be covered in this article as well (with due weight). Besides that, even historical views are included in Wikipedia medical articles, even this one. But somehow this debate can't be included in this article? That makes no sense and is not supported by the WP:MEDRS guideline. What I'd like to see in this article regarding this topic is what was here before about it, what we see in the Foreskin article about it, even if significantly cut down. Anything would be better than the two sentences left about it now. What was here before, what is still currently in the Foreskin article, are the sources/text I propose for this article -- whether significantly cut down to a healthy paragraph or not. Even including the American Academy of Family Physicians 2007 source (again, that I cited above) noting that there is debate on this subject would be better/more neutral than what is there now, despite the fact that it will be out of the "within 5 years" WP:MEDRS guideline in 2013. Something else I think that should be kept in mind regarding this article is where WP:MEDRS states, "While the most-recent reviews include later research results, do not automatically give more weight to the review that happens to have been published most recently, as this is recentism."
- And as for WP:CANVASS, please look at what that guideline cites as appropriate means of canvassing. I didn't act inappropriately at all. However, I'm clearly wasting my time at this talk page. So I may stop responding here now. 108.60.139.170 (talk) 01:02, 10 November 2012 (UTC)
Hi 108.60.139.170, you state that you are familiar with WP:MEDRS, but the responses here do not demonstrate a complete application of it--this is why WP:MEDRS was brought up again.
You appear to have two concerns (you'll have to correct me if I'm getting you wrong):
- The wording the article uses doesn't accurately relect the sources cited
- Other sources should be used in addition to the sources already in the article
Regarding 1), the lead says:
- "Circumcision does not appear to have a negative impact on sexual function."
The sources say:
- AAP 2012 technical report, "Male circumcision does not appear to adversely affect penile sexual function/sensitivity or sexual satisfaction."
- Sadeghi-Nejad 2010 review, "A number of investigators have evaluated the effects of circumcision on a range of sexual satisfaction measures. Despite conflicting results in some of the historical observational studies, most recent articles do not show evidence of adverse effects on sexual function."
- Perera 2010 systematic review, "The evidence suggests that adult circumcision does not affect sexual satisfaction and function."
- Doyle 2010 review, "The evidence suggests that adult circumcision does not affect sexual satisfaction and function."
I believe the article content sumamrizes the sources accurately, but of course specific improvements can be suggested. This article no longer has a big section about sexual function because there is consensus across the best sources that is easy to summarize in just a few sentences. (The sexual effects content was moved to complications and risks per WP:MEDMOS.)
Regarding 2), there is no reason to use old sources when we have multiple new ones of the highest quality on the WP:MEDASSESS scale covering the same topic. You suggest looking at a statement from AAFP 2007, but there were several studies in 2008 that examined sexual function and are cited by all the secondary sources supporting this article content. These studies were not available to the team preparing the AAFP 2007 report and that is exactly why we don't use older secondary sources when there are newer ones available. It's not recentism when four secondary sources published over a period of two years all say the same thing. RACP 2010 uses these 2008 studies, and does not really contradict the sources cited in the article, but its analysis is not nearly as in-depth as the sources the article does use, and so it seems unnecessary to use it. KNMG 2010 does not use the 2008 studies and makes no explicit statement about sexual sensitivity or function so it was not used as a source for this sentence.
This also addresses your assertion, "it is not scientific consensus that circumcision does not affect penile sexual function/sensitivity or sexual satisfaction." There are advocacy groups that say there is a negative effect, but for Wikipedia the publications of such groups are unacceptable as sources for medical claims. As shown under 1), the best sources actually do indeed have a strong consensus on this; the existence of unuseable publications by advocacy groups doesn't mean that there isn't consensus among the best-quality sources. To support the assertion that there isn't scientific consensus, you would have to provide several sources of at least equal strength that state otherwise. Where are those sources?
Regarding those other articles you mentioned: They either did have (Sexual effects of circumcision) or currently do have (Foreskin) very serious sourcing problems per WP:MEDRS and should not be used as any sort of standard for the sourcing in this article.
(The specific WP:CANVASS concern is vote-stacking, but this canvassing discussion really isn't on-topic for the purposes of this article talk page, and I'm OK with dropping it here. If you'd like to pursue this discussion further we can do it on one of our User Talk pages.) Zad68
05:28, 11 November 2012 (UTC)
The decision to exclude the sexual effects of circumcision is entirely ill-considered. There is a long trail of papers on the sexual injury of circumcision. The recent AAP statement on circumcision is NOT good evidence.
The AAP is a trade association of medical doctors who perform circumcision. The duty of the AAP is to represent the interests of its members. Its members profit by doing circumcisions. Other trade associations whose members profit by doing circumcisions are ACOG and AAFP, both of which had representatives who participated with the AAP in writing the 2012 statement. The AAP statement is self-serving promotional material, not sound medical advice. The statement was in the works for five years but nothing was published because they were waiting on the Bloomberg School of Public Health (funded by Michael Bloomberg) to produce pro-circumcision documents.
The 2012 AAP circumcision article is nothing more than a promotional piece designed to defend the incomes of obstetricians, family doctors, and pediatricians. Its position on circumcision is absurd and should not be used. It should not be considered to be a reliable source on circumcision.
Circumcision is an extremely controversial subject because of the emotional issues it creates in its victims. Religion also is involved.
Wikipedia policy requires a neutral point of view. Adopting the AAP point of view while excluding others is contrary to Wikipedia policy. Policy states:
Editing from a neutral point of view (NPOV) means representing fairly, proportionately, and as far as possible without bias, all significant views that have been published by reliable sources. All Wikipedia articles and other encyclopedic content must be written from a neutral point of view. NPOV is a fundamental principle of Wikipedia and of other Wikimedia projects. This policy is nonnegotiable and all editors and articles must follow it.
Controversy should be described, not censored. http://en.wikipedia.org/wiki/Wikipedia:CONTROVERSY
Editors must be aware of their personal bias. In the case of circumcision, bias frequently is produced by 1) being circumcised 2) having performed a circumcision 3) having given consent for the circumcision of a child or 4} having been born into a culture that circumcises.
The United States of America has had a pro-circumcision culture but that is changing. Any American is likely to have a bias for these reasons. Other English-speaking countries such as the UK, Canada, Australia, and New Zealand are less so.
Both view points on the sexual effects of circumcision must be presented.
The article that has been suppressed (Sexual effects of circumcision) was written by a former editor (Personal attack removed). Nevertheless, he allowed alternative viewpoints to be expressed. I think this article should at least do likewise. Sugarcube73 (talk) 13:02, 11 November 2012 (UTC)
- Sugarcube73, WP:NPA and WP:TPYES are quite clear: "Comment on content, not on the contributor". Please redact the personal attacks and comments you've made in your statement above, and focus instead on which specific changes you wish to make, based on which reliable medical sources, while adhering to WP:NPOV. Jayjg (talk) 20:17, 11 November 2012 (UTC)
- Sugarcube, as Jayjg said, you are commenting on other individual editors, and the comments are quite sweeping. Please redact the personal comments you have made about other editors, as they may be interpreted as personal attacks (see WP:NPA) or violations of Wikipedia's Biography of Living Persons policy (see WP:BLP).
- If the ad hominem attacks you made are ignored, the only Wikipedia policy and guideline-based argument you are making is your assertion that the AAP technical report is not a reliable source. Please view WP:MEDASSESS. If you are still unsure that the AAP technical report is a reliable source, and you'd prefer not have a discussion about that with the editors here due to the opinions you have aired here about your fellow editors, you can raise your concerns at WP:RSN--please be sure to notify the members of WP:MEDICINE. Otherwise, as you have not brought forward any sources or edits to consider, no further response is needed.
Zad68
04:15, 12 November 2012 (UTC)- Zad68 (and, yes, I'm the same IP from above), even though this will offend, I seriously have to be honest in stating that what I mostly see from the main contributors/watchers of this article is bias, word games, WP:Gaming the system, cherry picking sources and cherry picking statements from those sources, and you showing an absolute condescending ignorance to what I've stated. No, I don't need to be pointed to WP:MEDRS again; yes, I understand it. No, it's not only advocacy groups stating that circumcision may cause negative sexual effects other than botched surgeries, and you know that. For whatever reason, you also don't distinguish "adversely affect" and "adverse effects" from simply "affect" and "effects." No, my issue with this article is not that "[t]he wording the article uses doesn't accurately re[f]lect the sources cited." Nor is it that "sources should be used in addition to the sources already in the article." It's that this article does not relay that there is disagreement about whether or not circumcision negatively affects sexual function and in just what way some medical experts believe that it might. The Royal Dutch Medical Association source you even use in this article states that "complications in the area of sexuality" have been reported regarding circumcision. And not surprisingly, you leave out where it states that many sexologists view the foreskin as "a complex, erotogenic structure that plays an important role ‘in the mechanical function of the penis during sexual acts, such as penetrative intercourse and masturbation.'" And it's surely easy to see why they would/do think that, since the foreskin has thousands of nerve endings. Once again, the Royal Australasian College of Physicians source states that the foreskin protects the glans, and that "the foreskin is a primary sensory part of the penis, containing some of the most sensitive areas of the penis. The effects of circumcision on sexual sensation however are not clear, with reports of both enhanced and diminished sexual pleasure following the procedure in adults and little awareness of advantage or disadvantage in those circumcised in infancy." That right there shows that this supposed consensus you speak of does not exist. I reiterate that "does not appear" is different than stating "does not" and that "adverse effects" is different than stating "effects." Neither of these sources are anti-circumcision advocacy groups. I didn't point out what was the "Sexual effects of circumcision" article or the Foreskin article for standards of sourcing; I pointed them out because they provide comprehensive information on this topic -- ie., they were/are not stifling this information.
- Stating that "This article no longer has a big section about sexual function because there is consensus across the best sources that is easy to summarize in just a few sentences." shows a complete lack of regard for informing readers of the debate that has existed and still exists about this topic. If it was "easy to summarize in just a few sentences," most of these sources wouldn't go in depth about the topic far more sufficiently than this article does. My point is that this article is not comprehensive in this regard, and it should be because this is an encyclopedia. Covering this topic comprehensively is not WP:Undue weight. And regarding the outline of the article, WP:MEDMOS is not binding and it does not state that information about effects should be placed in the "Complications and risks" section while an "Effects" section covers other effects. And regarding WP:MEDRS's guideline about using the most up-to-date sources for medical information, again, this article has a section on historical beliefs about the procedure...which uses sources that are older than five years. But you are stating that this article cannot/should not have a section about the historical and current debate about negative effects of circumcision on sexual funcion? That makes no sense. And all of that is why I'm starting a WP:RfC about this dispute.
- And about Sugarcube73 (his comments that you censored)... Stating that an editor has a bias is not quite the type of personal attack that Wikipedia:No personal attacks means to combat (I know that from discussions all over Wikipedia, where "POV" and "bias" are thrown around without any view that it's something that needs to be redacted from an editor's comment). If it is, then, looking at his talk page, you have also attacked him.
- And I most certainly did not violate WP:CANVASS. But that part of this discussion is irrelevant. 37.123.118.82 (talk) 04:02, 24 November 2012 (UTC)
RfC: Should non-positive views on the sexual effects of circumcision be included?
The topic of sexual effects of circumcision has been widely debated and scientific consensus on the matter has yet to be established on whether or not circumcision causes any negative sexual effects for some circumcised males, aside from the belief that it "does not appear to adversely affect penile sexual function/sensitivity or sexual satisfaction" ("appear" and "adversely" being the key words) or the rare matter of botched surgeries. The differing views on this topic, however, have been excluded from the Circumcision article; this is after the fact that what was once the Sexual effects of circumcision article[4] was redirected to it on the claim that it sufficiently covers the topic. The question arises now: How is the Circumcision article sufficiently covering this topic when it has excluded these views? That is where this article dispute comes in. One viewpoint is that an American authoritative source is enough to leave readers with the impression that circumcision "does not appear to have a negative impact on sexual function," with the inclusion of a Netherlands source briefly tackling possible sexual complications by stating "complications in the area of sexuality" have been reported. The other viewpoint, as mentioned, is that the possible negative sexual effects are not sufficiently covered and that covering them is not WP:UNDUE WEIGHT, as long as they are given appropriate weight, since they are not a significant minority and/or WP:FRINGE and have WP:MEDRS (reliable medical sources) that pass the guideline's "last five years or so, preferably in the last two or three years" recommendation.
The prior discussion about this is available on the article talk page, at Discussion of effects on sexual function almost completely excluded from this article. Please read it or most of it (it's not too, too long) so that you can better understand the arguments and see some of the sources that are discussed before weighing in on this RfC discussion. 37.123.118.82 (talk) 04:02, 24 November 2012 (UTC)
- This is not a neutrally stated RfC. a13ean (talk) 04:34, 24 November 2012 (UTC)
- Seems neutral to me. The IP stated "differing views on this topic, however, have been excluded from the Circumcision article," which is true, and then he or she went on to explain both sides. 199.229.232.42 (talk) 17:07, 24 November 2012 (UTC)
- If you are proposing adding something. Simply state what you wish to add and the recent review article which supports it.Doc James (talk · contribs · email) (if I write on your page reply on mine) 06:13, 24 November 2012 (UTC)
- Yeah, let's see the reviews that 37. wants included. At the same time, I have to wonder why 37. asks only to include "non-positive views on the sexual effects of circumcision"? Isn't this indicative of bias? Why not also positive views on the sexual effects?89.204.130.144 (talk) 09:41, 24 November 2012 (UTC)
- Probably because this article already includes a ton of positive information on sexual effects, especially about STIs/STDs. 199.229.232.42 (talk) 17:07, 24 November 2012 (UTC)
- You are mixing up medical efffects (STIs/STDs) with sexual effects (e.g., erotic pleasure). On the latter, anti-circumcision activists claim various deleterious effects, while proponents claim that circumcised men have more fun and enjoy a more harmonious sex life with their spouses. Perhaps the best-quality review article supporting each side should get a brief mention in the article?89.204.139.112 (talk) 18:39, 24 November 2012 (UTC)
- Sexual effects of circumcision are a medical effect of circumcision, no matter if diminishing or increasing sexual pleasure or making it so that the penis is less susceptible to sexually transmitted infections/diseases. And the IP is correct that it's not just anti-circumcision activists claiming negative effects. Just like it's not just pro-circumcision activists claiming positive effects. 199.229.232.42 (talk) 23:12, 24 November 2012 (UTC)
- Also, like the IP pointed out, both views are mentioned in the "Complications and risks" section. But they are very brief, and the information is very vague on the negative effects side. 199.229.232.42 (talk) 23:18, 24 November 2012 (UTC)
- Sexual effects of circumcision are a medical effect of circumcision, no matter if diminishing or increasing sexual pleasure or making it so that the penis is less susceptible to sexually transmitted infections/diseases. And the IP is correct that it's not just anti-circumcision activists claiming negative effects. Just like it's not just pro-circumcision activists claiming positive effects. 199.229.232.42 (talk) 23:12, 24 November 2012 (UTC)
- You are mixing up medical efffects (STIs/STDs) with sexual effects (e.g., erotic pleasure). On the latter, anti-circumcision activists claim various deleterious effects, while proponents claim that circumcised men have more fun and enjoy a more harmonious sex life with their spouses. Perhaps the best-quality review article supporting each side should get a brief mention in the article?89.204.139.112 (talk) 18:39, 24 November 2012 (UTC)
- You have repeatedly asserted the existence of a scientific controversy, but you have not cited any reliable sources to substantiate this claim. You and your friend have alleged that medical professionals are involved in a conspiracy to promote circumcision for profits, personally attacked other editors, and complained about the approximate and uncertain nature of science itself; but nothing you have stated goes beyond your own original research. As long as that remains so, your objections deserve to be dismissed.TheTimesAreAChanging (talk) 13:28, 24 November 2012 (UTC)
- The IP didn't mention any controversy, speak of a conspiracy to promote circumcision for profits, or attack other editors in a way that requires penalization. The IP stated that "The topic of sexual effects of circumcision has been widely debated," and, looking at the evidence the IP provided, that is true. The IP mentioned specific non-fringe medical sources, two from 2010, and pointed to a redirected article (Sexual effects of circumcision) which discussed all of this and an existing article (Foreskin) discussing all of this. The IP indeed cited reliable sources to substantiate this claim. The IP says that he or she understands the WP:MEDRS guideline. I do also, and it does not encourage this type of exclusion. I read the dispute linked to, and I have to agree that it's odd and sketchy that some of this information is not in this article. There should at least be a bit more in this article about both no-effects and possible effects on sexual function. The "complications in the area of sexuality" piece is incredibly vague. 199.229.232.42 (talk) 17:07, 24 November 2012 (UTC)
- Probably because this article already includes a ton of positive information on sexual effects, especially about STIs/STDs. 199.229.232.42 (talk) 17:07, 24 November 2012 (UTC)
- Yeah, let's see the reviews that 37. wants included. At the same time, I have to wonder why 37. asks only to include "non-positive views on the sexual effects of circumcision"? Isn't this indicative of bias? Why not also positive views on the sexual effects?89.204.130.144 (talk) 09:41, 24 November 2012 (UTC)
- Procedural speedy-close This RFC is defectively malformed. From how the RFC is stated, no matter how it were to 'close,' there cannot be said to be any consensus for any specific action to the article itself. Also, as it says at WP:RFC, the RFC "statement should be neutral and brief," and this one is not: It assumes the conclusion that the RFC is driving toward--that there is significant lack of consensus across the best-quality WP:MEDRS-compliant sources--is true. Please propose: 1) Specific content for the article, with 2) Specific sources.
Zad68
00:07, 25 November 2012 (UTC)- Oh c'omn, we shouldn't close a RfC simply because the opposing editor feels that it's not worded neutrally. That view is clearly subjective, seeing as I view it as neutral. Participants are able to fairly weigh the arguments of both sides even in a non-neutrally worded RfC. And as you can see in this RfC, the initial and (currently) majority (though a slight majority) of arguments have been against the IP. Not sure how fair the judgements have been, however. 199.229.232.42 (talk) 12:34, 26 November 2012 (UTC)
- It's a counterproductive frame of mind to view editors as 'opposing' each other. Assume good faith that we are all here intending to improve the article in line with Wikipedia policies and guidelines. As I stated, my main concern isn't about the neutrality of the RFC wording, but rather that the RFC is malformed: it appears to be an RFC attempting to get consensus from the community about a proposed content change to the article, but the RFC's wording is far too vague for it to have any kind of productive result. Ask yourself, "If everyone were to !vote 'Support,' for what exact article content change can there then be said to have support?" None. So, this RFC is an unproductive use of editors' time, and should be procedurally speedy-closed.
Zad68
14:21, 26 November 2012 (UTC)- You are an opposing editor, and were the opposing editor. Calling you such has nothing to do with WP:BATTLEGROUND or Wikipedia:Assume good faith. Editors oppose each other on content all the time, as we are seeing in this discussion. Arguing that this RfC isn't neutrally-worded and is also malformed because it's vague is an opinion. I see nothing vague about what's been proposed. The IP is simply asking that some of the material about the possible negative effects of circumcision be added to this article. I stated before that the IP presented two non-fringe medical sources from 2010. The IP has also pointed to other sources, ones used in the article you redirected to this aticle and ones used in the Foreskin article. You have ignored these sources, almost as though every source discussing possible negative sexual effects of circumcision in both the redirected article and the Foreskin article are poor and do not pass WP:MEDRS, and have continually asserted that discussion of this sexual effects debate mentioned in reliable sources that pass WP:MEDRS should not be mentioned in this article because the 2012 American Academy of Pediatrics source sufficiently addresses the "no sexual effects" side and the 2010 Royal Dutch Medical Association source sufficiently addresses the "there are some negative sexual effects" side. The IP's argument is that this particular topic is not sufficiently covered in this article, and I agree. The information you've included certainly isn't neutral enough, considering that all you've included from the 2010 Royal Dutch Medical Association source is that "complications in the area of sexuality" have been reported. 199.229.232.42 (talk) 20:14, 30 November 2012 (UTC)
- Agree, but with caveat that close should be "without prejudice", i.e., editor who introduced RfC should be invited to propose a source, or sources, for inclusion, as well as addition to text of article. And if s/he fails to obtain consensus for such addition, s/he should be assisted by more experienced editors to bring another RfC that will not fail for procedural reasons.82.113.121.226 (talk) 17:04, 26 November 2012 (UTC)
(Welcome, new IP editor with no history of ever having edited Wikipedia before. Are you the same editor as 199.229.232.42? Any reason why you can't create an account?)Struck side-comment that gave offense Agree, absolutely. In fact, in this very RFC discussion alone, I count four different requests from four different editors asking for specific sources and/or proposed content. Five, actually, if you count the response here as its own request. This is in addition to similar requests made of the RFC-creating IP editor in the previous sections on this Talk page. That IP editor has already pointed to policy and guideline such as WP:UNDUE and WP:FRINGE, and stated confidence in familiarity with the guideline WP:MEDRS to the point of being annoyed by having other editors bring WP:MEDRS in response to a discussion contribution offered. I take the editor at face-value, and figure that assistance with such a basic thing as creating a productive RFC would not be appreciated. Maybe that IP editor would find assistance from you welcome, I'm fine with that. Actually I think an RFC is premature without having had proposed content and sources discussed first.Zad68
17:38, 26 November 2012 (UTC)- No, I am not 199.229.232.42. I am, however, the same person who previously posted using IP 82.113.121.34 and contributed two productive edits to this Talk page. I deeply resent the snide tone you employ ("Welcome, new IP editor with no history of ever having edited Wikipedia before") and I suggest that you redact/delete the parenthesis at the beginning of your comment as it borders on a personal attack.82.113.121.226 (talk) 17:59, 26 November 2012 (UTC)
- Struck as requested, but honestly, how was I possibly supposed to know? I apologize for any offense, none was intended. Cheers...
Zad68
18:07, 26 November 2012 (UTC)- Thanks, you are a gentleman. For future reference, when two IP addresses match in the first three octets and only differ in the last, you can safely assume that they belong to the same Internet service provider (ISP). Dynamical allocation of IP addresses makes the last octet (but sometimes the last two, or the entire IP address) change between log-off and log-on by a dial-up user. Another clue is to click on the IP address and then use "Geolocate" to find out more about the ISP and country/region. Static (unchanging) IP addresses are typically assigned to users with cable modems.82.113.121.226 (talk) 18:23, 26 November 2012 (UTC)
- Struck as requested, but honestly, how was I possibly supposed to know? I apologize for any offense, none was intended. Cheers...
- No, I am not 199.229.232.42. I am, however, the same person who previously posted using IP 82.113.121.34 and contributed two productive edits to this Talk page. I deeply resent the snide tone you employ ("Welcome, new IP editor with no history of ever having edited Wikipedia before") and I suggest that you redact/delete the parenthesis at the beginning of your comment as it borders on a personal attack.82.113.121.226 (talk) 17:59, 26 November 2012 (UTC)
- It's a counterproductive frame of mind to view editors as 'opposing' each other. Assume good faith that we are all here intending to improve the article in line with Wikipedia policies and guidelines. As I stated, my main concern isn't about the neutrality of the RFC wording, but rather that the RFC is malformed: it appears to be an RFC attempting to get consensus from the community about a proposed content change to the article, but the RFC's wording is far too vague for it to have any kind of productive result. Ask yourself, "If everyone were to !vote 'Support,' for what exact article content change can there then be said to have support?" None. So, this RFC is an unproductive use of editors' time, and should be procedurally speedy-closed.
- Agree with speedy closure. I agree with closing this RFC and allowing all involved parties to open it again in the future. Andrew (talk) 06:11, 29 November 2012 (UTC)
- Oh c'omn, we shouldn't close a RfC simply because the opposing editor feels that it's not worded neutrally. That view is clearly subjective, seeing as I view it as neutral. Participants are able to fairly weigh the arguments of both sides even in a non-neutrally worded RfC. And as you can see in this RfC, the initial and (currently) majority (though a slight majority) of arguments have been against the IP. Not sure how fair the judgements have been, however. 199.229.232.42 (talk) 12:34, 26 November 2012 (UTC)
- Comment This RFC is symptomatic of several things concerning the article and a wide range of views on the article. The article is a mess. Normally I prefer to see an article presenting a rounded view or overview of a topic, but because of the fact that practically any article dealing with the human body (actually, even animal bodies) between the abdomen and femur brings out all the fanatics (as defined by Churchill: "someone who can't change his mind and won't change the subject") such articles often are best served by splitting them up into subtopics in separate articles, together with suitable links. In my opinion this article is one such. I refuse to go back into the history of this article to see why the sexual aspects were redirected to the main article, but I think it was a blunder. It would have been better to move that material in the other direction. Anyone who disagrees may do so in good health, but don't bother to tell me about it; I am busy. As for covering the various aspects of the relevance of circumcision to sex, of course they should be covered, and should be covered in a balanced way; the mere fact that such a question could be asked strikes me as symptomatic; but don't mind me! Whether they should be covered in this article or not is another matter, but wherever they are covered the topic should be dealt with as distinctly and independently as possible, just as any other topic concerning the effects of the operation should be. JonRichfield (talk) 05:08, 25 November 2012 (UTC)
- Yes, non-positive views on the sexual effects of circumcision should be included, if they ground on reliable sources (which I presume). And yes, the background content of this RfC is hard to understand. Please take more care next time. Jesus Presley (talk) 02:46, 28 November 2012 (UTC)
- Yes. Include. --Nouniquenames 16:13, 28 November 2012 (UTC)
- Yes Include, and be comprehensive in that inclusion. Compare WP on female circumcision . Slicing off the most nerve rich sexual pleasure patch on a male body and allowing the penis head to desensitize and keratize ? There is plenty of good research out there....--— ⦿⨦⨀Tumadoireacht Talk/Stalk 19:21, 29 November 2012 (UTC)
- Endorse close and re-opening with a proper, neutrally phrased question. On the substance of the question, we should nclude only if supported by WP:MEDRS compliant sources. We don't include claims that are not properly sourced, of course. Yobol (talk) 22:07, 29 November 2012 (UTC)
- Mu. No specific action can be taken based on this RFC. Jayjg (talk) 01:19, 30 November 2012 (UTC)
- Comment Was someone going to come forwards with some evidence for us to discuss? There is no reference in this RfC to base if we should contain said content. Doc James (talk · contribs · email) (if I write on your page reply on mine) 05:08, 30 November 2012 (UTC)
- Moo-moo moot Some interesting historical acknowledgment of the sex pleasure reducing effect of cutting off foreskin here and some other little known rationales : Brit_milah#Reasons_for_circumcision --— ⦿⨦⨀Tumadoireacht Talk/Stalk 08:10, 30 November 2012 (UTC)
- Endorse speedy close as not neutrally worded and lacking a clear proposal. It would be impossible to determine what consensus means here. Dominus Vobisdu (talk) 08:25, 30 November 2012 (UTC)
- Speedy close I support the title of the RfC but the content of the RfC does not actually make a proposal. There does not need to be a proposal for this - someone should just provide WP:MEDRS sources then integrate them into the article. No one would prevent this. No one is providing sources of any kind. Blue Rasberry (talk) 18:56, 30 November 2012 (UTC)
- No speedy close/Nothing would be speedy about the close now anyway. Consensus is clear -- this information should be included. As I just commented to Zad68 above, I see nothing vague about what's been proposed. The IP is simply asking that some of the material about the possible negative effects of circumcision be added to this article. I mentioned before that the IP presented two non-fringe medical sources from 2010. The IP has also pointed to other sources, ones used in the article Zad68 redirected to this aticle and ones used in the Foreskin article. Zad68 has ignored these sources, almost as though every source discussing possible negative sexual effects of circumcision in both the redirected article and the Foreskin article are poor and do not pass WP:MEDRS, and has continually asserted that discussion of this sexual effects debate mentioned in reliable sources that pass WP:MEDRS should not be mentioned in this article because the 2012 American Academy of Pediatrics source sufficiently addresses the "no sexual effects" side and the 2010 Royal Dutch Medical Association source sufficiently addresses the "there are some negative sexual effects" side. The IP's argument is that this particular topic is not sufficiently covered in this article, and I agree. The information Zad68 has included certainly isn't neutral enough, considering that all he included from the 2010 Royal Dutch Medical Association source is that "complications in the area of sexuality" have been reported.
- Complications, huh? Exactly what are these complications? That should be discussed in this aricle. It's not like the source doesn't specify, considering that, like the IP stated, the source says that many sexologists view the foreskin as "a complex, erotogenic structure that plays an important role ‘in the mechanical function of the penis during sexual acts, such as penetrative intercourse and masturbation.'" It seems that some people in this RfC are ignoring this and are ignoring where the IP pointed to the very real fact that the Royal Australasian College of Physicians source reports that the foreskin protects the glans, and that "the foreskin is a primary sensory part of the penis, containing some of the most sensitive areas of the penis" and that the "effects of circumcision on sexual sensation however are not clear, with reports of both enhanced and diminished sexual pleasure following the procedure in adults and little awareness of advantage or disadvantage in those circumcised in infancy." 199.229.232.42 (talk) 20:14, 30 November 2012 (UTC)
- Can't answer We do need all relevant views on this; but that is true all over WP. It is far from clear exactly what is supposed to be changed, so I can not give an opinion on that. speedy continue discussion: Though I have just agreed with the arguments for speedy close above, I urge editors to avoid speedy-closing whatever discussion, except in veeeeryyyy rare occasion; instead clarify the question if you know how and care for it, anyway let the discussion go on if others think it should go on. - Nabla (talk) 19:35, 1 December 2012 (UTC)
- Yes should be included' if info complies with wikipedia policies. If this may happec to create udue bias to the overall text (which I doubt), we have Wikipedia:Summary style, which advices how to move various lesser detail from a general article into a subtopic article.Staszek Lem (talk) 20:02, 4 December 2012 (UTC)
- Speedy close unless there is an evidence someone deletes or reverts such information from the article. Staszek Lem (talk) 20:02, 4 December 2012 (UTC)
Apparently, MOST medical organizations do NOT endorse circumcision to prevent HIV. Should this be mentioned in the main article?
THIS COULD CHANGE EVERYTHING: PLEASE CHECK THIS STUFF OUT JOURNEY OF PUBLIC HEALTH IN AFRICA http://www.publichealthinafrica.org/index.php/jphia/article/view/jphia.2011.e4/html_9 http://jamespatemd.com/blog/?p=2153 http://www.psychologytoday.com/blog/moral-landscapes/201109/more-circumcision-myths-you-may-believe-hygiene-and-stds http://www.huffingtonpost.com/ali-a-rizvi/male-circumcision-and-the_b_249728.html http://www.plusnews.org/Report/88790/MALAWI-Clinics-dispel-male-circumcision-myths http://voices.yahoo.com/circumcision-myths-exposed-these-articles-281256.html http://www.aidscirc.org/2012/07/circumcision-prevents-hiv-infection-is.html OTHERS http://circumcisiondoctorsaustralia.wordpress.com/2012/01/28/dr-normal-blumenthal/ http://www.hsrc.ac.za/Research_Publication-20839.phtml http://www.circumcision.org/studies.htm
Not everyone nor every medical organizations believes circumcision can reduce HIV. Many doctors and researches point out the following and this should be mentioned in the Circumcision Wiki Page (in my opinion.)
1 Foreskin produces smegma, which fights off foreign bacteria (where viruses live)
2 The US (where most males are circumcised) have higher HIV rates than places where most men are not circumcised (like UK, Canada, Australia, New Zealand, Germany, Italy, France, Sweden, Spain, Norway, Japan, etc.)
3 MORE African countries have a higher rate of HIV/AIDS amongst the circumcised populations than the UNcircumcised populatoins (than the other way around)
4 Non-sterile circumcisions have been shown to SPREAD HIV/AIDS Just to name a few CHECK OUT THIS STUFF. Apparently, only the WHO and a small number of other organizations claim circumcision reduces HIV. MOST medical organizations claim it's a myth (like the circumcision prevents masturbation myth.) — Preceding unsigned comment added by 99.55.142.31 (talk) 09:29, 2 December 2012 (UTC)
- 1 - the viruses that infect humans do not infect (or "live" in) bacteria (nor vice versa)
- 2,3 - interesting, but reliable sources do not indicate a causal relationship. There are many reasons why HIV rates differ.
- 4 - perhaps but the net effect, in Africa at least, is the opposite.
- I urge you to tone down your posting a bit (i.e. the over-use of caps lock) to reduce the risk that your posts will be removed as "rants". Shouting does not foster collaboration. -- Scray (talk) 14:33, 2 December 2012 (UTC)
I agree with you about the caps lock...I didn't notice how much caps I used at first.
vi·rus/ˈvīrəs/ Noun: 1.An infective agent that typically consists of a nucleic acid molecule in a protein coat.
I'm not sure how much you know about biology, but that is basically the definition. Nucleic acid molecules survive in bacteria. That is what it means. Viruses can not survive unless in bacteria.
I'm just curious as to why only the WHO's position is mentioned. Most medical organizations around the world disagree with the WHO. Click the links/sources I provided. It's fascinating stuff. Most medical organizations disagree and have always seen the WHO as an overrated beauracracy with special interests and alternative motives (like during the H1N1 scare the WHO hyped up and turned out to be wrong.) There are other medical experts who say circumcision does not prevent HIV. These perspectives are not even mentioned in the article. Should I be suspicious or simply believe it is laziness? We're talking about a very controversial subject matter (cutting off parts of people's genitals.) The opposing viewpoint should be at the very least mentioned, if not endorsed on either side. This article seems to ignore certain evidence and studies/medical opinions and endorce the WHO's claim. I'm wondering why. 99.55.142.31 (talk) 03:42, 3 December 2012 (UTC)
- This is tangential to the article so I won't belabor it here - but regarding point #1 above, you have a major misconception about viruses. To keep it simple, I suggest you read about bacteriophages, and notice that no human virus is listed there. Then, you might want to look at eukaryotic viruses like HIV, influenza virus, and Hepatitis B virus and note that none of them infect bacteria (i.e. they are not bacteriophages). If you'd like to discuss this further, we should probably take it to my Talk page (link follows in my signature). -- Scray (talk) 13:56, 3 December 2012 (UTC)
Hi 99.55.142.31, as you took the time to provide the list of sources, I carefully reviewed each one of them:
Article | Type |
---|---|
Journal of Public Health in Africa | Letter to the editor |
JamesPateMD.com | Personal blog of James Pate |
Psychology Today "Moral Landscapes" blog | Blog in non-medical popular-press magazine |
Ali Rivzi's blog in Huffington Post | Blog in popular-press newspaper |
Article in "PlusNews" | News article,Doesn't actually criticize results of African trials |
"Circumcision Myths Exposed" | Blog post |
"AidsCirc" blog | Blog |
"Circumcision Doctors Australia" | Blog |
Male circumcision and its relationship to HIV infection in South Africa: results of a national survey in 2002 | Primary study, survey-based |
Based on what you provided, the answer to your question, 'Why only the WHO's position is mentioned?' is very easy: It's because the quality of the arguments and evidence the WHO is using is vastly superior to the kinds of evidence in the sources provided. This list of sources is one letter to the editor, six blog posts, a news article that does not actually address the African trials, and a primary study providing the results of an analysis of a 2002 survey. Per Wikipedia standards, letters to the editor, news articles and blog posts are entirely unacceptable as sources for medical claims. The only actual study provided is of the lowest evidence quality. In contrast, there are many, many high-quality peer-reviewed secondary source review articles and systematic reviews, published in the most reputable journals, that have reviewed the evidence of the effect of circumcision on HIV transmission, and are in nearly unanimous agreement. Per WP:FRINGE, Wikipedia articles do not present pohorly-supported minority ideas alongside well-supported mainstream idea. That is the reason.
If instead of blog posts and letters to the editor, you could provide WP:MEDRS-compliant reliable secondary sources supporting the idea that circumcision does not have a protective effect against HIV transmission, that would be worth considering. But until such sources are brought forward, there is no policy or guideline-based reason for including the idea in the article. Cheers... Zad68
04:43, 3 December 2012 (UTC)
P.S. You keep saying, "Most medical organizations around the world disagree with the WHO." However, I haven't seen any evidence at all that this is true. Zad68
04:46, 3 December 2012 (UTC)
Sure this is very easily answered. You see "no evidence at all that that is true". I'm not sure what you are talking about. There are over 12,000 medical organizations in the world (both governmental and non-governmental). Only about three (the CDC, AAP, and WHO) claim that circumcision reduces HIV. So out of 12,000 only 3 (that I know of, maybe there are more) that make this claim. Only .1% of all medical organizations in the world make this claim. Of the 12,000 medical organizations in the world. You would need to find me 6,000 + that make the same claim the WHO makes for it to be 51%. So far, only about .1% of all medical organizations make this claim. That is far beyond evidence. That is factual. For example, the European Medical Association (which comprises of over 40 European GOVERNMENT medical associations) do NOT agree with the WHO. That's 40 vs 3 right there, just off the top of my head. I'm sure there are more. Also, the Japanese Ministry of Health finds no correlation between circumcision and HIV. Go to their website. Japan is almost 99% UNcircumcised and it also has the LOWEST HIV infection rate on planet earth.
Not sure what you mean by "I haven't seen any evidence". Perhaps you're not looking. 99.55.142.31 (talk) 07:58, 4 December 2012 (UTC) Strikeout duplicate of below. Zad68
13:29, 4 December 2012 (UTC)
- Nice work, Zad68. Thank you for laying it out so clearly. Regarding your removal of information on the ultimate disposition of foreskins, can some other place be found in Wikipedia for that?89.204.135.51 (talk) 21:06, 3 December 2012 (UTC)
- Thanks... discussions are always the most productive when actual sources are provided to review. Regarding the foreskin disposition content--The removed source were entirely too old to support anything here, and the content was off-topic trivia. I guess if up-to-date scholarly sources could be found that provide in-depth coverage of the topics (not individual popular press reports that provided only tangential mentions, like the ones from NBC News and Wired that were removed), a paragraph at foreskin would seem logical.
Zad68
02:38, 4 December 2012 (UTC)
- Thanks... discussions are always the most productive when actual sources are provided to review. Regarding the foreskin disposition content--The removed source were entirely too old to support anything here, and the content was off-topic trivia. I guess if up-to-date scholarly sources could be found that provide in-depth coverage of the topics (not individual popular press reports that provided only tangential mentions, like the ones from NBC News and Wired that were removed), a paragraph at foreskin would seem logical.
Sure this is very easily answered. You see "no evidence at all that that is true". I'm not sure what you are talking about. There are over 12,000 medical organizations in the world (both governmental and non-governmental). Only about three (the CDC, AAP, and WHO) claim that circumcision reduces HIV. So out of 12,000 only 3 (that I know of, maybe there are more) that make this claim. Only .1% of all medical organizations in the world make this claim. Of the 12,000 medical organizations in the world. You would need to find me 6,000 + that make the same claim the WHO makes for it to be 51%. So far, only about .1% of all medical organizations make this claim. That is far beyond evidence. That is factual. For example, the European Medical Association (which comprises of over 40 European GOVERNMENT medical associations) do NOT agree with the WHO. That's 40 vs 3 right there, just off the top of my head. I'm sure there are more. Also, the Japanese Ministry of Health finds no correlation between circumcision and HIV. Go to their website. Japan is almost 99% UNcircumcised and it also has the LOWEST HIV infection rate on planet earth. Not sure what you mean by "I haven't seen any evidence". Perhaps you're not looking. 99.55.142.31 (talk) 08:01, 4 December 2012 (UTC) (Personal attack removed)
- I'm not sure why you think that copy-pasting your own responses is going to get you anywhere. Neither is making up numbers like "99% of all medical organizations". The fact that you personally only know about three doesn't mean you can just assume all the rest. That's ridiculously horrible logic. As we keep telling you, Wikipedia has policies about RELIABLE SOURCES. If you provide us with some of these authoritative sources, then of course they would be considered for providing balanced statements in the article. Until then, you're simply demanding that unsourced information be put in the article just because you say so. That isn't going to happen. -- Fyrefly (talk) 08:23, 4 December 2012 (UTC)
Um???
Unfortunately for Fyrael, my 99% is actually accurate.
ONE-SIXTH of the world's males are circumcised, not one-third. This below is a source CITED in the first paragraph of this article, Somebody please change 1/3 to 1/6.
http://whqlibdoc.who.int/publications/2007/9789241596169_eng.pdf
Medical Organizations that DO NOT support circumcision for medical reasons (including HIV/AIDS)
The Royal Australasian College of Physicians
Division of Paediatrics and Child Health
Canadian Paediatric Society
College of Physicians and Surgeons of Manitoba (CPSM)
Central Union for Child Welfare (Lastensuojelun Keskusliitto)
Royal Dutch Medical Society
Paediatric Society of New Zealand and the New Zealand
Society of Paediatric Surgeons
British Medical Association (BMA) General Medical Council (GMC)
British Association of Paediatric
Surgeons British Association of Paediatric
Surgeons Royal College of Nursing
Royal College of Paediatrics and Child Health
Royal College of Surgeons of England
The Royal College of Anaesthetists
American Academy of Family Physicians (AAFP)
American Medical Association (AMA) American College of Obstetricians and Gynecologists (ACOG) http://www.mhlw.go.jp/english/
http://www.cirp.org/library/statements/ http://www.cirp.org/library/statements/BAPS1997/ http://www.cirp.org/library/statements/RCS2001/ http://www.cirp.org/library/statements/bma2003/ http://www.cirp.org/library/statements/finland2003/ 99.55.142.31 (talk) 08:21, 6 December 2012 (UTC) — Preceding unsigned comment added by 99.55.142.31 (talk)
Just state the results
We do not need to preface every statement with the 1) journal 2) year of publication 3) type of study ect. This is a general encyclopedia. Please paraphrase and just present the results. Doc James (talk · contribs · email) (if I write on your page reply on mine) 18:02, 6 December 2012 (UTC)
- Agree, I will get to it if it isn't done.
Zad68
18:04, 6 December 2012 (UTC)
Mohels
Mohels circumise babies and they are not surgeons, nor is the Bris a medical procedure. It is not a medical procedure. Most of the world acknowledges that circumcision is not a "surgical procedure" It is technically mutilation
Mutilation: (noun) an injury that causes disfigurement or that deprives you of a limb or other important body part.
1. To deprive of a limb or an essential part
http://www.thefreedictionary.com/mutilate
Foreskin has functions, therefore cutting it off is technically mutilation, not surgery
1. protects the glans from the element s 2. protects the glans from injury 3. produces smegma which protects against foreign bacteria 4. keeps the glans sensitive 5. keeps the glans lubricated during intercourse 6. makes it easier to masturbate 7. warns the brain 60 seconds before orgasms, preventing premature ejaculation 8. keeps the glans mucous and prevents calcification, keratinization, and desensitizing 9. adds 2-300% stimulation to a woman during intercourse as the neuronic gliding action
increases a woman's overall inner vaginal wall stimulation and clitoral stimulation by over 300% which allows for the achievement of female orgasm more often and in shorter periods of time between penetration in what is referred to as Neuronic Gliding Stimulation as it glides up and down along the vaginal walls and puckers up near the bottom of the clitoris (the most sensitive part)
So much attention is given to how circumcision can "prevent" HIV, and no paragraphs on how it can prevent female orgasm. LMAO 99.55.142.31 (talk) 08:37, 6 December 2012 (UTC)
- @99.55.142.31|99.55.142.31 i heartily agree with most of your entry but WP will only countenance inclusion if referenced. ironically jewish philosophers have for 2000 years been citing diminished pleasure as a good reason to chop boys--— ⦿⨦⨀Tumadoireacht Talk/Stalk 16:01, 6 December 2012 (UTC)
- So did that Kellogg guy. Gråbergs Gråa Sång (talk) 14:39, 7 December 2012 (UTC)
- @99.55.142.31|99.55.142.31 i heartily agree with most of your entry but WP will only countenance inclusion if referenced. ironically jewish philosophers have for 2000 years been citing diminished pleasure as a good reason to chop boys--— ⦿⨦⨀Tumadoireacht Talk/Stalk 16:01, 6 December 2012 (UTC)
The Wikipedia page name "Circumcision" should be changed to "Male genital mutilation (circumcision)".
Why was my original post deleted? I have extremely valid points. (Personal attack removed) If you don't like this post, then shouldn't you stop using the word, "Talk" for the title of this Wikipedia section? Maybe it should be, "Only Talk allowed if approved by Wikipedia editors." Or "Censored Talk" might be a better title for this section.
The Wikipedia page name "Circumcision" should be changed to "Male genital mutilation (circumcision)". If Wikipedia refuses to change the Wikipedia page named "Circumcision" to "Male genital mutilation (circumcision)", then please change the Wikipedia page, "Female genital mutilation" to "Female Circumcision" http://en.wikipedia.org/wiki/Female_genital_mutilation and here's why:
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Speaking from a male's point of view, don't cut the skin off my penis! I cannot believe the amount of immoral parents, worldwide, who continue to approve the genital mutilation of their male children. This is a completely immoral action. A normal person without any religion would never perform genital mutilation on their male child. Only those people who think they'll receive an imaginary blessing from their belief in their imaginary invisible sky daddy, would commit such a horrific immoral action. That fact is this: Genital mutilation is genital mutilation is genital mutilation. Regardless if it is male or female genital mutilation. |
Modern science has shown that circumcision is not medically beneficial. Do you need a list of scientific studies that cite the harmful effects of male circumcision? I'm glad you asked, here: http://www.circumcision.org/studies.htm
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But back to the main point of my post. How about some equal rights for the male? My point is all about education. Here is a great way to prove the point that many people simply are not educated to where they realize that male circumcision is, in fact, male genital mutilation. Here is a great way to test my point. Do a survey asking several males and females you know (who are not Muslim) if female genital mutilation is an acceptable practice. Every person you interview will have a horrific facial expression and then they will always say that female genital mutilation is horrible and should never be done. Now ask these same people about male circumcision. Many will be indifferent and many will say it's up to the parent. Many people will say it's not a big deal. In fact, I've had females say that males need circumcision to keep it clean down there. Talk about the pot calling the kettle black! If anyone has more foreskin, it's females. When someone seriously starts talking about extra genital skin, for males, being a medical necessity to cut off for health reasons, then that's when it's time to point out that females have more "dangerous extra skin" and they should be the first to be circumcised before any male child. Male and female circumcision should be outlawed. If you don't agree, then make it a law that females must be circumcised. Now that you disagree with that statement, now it's time that you agree that male circumcision is genital mutilation and is an immoral action and should be outlawed for anyone under 18 years of age. |
— Preceding unsigned comment added by Mikewest (talk • contribs) 17:24, 8 December 2012
Mike west is right. Circumcision should be banned. But it won't be banned for a few more years. Intactivism is growing everyday but is not yet at the 80% mark, where it needs to be before it will be banned. I predict another five years or so, it will start being banned, city by city, state by state. It will be another 10 years at least until it is federally banned. The German WP may be anti-circ. But the English WP is certainly pro-circ. It just comes with the territory.
Interestly I found this article.
http://www.cirp.org/library/disease/HIV/vanhowe4/
R. S. Van Howe MD FAAP Department of Pediatrics, Marshfield Clinic, Lakeland Center, USA
This doctor claims that circumcision increases the risk of HIV/AIDS. Notice how sources like this don't make it to the English WP article? Coincidence? 99.55.142.31 (talk) 21:26, 10 December 2012 (UTC)
- Many of your points reflect your own personal opinions (i.e. original research) or synthesis of ideas not reflected in reliable sources (and you have not provided a single one). Our sense of fairness is not at issue here - WP reflects what is said in sources, giving weight according to those sources. I removed your prior post because it primarily used this talk page as a soapbox for making a point rather than an earnest effort to improve the page (I've included all these wikilinks because I think reading them will help you understand how WP policies and guidelines apply here). Your proposal to outlaw circumcision is a prime example - this is not the place to discuss outlawing anything. Regarding the suggestion that the page be renamed and more strongly reflect other points of view, these have been made many times before here - I suggest that you search the archives of this page (search box above) for terms like "mutilation" and "rename" (or just click here). If you do so, you will see that these points have been made before, and we've been unable to locate reliable sources to justify what you are propose. -- Scray (talk) 20:10, 8 December 2012 (UTC)
- It could be a worthwhile project for a sociology grad student to compare and contrast the circumcision articles of the various language wikipedias. I can tell you that last time I looked at the German WP, it was unbelievably bad. Horrifying color photographs of botched circumcisions, not a single photograph of what can go wrong in an un-circumcised penis. "Intactivists" like Dan Bollinger cited as authorities. Anonymous/pseudonymous commentary on intactivist internet message boards used as valid references. Complete disregard even for their own policies on sourcing in medical articles. During the so-called circumcision "debate" in Germany last summer, the anti-circumcision campaigners were routinely referring to that German WP article for backup. This article on WP en has its problems but it is in vastly better shape in every major respect and the reason is adherence to sensible sourcing guidelines.89.204.135.137 (talk) 04:12, 9 December 2012 (UTC)
- That's a shame, indeed. In doing research for this article, I ran across this interesting study from Harvard, which analyzed the differences in quality between websites dedicated to non-controversial urology topics (e.g. cryptorchidism, testicular torsion) vs. controversial urology topics (e.g. circumcision, penis lengthening). Finding: "Web pages dedicated to controversial urological topics have lower quality content in regard to diagnosis, natural history, and treatment. Such quality issues may contribute to ongoing public confusion and misinformation regarding these challenging topics." Not unexpected. If I can get the full text of that study it might make for a useful sentence in this or a related article. Appreciate the feedback, and would like to hear at some point about your ideas for improvements to this article. Cheers...
Zad68
04:40, 10 December 2012 (UTC)
- That's a shame, indeed. In doing research for this article, I ran across this interesting study from Harvard, which analyzed the differences in quality between websites dedicated to non-controversial urology topics (e.g. cryptorchidism, testicular torsion) vs. controversial urology topics (e.g. circumcision, penis lengthening). Finding: "Web pages dedicated to controversial urological topics have lower quality content in regard to diagnosis, natural history, and treatment. Such quality issues may contribute to ongoing public confusion and misinformation regarding these challenging topics." Not unexpected. If I can get the full text of that study it might make for a useful sentence in this or a related article. Appreciate the feedback, and would like to hear at some point about your ideas for improvements to this article. Cheers...
- @Scray: I edited your collapsing so to enable a source to be displayed. Nabla (talk) 01:45, 12 December 2012 (UTC)
- It could be a worthwhile project for a sociology grad student to compare and contrast the circumcision articles of the various language wikipedias. I can tell you that last time I looked at the German WP, it was unbelievably bad. Horrifying color photographs of botched circumcisions, not a single photograph of what can go wrong in an un-circumcised penis. "Intactivists" like Dan Bollinger cited as authorities. Anonymous/pseudonymous commentary on intactivist internet message boards used as valid references. Complete disregard even for their own policies on sourcing in medical articles. During the so-called circumcision "debate" in Germany last summer, the anti-circumcision campaigners were routinely referring to that German WP article for backup. This article on WP en has its problems but it is in vastly better shape in every major respect and the reason is adherence to sensible sourcing guidelines.89.204.135.137 (talk) 04:12, 9 December 2012 (UTC)
It's a question of naming guidelines. As a general rule we name articles according to their common English name. The procedure is called "circumcision". I wouldn't call it mutilation if there is a medical reason to do it just as, for example, an appendectomy is not mutilation when a patient has a case of acute appendicitis. Is it mutilation when there is no medical reason for it? Sure but that's to be addressed in the text not the title. Moreover, it isn't the only form of male genital mutilation possible, as the suggested title would indicate, some blokes may go in for piercings of the genitals, for example. Thus some circumcisions are not male genital mutilations and some male genital mutilations are not circumcisions. We don't need a title to conflate the two no matter how extensively they happen to overlap. No, the title refers to the procedure by it's common English name, as it should. JIMp talk·cont 15:56, 17 December 2012 (UTC)
No sexual drawbacks ?
About five years ago a male (heterosexual) friend of mine suddenly said "I'm going to have a small sergury tomorrow...". When he told me that , I tried to warn him. But obviosly he had some kind of infection that troubled him for long. He now sais that he is impotent due to the operation. He has not been with a woman for five years ! The operation was made when he (and I) was little above 40 years old. Perhaps there is no problem with this sergury if it's done pre-puberty. But if done as adult then I would not recommend it. If there is no religious issues I cannot see why circumcision is done at all. The african HIV-study, if true, may very well got to do with less sexual activity after circumcision. But about statistics that is not a lie I've read about a toothpaste that was proven to reduce the number of karies attacks by 20%. A group of 100 people had tested the new toothpaste and they actually got 20% fewes holes according to thestudy. But... it was never revealed that the tooth-paste-company had used 20 groups of 100 people each, and used the result from the best group. Several other groups ha got an increased number of holes by about 20%. I do not imply that the african stydy has used such methods, but to be certain that they are right in their conclusions many independant studies must also be done - and with about the same result (and including a study if sexual pattern is not changed by the circumcision). Castration must be an even better way of reducing HIV... 83.249.168.22 (talk) 02:03, 16 December 2012 (UTC)
Hi Johnny Eriksson, I am sorry to hear about your friend's medical problems, and hope they are resolved soon. With that, you need to know a Wikipedia article's talk page is really not for general discussion, it is only for discussing improvements to the article. The Talk page is not for discussion of our personal opinions. Regarding the studies, we use the best available sourcing for the statements the article makes. I understand your concerns about that results of the African studies, and your point about the toothpaste tests. In this case of circumcision and HIV, there are many, many high-quality scientific sources that support the statement the article is making. A Wikipedia article reflects the consensus of the best sources, and if the best-quality sources all report the same thing, as in this case, that is what the article will state. Thanks for your feedback. Cheers...
Zad68
03:03, 16 December 2012 (UTC)
- Thanks for the fast reply. Since a part of this article deals with religous aspects, I find it strange to not mention what Chistianity has to say. In "The acts of the Apostles" (Cyprus meeting) is stated than no not Jewish followers of Chistianity do not need to be circumcised. Although this may seems a bit vague, You certainly may be circumcised as a Christan, but still I think it would be a benefit for the article as such, to mention that Chistianity has no real thoughts about the issue. The Cyprus meeting was of great importance and ought to be mention in the religious part. (just pretend that the outcome of the meeting would have been the opposit, all Chistians must be circumcised) /Johnny Eriksson Sweden (my IP-number is changing all the time, but thanks for the invition, Zed) 83.249.168.22 (talk) 10:12, 17 December 2012 (UTC)83.249.168.22 (talk) 10:14, 17 December 2012 (UTC)
- Done As requested I just added a short paragraph on circumcision and Christianity.
Zad68
02:59, 21 December 2012 (UTC)
- Done As requested I just added a short paragraph on circumcision and Christianity.
FWIW
- This post strangely appeared on my talk page, copying it to here: SandyGeorgia (Talk) 02:41, 16 December 2012 (UTC)
Hello SandyGeorgia !
Since the article "Circumcision" seems to be locked and controlled by You, at the religious part, I think that You should add
"Christianity" there aswell. In the Acts of the Apostles is describen that on the Cyprys meeting , the deciples and other of the very early Chistians decided that "unjewish" followers of the new faith, did not need to became cicumcised. This is well as relevant as what jewesand muslims belive. I see no otherway than contact You about this issue. Best reguards Johnny Eriksson, Sweden 83.249.168.22 (talk) 02:29, 16 December 2012 (UTC)
- The Circumcision article is locked and controlled by me? Who knew? Not me. From whence came such a notion. Gee, I don't even own one of those things, but I did edit the article once or twice. I will copy your post to Talk:Circumcision so the propah authorities with penii can deal with it. SandyGeorgia (Talk) 02:39, 16 December 2012 (UTC)
- I'm sorry if I misunderstood something. There is a lock. The article history file though shows (to my knowlidge) that You can edit it. I've only used Wikipedia for editing a few times. Mainly to correct errors. Sorry again.
Hello Johnny Eriksson... you are right, the article could have more content about circumcision and Christianity. I will be adding content to the article about circumcision and Coptic Christians soon. The article does already mention Paul's views on circumcision, but it does need more information on Christianity's general view of circumcision today. Thank you for pointing out these areas that need improvement, I will work on it.
Zad68
02:50, 16 December 2012 (UTC)- And I'm sorry to You too Zeb, did not notice You already had answered my suggestion. Sorry and Cheers! 83.249.168.22 (talk) 10:20, 17 December 2012 (UTC)
- Done Short paragraph on circumcision and Christianity added.
Zad68
03:01, 21 December 2012 (UTC)
- Done Short paragraph on circumcision and Christianity added.
- And I'm sorry to You too Zeb, did not notice You already had answered my suggestion. Sorry and Cheers! 83.249.168.22 (talk) 10:20, 17 December 2012 (UTC)
One-Third????????????????
Um NOBODY estimates that 1/3 of men are circumcised. EVERY ESTIMATE is at 1/5 (one-fifth) 20%. Even the source used for this bad quote says 1/3 at most to 1/6, 1/3 being unlikely and 1/5 being the most common estimate.
China's, India's, and Europe's males are over 2/3 of the male population right there. Only 700 - 800 million men are cut. That is only 20% of men.
Who the hell is editing this horrible article?
75.1.54.56 (talk) 23:12, 20 December 2012 (UTC)
sale of excised foreskins to cosmetics or med research industry and also the foreskin of jesus
Should the article contain reference to the above ?--— ⦿⨦⨀Tumadoireacht Talk/Stalk 10:07, 22 December 2012 (UTC)
- <siiigh!!!> It all sounds like BS to me. IMO opinion no, not unless we have a) Encyclopedic themes to hang it on, b) Unimpeachable, articulate, verifiable, accessible sources etc. C) It should be aired in the Talk page first and some degree of consensus attained first. d) the questions of harvesting, sale, interested parties and applications (as opposed to simple truth or reliability) should be dealt with separately if so. Etc etc... Look: even mentioning this sort of thing exposes us to "hatred, ridicule, or contempt", so there is nothing that ill-willed enemies of civilised discourse would like better than for us to mention it. That is not in itself a show-stopper, but it is a hell of a show-cautioner. I am frequently inclined to react like the chap foregoing, who spoke of this horrible bloody article. JonRichfield (talk) 12:57, 22 December 2012 (UTC)
hatred, ridicule, or contempt" - who gets exposed to them ? WP ? foreskin choppers ? foreskin sellers ?http://web.archive.org/web/20080204011552/http://www.nbc10.com/health/1808693/detail.html is one initial reference. --— ⦿⨦⨀Tumadoireacht Talk/Stalk 13:28, 22 December 2012 (UTC)
- Regarding sale of excised foreskins: I agree with Jon, "No," at least not here, and Jon articulated the problems well. First, such material appears off-topic for this article, and shouldn't be added here as trivia, which is how I interpret what Jon means by "encyclopedic themes to hang it on". It's appropriate at foreskin (or at least could be appropriate) where it is already covered. Second (and here I am only talking about content that should appear at foreskin) I agree that such material needs appropriate sourcing. The 2008 NBC 10 transcript about the "TNS Recovery Complex" wrinkle cream--or even if we had several like it--wouldn't be sufficient sourcing for a general statement, because it would be synth based in primary sources. I did a PubMed search for a review article covering the subject of the use of foreskins by the pharmaceutical industry and did not find anything. What is at foreskin now is poor quality content that needs to be addressed.
Regarding the foreskin of Jesus: This subject also would seem to be more appropriate at foreskin rather than here. This article already does mention the circumcision of Jesus, and wikilinks to it, in the history section; that article covers and links to Holy Prepuce.
Zad68
03:48, 23 December 2012 (UTC)- I'd completely disagree with that assessment. I see no reason not to put Holy Prepuce in see also. The sale of foreskins should be included in the article concerning the harvest of foreskins. --Nouniquenames 04:11, 23 December 2012 (UTC)
- Jon and Zad ; Circumcision is chopping off foreskins, but we should not mention what happens to the chopped off foreskins in the chopping article ? --— ⦿⨦⨀Tumadoireacht Talk/Stalk 16:27, 23 December 2012 (UTC)
- Definitely and decidedly not. Not unless we can find something encyclopaedic (read: "Constructive, interesting, edifying and educational") to say about them. It need not be big, it need not be earth-shaking or even seriously important, but it must be worth saying in the contexts of WP. Can we find anything like that? Maybe, and if so I support its inclusion, but just the fact that it concerns something between the thighs won't cut it, if you will excuse the expression. If we cannot find anything worthwhile, do you support its inclusion? And if so, why? Or must there be a "why"? JonRichfield (talk) 20:14, 23 December 2012 (UTC)
- This is the section on medical re-usage of foreskinsin the foreskin article. It is well written and researched. :
- Definitely and decidedly not. Not unless we can find something encyclopaedic (read: "Constructive, interesting, edifying and educational") to say about them. It need not be big, it need not be earth-shaking or even seriously important, but it must be worth saying in the contexts of WP. Can we find anything like that? Maybe, and if so I support its inclusion, but just the fact that it concerns something between the thighs won't cut it, if you will excuse the expression. If we cannot find anything worthwhile, do you support its inclusion? And if so, why? Or must there be a "why"? JonRichfield (talk) 20:14, 23 December 2012 (UTC)
- Foreskin-based medical and consumer products
- Foreskins obtained from circumcision procedures are frequently used by biochemical and micro-anatomical researchers to study the structure and proteins of human skin. In particular, foreskins obtained from newborns have been found to be useful in the manufacturing of more human skin.[56]
- Human growth factors derived from newborns' foreskins are used to make a commercial anti-wrinkle skin cream, TNS Recovery Complex.[57]
- Foreskins of babies are also used for skin graft tissue,[58][59][60] and for β-interferon-based drugs.[61]
- Foreskin fibroblasts have been used in biomedical research.[62]
- The circumcision article should have a similar but maybe slightly smaller section. An examination of how different religions or societies differ in disposing of the foreskins they cut off might be worthwhile too.
- An examination of how much they fetch at resale might be edifying too. De-Constructive, interesting, edifying and educational also ?
- Would we write a WP article on sweetcorn describing cultivation but omitting any material on consumption ?--— ⦿⨦⨀Tumadoireacht Talk/Stalk 20:45, 23 December 2012 (UTC)
- The flaws in this analogy are that 1) the analogous article would not be maize but rather an article on corn harvest (there isn't one, but the section on Production in maize does not cover end-uses, in line with what we are saying--end-uses of the foreskin should not be covered here but at foreskin), and 2) corn is raised for the explicit purpose of harvest, sale and consumption, and I have not seen a reliable source stating that this is the case for foreskins. Further, the content from foreskin you're quoting above I would in no way characterize as "well written and researched." The first sentence is sourced to a 1995 (the article inaccurately says 1999) popular-press article from a small newspaper, and suffers from a particularly awful case of WP:SYNTHESIS by taking the article--a primary source which describes a proposed business that actually was not underway at the time--and uses it to make an unsupported general statement. It does this several other times with articles from the Orange County Business Journal (2002), Wired magazine (1999), a Medscape article that mentions neither "foreskin" nor "circumcision", Businessweek (2008), and New York Times (1992). See WP:MEDRS, WP:NOR and WP:INDISCRIMINATE for discussions on why the sourcing is insufficient and that article content violates Wikipedia policy. What should happen is that the entire paragraph should be ripped out of foreskin. It should not be copied here.
Zad68
03:30, 24 December 2012 (UTC)
- The flaws in this analogy are that 1) the analogous article would not be maize but rather an article on corn harvest (there isn't one, but the section on Production in maize does not cover end-uses, in line with what we are saying--end-uses of the foreskin should not be covered here but at foreskin), and 2) corn is raised for the explicit purpose of harvest, sale and consumption, and I have not seen a reliable source stating that this is the case for foreskins. Further, the content from foreskin you're quoting above I would in no way characterize as "well written and researched." The first sentence is sourced to a 1995 (the article inaccurately says 1999) popular-press article from a small newspaper, and suffers from a particularly awful case of WP:SYNTHESIS by taking the article--a primary source which describes a proposed business that actually was not underway at the time--and uses it to make an unsupported general statement. It does this several other times with articles from the Orange County Business Journal (2002), Wired magazine (1999), a Medscape article that mentions neither "foreskin" nor "circumcision", Businessweek (2008), and New York Times (1992). See WP:MEDRS, WP:NOR and WP:INDISCRIMINATE for discussions on why the sourcing is insufficient and that article content violates Wikipedia policy. What should happen is that the entire paragraph should be ripped out of foreskin. It should not be copied here.
Here is a medical research supplies company website that sells Neonatal Foreskin Epidermal Keratinocytes at 250 dollars a pop.https://ccr.coriell.org/ViewCart.aspx Should we not mention these sales of circumcised foreskins on the page about circumcision as circumcision is their only source ? @Zad You may have skimmed past the long section 8 in maize devoted to uses of Maize. Ah-maizing !--— ⦿⨦⨀Tumadoireacht Talk/Stalk 04:25, 24 December 2012 (UTC)
- LOL at the pun, cute! I apologize if I'm being unclear, but you are still not connecting to my points. 1) This article is about the circumcision procedure, the act of removing, and not the foreskin, that which is removed. Section 6.1 in maize describes the method of production of maize, but does not at all cover what is done with the maize once produced. 2) You also did not address the stark differences purposes. 3) Primary sources like the sales page you linked to are not what we need to create the kind of content you are describing. Please provide excellent-quality secondary sources. I looked for them myself and could not find them.
Zad68
05:04, 24 December 2012 (UTC)
Revision Deletion
This circumcision article by reason of its controversial subject matter has attracted 8 WP:REVDEL revision deletions within the last year. In this exercise an administrator removes a chunk of an article or talk page leaving no record and no trace. One such RD occurred today. Does anyone know if what was excised can be viewed anywhere else ?--— ⦿⨦⨀Tumadoireacht Talk/Stalk 06:28, 24 December 2012 (UTC)
- Your description of revdel isn't entirely correct (it's usually just removing an inappropriate edit summary), and I see no revdels here recently, so I don't know what you're referring to. Unless something is also oversighted, admins can see what was revdel'd. SandyGeorgia (Talk) 06:48, 24 December 2012 (UTC)
- Replied at Wikipedia talk:Revision deletion#I saw briefly a page listing Revision Deletions for a particular article talk page -how can I call this up again ? --Redrose64 (talk) 15:19, 24 December 2012 (UTC)
Thank you for a complete and useful answer and being kind about my ignorance.--— ⦿⨦⨀Tumadoireacht Talk/Stalk 15:34, 24 December 2012 (UTC)
Recent edits
I'm trying to find a happy medium between the faction that wants to include everything, the faction that wants to include anything negative, the faction that thinks circumcision is great and the article should reflect that, the faction that thinks the article is great, thanks, and let's leave it as is, and some other faction. Note that I'm not assigning any editor to any of these factions, and I'd appreciate it if no one else did either.
There was a recent attempt by two editors (myself included) to add a "See Also" section. This was opposed and undone by two other editors. Discussion elsewhere pointed out that "See also: Avoid the See also section when possible; prefer wikilinks in the main article and navigation templates at the end." Thus the see also section has been removed" is apparently the recommendation at MEDMOS. I have attempted to introduce some of the appropriate links into the article without reverting to a "See Also." If you don't like the way I did it, that's fine, but don't remove the links. Fix the text. Let us all work together here.
Note that the references I used are all accepted elsewhere on Wikipedia to say the same thing they say here. --Nouniquenames 05:23, 24 December 2012 (UTC)
- If you would supply diffs others might understand what specifically you're referring to. On what works on other articles, please see WP:OTHERSTUFFEXISTS. The recommendation on See also is not only per WP:MEDMOS; it's Wiki-wide. I'm not sure which edits you're specifically referring to, but I did see you reverting to a preference of your interpretation of a primary source (the Bible) over secondary sources, which is a no go. By the way, you're also edit warring; once you've been reverted once, you should discuss. Instead, you reverted again, and then started this discussion. See WP:EDITWAR; WP:3RR is not a license to edit war. SandyGeorgia (Talk) 05:28, 24 December 2012 (UTC)
- (e/c) Nouniquenames are you talking about the See also section, or the more recent edits that attempted to use a primary source to counter a secondary source, and use a religious primary text to support article content? If it's the latter, I explained in the edit summary and on your talk page that using primary sources in those ways isn't good. You reverted and said, "See Talk" but you don't seem to be addressing why you undid the revert of your edit that use the primary sources.
Zad68
05:30, 24 December 2012 (UTC)
- (edit conflict)My apologies.
- The article at Preputial mucosa covers the preputial epithelium ("The preputial mucosa of the penis is the epithelium of the inside of the prepuce, or foreskin").
- The source at Dorsal slit#Phimosis is used there used to support alternative method for treating phimosis, added here
- Holy Prepuce#History and rival claims's first source is the same reference I used, albeit I omitted the direct quote there. my edit, originally added there in 2009.
- I will self-revert my last edit. I would, however, like to see the material included within the article. --Nouniquenames 05:46, 24 December 2012 (UTC)
- Thanks Nounique... Regarding the two edits you made and mentioned you'd like to see in the article: Your first edit added a mention of the circumcision of Jesus. The good news is that this content is already in the article, with a wikilink just like you were looking for, but that content is in the History section, where it's more appropriate. The section you added it to covers current religious practices, but the circumcision of Jesus is a historical event. The second edit added information about a dorsal slit as a treatment option for phimosis. This content is absolutely appropriate at phimosis but is off-topic here. Per WP:MEDICAL and WP:MEDMOS we must not be appearing to be giving medical advice. We don't cover alternatives for each of the conditions mentioned, that would be going down the road of giving medical advice. We just state the facts relating to circumcision here.
Zad68
01:21, 25 December 2012 (UTC)
- Thanks Nounique... Regarding the two edits you made and mentioned you'd like to see in the article: Your first edit added a mention of the circumcision of Jesus. The good news is that this content is already in the article, with a wikilink just like you were looking for, but that content is in the History section, where it's more appropriate. The section you added it to covers current religious practices, but the circumcision of Jesus is a historical event. The second edit added information about a dorsal slit as a treatment option for phimosis. This content is absolutely appropriate at phimosis but is off-topic here. Per WP:MEDICAL and WP:MEDMOS we must not be appearing to be giving medical advice. We don't cover alternatives for each of the conditions mentioned, that would be going down the road of giving medical advice. We just state the facts relating to circumcision here.
Some notes
- Not important for GA, but would be for FA: There is an inconsistent citation style, particularly with respect to author names. [5] I suggest using the Diberri template filler for a consistent format. Also, because the article uses list-defined references and mixes SFN with Ref Harv with regular citation templates, I find the article very hard to work on, so will leave citation work to someone else. (I hate SFN and list-defined refs, would use the Diberri cite templates for consistency as is done in most medical articles.)
- Done making cite journal citation consistent in Diberri style
Zad68
19:19, 17 December 2012 (UTC) - In progress still need to do cite book and cite web
Zad68
19:19, 17 December 2012 (UTC)
- Done making cite journal citation consistent in Diberri style
- It won't matter for GA, but would for FA: I wouldn't cite this to Mayo Clinic: Circumcision has a protective effect against the risks of penile cancer in men, and cervical cancer in the female sexual partners of heterosexual men. Penile cancer is rare, with about 1 case per 100,000 men in developed countries, ref name=mayo_clinic_2012/ I'm still looking, but generally the sourcing is excellent-- replace Mayo with a journal review if you can.
- Done removed Mayo Clinic as a sub-par source, used existing source to support
Zad68
19:40, 17 December 2012 (UTC)
- Done removed Mayo Clinic as a sub-par source, used existing source to support
- Done looks like you did most of these, I just moved the one image in Judaism
Zad68
19:57, 17 December 2012 (UTC)
- Done looks like you did most of these, I just moved the one image in Judaism
SandyGeorgia (Talk) 21:04, 13 December 2012 (UTC)
Turning to prose issues, I jumped down to the middle of the article for a sampling:
- Circumcision is (arguably) the world's oldest planned surgical procedure, hypothesized to be over 15,000 years old, well pre-dating recorded history.
- First, no need for parentheticals-- generally, anything worth saying in an encyclopedia is worth saying. Second, the reader is given no indication why this weasly word is used or who is doing the hypothesizing. When we "argue" or "hypothesize", we need to attribute. "Well" is redundant.
- In the study of the history of circumcision, there are two main "streams" that are followed
- Confusing. When I first read the sentence, I think what follows will relate to two streams of thought. The text that follows is all about geography. So I'm left not knowing what these "streams" are referring to.
- Evidence exists that circumcision was in general practice in the Arabian peninsula in the 4th millennium BCE, and moved into the area that is modern-day Iraq with the Sumerians and the Semites.
- Convoluted. Evidence suggests that circumcision was practiced in the Arabian peninsula in the 4th millennium BCE, and the Sumerians and the Semites brought it into the area that is modern-day Iraq.
- Or at least, you would have to say "the practice moved into the area". Circumcision doesn't move.
- Done I see my wording misled you factually, corrected
Zad68
03:41, 18 December 2012 (UTC)
- Done I see my wording misled you factually, corrected
OurThe earliest historical record of circumcision comes from Egypt ...
- Done 03:41, 18 December 2012 (UTC)
- Redundant prose can be reduced, sample: No single well-accepted theory
has been put forth toexplains the significance of circumcision to the Egyptians, but it appears to have been endowed with great honor and importance as a rite of passage into adulthood, done in a public ceremony emphasizingthe ideas ofthe continuation of family generations and fertility.
- Repetitive, purity, purification, try to recast the sentence to vary the prose: In addition to possible hygenic reasons, for the purity-obsessed Egyptians circumcision surely concerned purification,
- it was an outward sign of their covenant with God, and enabled the penis to allow a Jew to fulfill properly the commandment to create offspring. Outside of considering that it was taken up by the Jews
- Ugh, lost. I know that penii have minds of their own, but "enabled the penis to allow a Jew"? I don't know what this wants to say.
- Outside of considering that it was taken up by the Jews purely as a biblical commandment, scholars have suggested that Abraham and his followers adopted circumcision from neighboring cultures
as a meansto make penile hygiene easier in hot, sandy climates; as a rite of passage into adulthood; or as a form of blood sacrifice.
- Ugh, ok, this needs a lot of help. The first part is either redundant to prior text, or should be a separate sentence, but the "outside of considering" is most awkward. Was the Bible written then?
- Circumcision was not taken up by the Jews purely as a religious mandate; scholars have suggested that Abraham and his followers adopted circumcision to make penile hygiene easier in hot, sandy climates; as a rite of passage into adulthood; or as a form of blood sacrifice.
- Done with a bit of a tweak for accuracy to sources
Zad68
04:34, 23 December 2012 (UTC)
- Done with a bit of a tweak for accuracy to sources
OK, that's a mini review of prose, samples only, you should probably work on a copyedit before going to GA. I'll try to pop in occasionally. Very nice sourcing! SandyGeorgia (Talk) 21:24, 13 December 2012 (UTC)
- Thank you for your input! I know the prose is... um... uneven. I will work on fixing everything you mentioned. Appreciate it!
Zad68
21:32, 13 December 2012 (UTC)
I've continued to tinker here and there (I've left some inline queries, just remove them when you fix), and I think you've got yourself a future FA here, but you've got some work to do to get there. It needs little prose fixes everywhere I look ... sometimes it's linking (over and underlinking-- you don't have to link terms that everyone knows, but you do need to link jargon and technical terms), sometimes it's some lack of clarity in the writing. My suggestion at this point (because this will be GA soon) is to work on the technical stuff I've pointed out, then set the article aside for a week or two to gain distance from the prose, and then come back and re-visit the prose with new eyes, thinking about whether every sentence is comprehensible to someone unfamiliar with the text. This article is in great shape, and with just a bit more work, it will be over the hump, but it's prose, not sourcing-- fixing an article with bad sourcing is awful, cleaning up prose is doable! SandyGeorgia (Talk) 04:56, 14 December 2012 (UTC)
- Delighted! Will get to work, thanks again.
Zad68
17:08, 14 December 2012 (UTC)
2nd Paragraph?
"Circumcision does not appear to have a negative impact on sexual function"
This is a sick joke right?
Circumcision causes calcification and keratinization of the glans, desensitizing it by 70-90%. It also causes early impotence. Foreskin also adds extra stimulation to a woman's inner vaginal walls and lower part of the clitoris, increasing a woman's overall stimulation by over 200%. Removing it, reduces a woman's stimulation with her man by 67%.
This is the worst article on circumcision I have ever seen.
Who the hell is editing this crappy article? Apprently, nothing but insecure mutilated men. This is sad and pathetic.
75.1.54.56 (talk) 05:30, 23 December 2012 (UTC)
- Got some high-quality medical sources that meet the Wikipedia guidelines for your above claims? You will want to remove your personal attacks on editors, which are against the rules here.89.204.154.177 (talk) 10:42, 23 December 2012 (UTC)
- @75.1.54.56 The way that the information about both desensitization and about effects on HIV transmission are presented at present in the article do seem skewed in favour of circumcision. However the way to address this is to locate good sources for the information that contradicts that view rather than characterize other editors. The article could also usefully mention Philo the jewish philosopher saying circumcision "signified figuratively the excision of all superfluous and excessive pleasure" and Maimonides arguing that "circumcision acts to repress sexual pleasure" . as referenced in the WP article on Bri Milah or circumcision within Judaism. These are early recognition of the reduction of pleasure caused by lopping off the business end of the rhythm stick. The ideas about circumcision being a symbolic castration of slaves or the Talmud professor Daniel Boyarin's suggestion that the act of bleeding represents a feminization of Jewish men are fascinating too. The marked difference between USA and other anglophone countries would bear further scrutiny -could it be down to Puritan origins, recent USA hygiene fetish or the large number of Jewish doctors in USA ? --— ⦿⨦⨀Tumadoireacht Talk/Stalk 16:58, 23 December 2012 (UTC)
- Tumadoireacht, first, thank you for pointing out to the IP that personal attacks are not allowed on Wikipedia, and I agree that excellent sourcing should be found for all article content. However, I'm concerned about the approach to article development that you are expressing here. Starting off with a goal in mind ("Get the article to say something negative about sexual effects") and then looking for sourcing to get the article to say what you want it to say will not result in content in line with Wikipedia policy and guideline. Detailed content about what medieval religious philosophers thought belongs in the appropriate religion-based articles and not in this general survey article. As for the rest of your comments, see WP:NOTAFORUM.
Zad68
04:20, 24 December 2012 (UTC)
- Tumadoireacht, first, thank you for pointing out to the IP that personal attacks are not allowed on Wikipedia, and I agree that excellent sourcing should be found for all article content. However, I'm concerned about the approach to article development that you are expressing here. Starting off with a goal in mind ("Get the article to say something negative about sexual effects") and then looking for sourcing to get the article to say what you want it to say will not result in content in line with Wikipedia policy and guideline. Detailed content about what medieval religious philosophers thought belongs in the appropriate religion-based articles and not in this general survey article. As for the rest of your comments, see WP:NOTAFORUM.
- @75.1.54.56 The way that the information about both desensitization and about effects on HIV transmission are presented at present in the article do seem skewed in favour of circumcision. However the way to address this is to locate good sources for the information that contradicts that view rather than characterize other editors. The article could also usefully mention Philo the jewish philosopher saying circumcision "signified figuratively the excision of all superfluous and excessive pleasure" and Maimonides arguing that "circumcision acts to repress sexual pleasure" . as referenced in the WP article on Bri Milah or circumcision within Judaism. These are early recognition of the reduction of pleasure caused by lopping off the business end of the rhythm stick. The ideas about circumcision being a symbolic castration of slaves or the Talmud professor Daniel Boyarin's suggestion that the act of bleeding represents a feminization of Jewish men are fascinating too. The marked difference between USA and other anglophone countries would bear further scrutiny -could it be down to Puritan origins, recent USA hygiene fetish or the large number of Jewish doctors in USA ? --— ⦿⨦⨀Tumadoireacht Talk/Stalk 16:58, 23 December 2012 (UTC)
- Got some high-quality medical sources that meet the Wikipedia guidelines for your above claims? You will want to remove your personal attacks on editors, which are against the rules here.89.204.154.177 (talk) 10:42, 23 December 2012 (UTC)
@Zad What an odd misinterpretation you use to characterize my suggesting seeking excellent sources as inappropriate and your using quotation marks for an invented quotation is a bit much now really. As the impetus to cut babies penises is largely religion driven the early sources of religious ideas that created and reinforced the idea are, I believe, central to this article. These philosophers and doctors quoted greatly predate the medieval. Pretending that circumcision is only a medical issue damages the article--— ⦿⨦⨀Tumadoireacht Talk/Stalk 04:39, 24 December 2012 (UTC)
- The scope of this article is indeed circumcision as a medical procedure. Religious aspects are mentioned here briefly and the detail goes in the specialized subarticles or related articles, on Wikipedia this is called "Summary style," see WP:SUMMARY.
Zad68
05:04, 24 December 2012 (UTC)- There is an article devoted entirely to the procedure http://en.wikipedia.org/wiki/Circumcision_surgical_procedure . This is not it.
This article here is the flagship of a fleet of about two dozen articles ( which really should be listed in a nice handy See Also section) and as well as describing the "procedure" also gives social, historical, societal, religious and other contexts for it. A good analogy is Addiction - now largely medicalized in "treatment" but the treatment modalities still often bear the traces of the "moral" ideas that historically gave rise to them. So the ideas about cleanliness and protection from disease effected by dircumcision while selling themselves as objective owe their origins to idea sets outside and predating medicine --— ⦿⨦⨀Tumadoireacht Talk/Stalk 06:23, 24 December 2012 (UTC)
I am going to say that I do agree with the content in the first opposing "editor's" claims about penis sensitivity, but I would like to more professionally explain why, as well as cite a few bullet proof sources. Circumcision removes the 4 most sensitive reasons of the penis; the outer cutaneous, inner mucosal, ridged bands, and frenulum, are all the most sensitive regions of the penis. The most sensitive region of a circumcised penis is the underside of the scar, or frenulum remnant. The intact penis' glans is significantly more sensitive than of the circumcised penis. The glans is an organ designed by nature to be internal. Circumcision exposes the glans, drying it out and causing callousing. The foreskin also prevents direct contact with the corona glandis (mushroom shaped base of the glans) and the vaginal walls during intercourse; this helps to prevent premature ejaculation. In terms of sexual function, the foreskin is very important because it keeps the peni shaft skin motile. Special stretch receptor nerves are stimulated during the retraction process, and it also provides stimulation for the vagina. Also, the foreskin is the man's mechanical contribution to lubrication, it also helps to absorb vaginal lubricant and keep it inside. A circumcised penis tends to draw moisture out of the vagina exposing it to air and adding friction. Many american women are now realizing why they've often found sex to be uncomfortable and sometimes painful. The foreskin is the primary erogenous tissue in a male and is the main location of sexual/sensual expression and reception. The foreskin has 20,000 fine touch nerve endings as opposed to the clitoris' 8,000. Circumcision removes the most sensitive area of the penis. This is a proven fact. Please see my sources. This wikipedia circumcision article has too much debunked information and it is concerning to me as this is such an important controversial topic that most Americans are misinformed about; this article is continuing the spread of false information validated by flawed scientific studies. Circumcision results in dramatic loss of sexual pleasure in both intensity and range of sensations, and has been linked to impotence, ED, as well as other sexual detriments.FatStrat87 (talk) 18:54, 26 December 2012 (UTC)
Doctors opposing circumcision: [15]
Penis sensitivity/sexual function study: [16]
- See WP:MEDRS for Wikipedia's standards concerning biomedical information.
Zad68
21:18, 26 December 2012 (UTC)- @ FatStrat 87 - Fascinating stat. re nerve endings between foreskin and clitoris and your entry above included other information I had not seen before. There seems to be a strong consensus at least among the regular patrol editors of this article to resist any addition of material that is not from "secondary" med journal sources. I maintain that MC is a much wider issue than the medical and both the selection of material for the article and the article content should reflect this. Do you think there is a place for a new article contrasting the remarkable difference between attitudes to female and male genital mutilation ?--— ⦿⨦⨀Tumadoireacht Talk/Stalk 15:44, 27 December 2012 (UTC)
- Tumadoireacht, you are 100% correct in your assessment that there is strong consensus that biomedical claims on Wikipedia must be sourced to high-quality medical secondary sources. It looks like you have read and are paying attention to WP:MEDRS, that is very much appreciated, thank you. Just to be clear, WP:MEDRS applies to sources used for biomedical information anywhere in any article on Wikipedia. Societal attitudes towards genital modification and mutilation would be most logically covered at the article genital modification and mutilation.
Zad68
16:15, 27 December 2012 (UTC)- I made no such assessment. Re-read my entries with the attention and appreciation you are wrongly or perhaps patronizingly thanking me for. --— ⦿⨦⨀Tumadoireacht Talk/Stalk 16:31, 27 December 2012 (UTC)
- Tumadoireacht, there's something I'm not understanding here. I recognize that you are concerned that circumcision is not solely a medical phenomenon. Nevertheless, as has been pointed out, this article already devotes considerable space to non-medical aspects of the surgery; see, for example, Circumcision#Society and culture. In addition, WP:WEIGHT "requires that each article or other page in the mainspace fairly represents all significant viewpoints that have been published by reliable sources, in proportion to the prominence of each viewpoint in the published, reliable sources". The vast preponderance of reliable sources on circumcision discuss its medical aspects; given that fact, one could make a strong argument that this article already devotes undue space to the non-medical aspects of the procedure.
- My confusion, however, is that in this and other active Talk: page sections, various new/IP editors are presenting arguments and sources on medical findings. Even if, for arguments sake, all editors here agreed that the article should devote more weight to circumcision's non-medical aspects, one still could not abrogate or ignore WP:MEDRS when discussing medical studies and medical aspects of circumcision. An individual study is a primary source as regards the findings of that study, and WP:MEDREV clearly states "Individual primary sources should not be cited or juxtaposed so as to "debunk" or contradict the conclusions of reliable secondary sources." - apparently exactly what is being proposed here.
- I admit that I may have misinterpreted the thrust of your statements, and I don't mean to misrepresent you in any way. So, for my benefit, could you please explain exactly what use you wish to make of these primary medical studies? Or, if you do not wish to make use of them, could you explain what specific changes you are proposing to make to the article? I would greatly appreciate that. Jayjg (talk) 23:31, 27 December 2012 (UTC)
- I made no such assessment. Re-read my entries with the attention and appreciation you are wrongly or perhaps patronizingly thanking me for. --— ⦿⨦⨀Tumadoireacht Talk/Stalk 16:31, 27 December 2012 (UTC)
- Tumadoireacht, you are 100% correct in your assessment that there is strong consensus that biomedical claims on Wikipedia must be sourced to high-quality medical secondary sources. It looks like you have read and are paying attention to WP:MEDRS, that is very much appreciated, thank you. Just to be clear, WP:MEDRS applies to sources used for biomedical information anywhere in any article on Wikipedia. Societal attitudes towards genital modification and mutilation would be most logically covered at the article genital modification and mutilation.
Realistic death risk
The one reference for circumcision-related death is 1:500,000 from http://en.wikipedia.org/wiki/Circumcision#cite_note-AAFP_2007-16. That is second-hand information from a very old source, which was not peer-reviewed, but just a 1953 letter to a journal editor: Speert, H. (1953). (Letter to editor) Obstetrics and Gynecology, 2, 104. The most recent estimate, and seemingly comprehensive, is: Bollinger, D. (2010). Lost boys: An estimate of US circumcision-related infant deaths. Thymos: Journal of Boyhood Studies, 4(1):78-90.. It says the rate is about 117 per year, or an incidence of 9.01 per 100,000. At one time, this article was cited. I think this rate should be used instead of the present one. Frank Koehler (talk) 23:20, 23 December 2012 (UTC)
- Although this site is apparently anti CC it includes what appears to be solid references to a peer reviewed journal supporting a rate of 9/100,000.http://www.circumstitions.com/death.html (THYMOS: Journal of Boyhood Studies, Vol. 4, No. 1, Spring 2010, 78-90)
- Does the 1/500,000 figure derive from worlwide figures or from USA ? If either does it include those boys who have died from brain damage induced by herpes contracted during circumcision, or those conducted in unsanitary third world conditions ?--— ⦿⨦⨀Tumadoireacht Talk/Stalk 06:23, 24 December 2012 (UTC)
- Actually, it is must for New York city from an adhoc review for deaths during the surgery and not after, so is not a good representation of the truth.Frank Koehler (talk) 14:40, 24 December 2012 (UTC)
Frank, regarding the AAFP number, generally we leave it to the secondary sources to do the vetting of the data. But, looking at it, the "500,000" number appears to trace back to King 1982. From my searching I'm not finding a reliable source that makes a direct connection from King 1982 to Speert 1953. However, even if the number is coming from 1982, that's 30 years ago, and if it's from 1953, that's nearly 60 years ago.
- I just reread King, while it does not cite Speert, it is clear that is the source since is says, "During one period, 500,000 consecutive neonatal circumcisions in New York city without fatality." Speert reported that approximately 566,483 babies had been circumcised in New York between 1939 and 1951, with one death. So this is their source. But Speert, an op/ed only looked at fatalities DURING the operation. Mortality from circumcision comes later, typically after hospital release, which explains why AAFP/King/Speert have such low rates. Unless this is stated, it misleads readers.Frank Koehler (talk) 14:40, 24 December 2012 (UTC)
- I would certainly expect the death rate now to be much, much lower than it was 30 or 60 years ago.
- One would assume, but that's not the case. A paper presented at the 2011 American Academy of Pediatrics showed that "nationwide data from 2004-2009 have shown an unexplained 119% increase in the rate of revision circumcisions." Here is the press release: http://www.medpagetoday.com/MeetingCoverage/AAP/29075Frank Koehler (talk) 14:40, 24 December 2012 (UTC)
- Also, by now I have probably reviewed a dozen excellent-quality WP:MEDRS-compliant secondary and tertiary sources covering circumcision complication rates, and none of them mentions a death rate. If the best-quality, most up-to-date sources don't mention a rate, this article should not either.
- Bollinger goes into this. Have you read it? It is very convincing. It states that circumcision is not listed as the cause of death; the COD is usually hypovolemic shock, exanguination, and infection. And also that circumcision-related deaths are not tracked very well. When they are, it is just for the same hospital stay as the birth, but death risk is postrelease, and therefore they don't show up when searching large databases, so the risk is hidden from view. Plus, doctors (and parents) are prone to hide such deaths since the surgery was optional and the child died unnecessarily. Frank Koehler (talk) 14:40, 24 December 2012 (UTC)
- I agree with you that we should probably remove the death rate sourced to AAFP 2007.
Regarding Bollinger 2008--that has come up twice in the past months, and the bottom line is that it is not a WP:MEDRS-compliant reliable source. To start with, "Thymos: Journal of Boyhood" is not even MEDLINE-indexed, which is a bare minimum requirement for such medical information regarding a surgical procedure's complication rate.
Given these two things, we should remove the death rate sentence altogether.
- If this article was ONLY about medical circumcisions performed in a hospital setting then I'd agree, but that's not the case. It talks about cultural, traditional, and religious circumcision; many that are not performed within a medical setting. Even so, hospital circumcisions are not performed in a sterile operating room (which is why MRSA is one cause of death for such infants). As such the article covers religious, psychological, sociological, and antropological aspects and Thymos is a peer-reviewed journal in the social sciences. Frank Koehler (talk) 14:40, 24 December 2012 (UTC)
- In sum, if I were a parent researching circumcision on the Internet for my newborn son this page would be at the top of the search results I'd want to know that death was a possibility and what that risk ratio might be. Frank Koehler (talk) 14:40, 24 December 2012 (UTC)
In case anyone is wondering who this "Dan Bollinger" cited by Frank Koehler is, check out this page. Quote: "For most of my life I’ve been troubled by night terrors that I later became convinced were an early recollection of my circumcision at age three-days." With all due respect to Mr. Bollinger, whom I've never met, but the idea of citing this gentleman as a reliable source on medical issues (or, for that matter, any issue that lends itself to investigation by the scientific method) seems absurd to me on its face.82.113.121.238 (talk) 16:26, 24 December 2012 (UTC)
- I don't find that problematic. So he has a personal interest in the topic, I think it safe to say that most scientists do. His work should be judged on its scientific methodology, not the author's early recollections. You didn't say whether or not you had read the article, so I'm guessing you haven't. I found it online here: http://www.readperiodicals.com//201004/2026622071.htmlFrank Koehler (talk) 17:42, 25 December 2012 (UTC)
- Mr. Bollinger is no scientist.--89.204.135.100 (talk) 17:03, 27 December 2012 (UTC)
- The article linked by Frank Koehler is ripped to pieces here. Although the author of the scathing review is himself apparently not a scientist, either, the errors of logic and arithmetic pointed out therein are so crude and elementary that Mr. Bollinger's "article" simply cannot be taken seriously, quite apart from its unsuitability under WP sourcing guidelines.--89.204.135.100 (talk) 17:50, 27 December 2012 (UTC)
- I don't find that problematic. So he has a personal interest in the topic, I think it safe to say that most scientists do. His work should be judged on its scientific methodology, not the author's early recollections. You didn't say whether or not you had read the article, so I'm guessing you haven't. I found it online here: http://www.readperiodicals.com//201004/2026622071.htmlFrank Koehler (talk) 17:42, 25 December 2012 (UTC)
(I moved this into a new section. Frank Koehler (talk) 14:40, 24 December 2012 (UTC))
- Frank, I'm not exactly sure what you did to my post, but it confusingly broke up the integrity of what I wrote and what should have been attributed to me over my signature. I'd like to repeat and emphasize what Jayjg said, do not refactor others' talk page contributions like you did here. It would be within reason for me to revert how you edited up my post, see WP:TPG. I do not want to chase down responses across seven threads. Regarding the Bollinger article, see WP:MEDRS for the requirements for sourcing biomedical claims in any Wikipedia article. The complication rate of a surgical procedure is a biomedical claim. As the journal the article is published in isn't even MEDLINE indexed, it is of insufficient quality to use here.
Zad68
01:02, 25 December 2012 (UTC)- Zad, My apologies. And, I found your post difficult to respond to since you combined multiple topics within the same paragraph, and some of Tumadoireacht's comments weren't about death risk, so, I chose to respond point-by-point. Frank Koehler (talk) 17:28, 25 December 2012 (UTC)
- Frank, I'm not exactly sure what you did to my post, but it confusingly broke up the integrity of what I wrote and what should have been attributed to me over my signature. I'd like to repeat and emphasize what Jayjg said, do not refactor others' talk page contributions like you did here. It would be within reason for me to revert how you edited up my post, see WP:TPG. I do not want to chase down responses across seven threads. Regarding the Bollinger article, see WP:MEDRS for the requirements for sourcing biomedical claims in any Wikipedia article. The complication rate of a surgical procedure is a biomedical claim. As the journal the article is published in isn't even MEDLINE indexed, it is of insufficient quality to use here.
- Some solid academic negative articles here too http://www.circumstitions.com/References.html#Gairdner
- --— ⦿⨦⨀Tumadoireacht Talk/Stalk 23:48, 23 December 2012 (UTC)
Frank, regarding the AAFP number, generally we leave it to the secondary sources to do the vetting of the data. But, looking at it, the "500,000" number appears to trace back to King 1982. From my searching I'm not finding a reliable source that makes a direct connection from King 1982 to Speert 1953. However, even if the number is coming from 1982, that's 30 years ago, and if it's from 1953, that's nearly 60 years ago. I would certainly expect the death rate now to be much, much lower than it was 30 or 60 years ago. Also, by now I have probably reviewed a dozen excellent-quality WP:MEDRS-compliant secondary and tertiary sources covering circumcision complication rates, and none of them mentions a death rate. If the best-quality, most up-to-date sources don't mention a rate, this article should not either. I agree with you that we should probably remove the death rate sourced to AAFP 2007.
Regarding Bollinger 2008--that has come up twice in the past months, and the bottom line is that it is not a WP:MEDRS-compliant reliable source. To start with, "Thymos: Journal of Boyhood" is not even MEDLINE-indexed, which is a bare minimum requirement for such medical information regarding a surgical procedure's complication rate.
Given these two things, we should remove the death rate sentence altogether.
Tumadoireacht--you will not find sourcing of sufficient quality for this article at "circumstitions.com". You really should read WP:MEDRS for information on how to identify quality medical sourcing.
Zad68
04:01, 24 December 2012 (UTC)
Here are several decent articles from that site
M. Machmouchi, A. Alkhotani Is Neonatal Circumcision Judicious? Eur J Pediatr Surg 2007; 17: 266-269
Morris L. Sorrells, James L. Snyder, Mark D. Reiss, Christopher Eden, Marilyn F. Milos, Norma Wilcox, Robert S. Van Howe Fine-touch pressure thresholds in the adult penis BJU International 99 (4), 864-869 (British Journal of Urology International, Volume 99 Issue 4 Page 864 - April 2007)
J. S. Svoboda, and R. Darby A Rose by any other Name: Rethinking the Similarities and Differences between Male and Female Genital Cutting Medical Anthropology Quarterly, Volume 21, Number 3 (September 2007), pp. 301-323.
A. Way, V. Mishra, R. Hong, K. Johnson Is male circumcision protective of HIV infection? AIDS 2006 - XVI International AIDS Conference Abstract no. TUPE0401
The chief fault of this WP article is perhaps that in a good faith effort to maintain high standards of medical referencing it is neglecting, diminishing or excluding the behavioural, social, historical and religious aspects and influences and how these dictate the incidence of the choice to circumcise in different settings--— ⦿⨦⨀Tumadoireacht Talk/Stalk 05:22, 24 December 2012 (UTC)
- Tumadoireacht, if you're thinking any of those four articles would be useful to support biomedical claims in Wikipedia articles, you really need to read WP:MEDRS.
Zad68
05:26, 24 December 2012 (UTC)
The first two are recent peer reviewed medical journal articles -what's not to like ?. The latter two are included as illustration of the biopsychosocial aspect which I feel the article neglects fetishising instead the "medical" like the Orangutans in"Planet of the Apes" !--— ⦿⨦⨀Tumadoireacht Talk/Stalk 05:35, 24 December 2012 (UTC)
- "What's not to like" is clearly laid out for you in WP:MEDRS. Tell you what, I'll stop the ping-pong here for now, the next step really should be for you to read WP:MEDRS.
Zad68
05:39, 24 December 2012 (UTC) - Tumadoireacht, when reading WP:MEDRS, I recommend you focus first on WP:MEDREV. Jayjg (talk) 20:48, 24 December 2012 (UTC)
There is a pervasive presumption of a Western clinical practice model in considering circumcision here. A Xhosa or Aborigine or Mohel circumcision may have little in common with this. Circumcision belongs to a wider group than physicians--— ⦿⨦⨀Tumadoireacht Talk/Stalk 23:00, 24 December 2012 (UTC)
- Tumadoireacht, perhaps this is part of the issue you're having here. As has been explained to you before, the scope of this article is indeed circumcision as a medical procedure, and it is part of a group of articles connected in WP:SUMMARY style. This article is an overview article that focuses on the aspects of circumcision as a medical procedure. Other articles (should) provide in-depth coverage of the details about the various aspects of it, such as the surgical detail, prevalence, use in religious practices, etc. If you have any further questions along this line you should see WP:SUMMARY... in fact, the response to further misunderstandings along this line will be to refer you to WP:SUMMARY.
Zad68
01:08, 25 December 2012 (UTC)
- If you are correct, then the article should be at "Curcumcision as a medical procedure" with a more general article here. Absent that, I disagree with your assessment (in the way it should be, not necessarily in the current iteration of implementation). --Nouniquenames 16:22, 27 December 2012 (UTC)
- I think I agree with you exactly Nouniqueusernames. This"Circumcision" general article should be the encyclopeaedic summary overview article referencing all the currently missing parts of the phenomenon of Circumcision, such as disposal of foreskins post the chop , death statistics from medical and other circumcisions et cetera."Curcumcision as a medical procedure" could be one of the useful sub articles and should be listed here as a See Also section for ease of navigation despite some guidelines recommending less use of See Also sections in general.--— ⦿⨦⨀Tumadoireacht Talk/Stalk 16:49, 27 December 2012 (UTC)
- If you are correct, then the article should be at "Curcumcision as a medical procedure" with a more general article here. Absent that, I disagree with your assessment (in the way it should be, not necessarily in the current iteration of implementation). --Nouniquenames 16:22, 27 December 2012 (UTC)
- You both appear to misunderstand. This is the general survey article. It touches on all the aspects of circumcision as discussed in reliable sources. As it so happens, most of the reliable source coverage of circumcision is the medical aspects of it, and per policy that is what this article reflects. This article covers far more about the religious and societal and other non-medical aspects than most any other WP:MEDICINE article. There are appropriate Wikilinks from this article to the detailed articles about those various aspects.
Zad68
17:05, 27 December 2012 (UTC)
- You both appear to misunderstand. This is the general survey article. It touches on all the aspects of circumcision as discussed in reliable sources. As it so happens, most of the reliable source coverage of circumcision is the medical aspects of it, and per policy that is what this article reflects. This article covers far more about the religious and societal and other non-medical aspects than most any other WP:MEDICINE article. There are appropriate Wikilinks from this article to the detailed articles about those various aspects.
Outdated statements
This article should not be citing 1999 statements. They are irrelevant and out of date for medical purposes (per WP:MEDRS). Biosthmors (talk) 19:34, 5 September 2012 (UTC)
- I agree this article needs to have its sources reviewed, pruned and updated... but please keep in mind this is a highly-watched and contentious article. If I were you, I'd move a little slower and bring the new sources and proposed changes to the talk pages for review and discussion first. You might find that making big changes fast will be met with lots of resistance, and you'll actually achieve your goal of getting the article updated done faster by going a little slower. That's just what I'd do...
Zad68
19:44, 5 September 2012 (UTC)
- I did the same kind of source review for this article that I did for Medical analysis. This article's sourcing is in better shape than that one, but there's clearly some updating we need to do. If we take 2006 as a cut-off year, about half the sourcing is out of date.
Sources table
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- Starting to do some source updating today. I'm basically working my way down from the top of the list and trying to update claims based on sources too old for WP:MEDRS with new content and sources, and removing where I have to.
Zad68
17:27, 6 September 2012 (UTC)
- Starting to do some source updating today. I'm basically working my way down from the top of the list and trying to update claims based on sources too old for WP:MEDRS with new content and sources, and removing where I have to.
- That's great. In general, I wouldn't worry about older sources if they are not being cited for biomedical information. If they are used for historical or cultural facts, a medicine guideline wouldn't necessarily apply. Biosthmors (talk) 19:11, 6 September 2012 (UTC)
- Yeah, luckily the 1442 reference isn't being used to support any medical claims! :)
Zad68
20:58, 6 September 2012 (UTC)
- Yeah, luckily the 1442 reference isn't being used to support any medical claims! :)
- Good to hear. =) Biosthmors (talk) 21:30, 6 September 2012 (UTC)
- Agree that outdated statements (>10 years old) should be removed. Yobol (talk) 21:55, 9 September 2012 (UTC)
- Working on it, largely in the order you see in the table above. Hopefully you'll see the sources table have more and more strike-throughs as I remove the old sources.
Zad68
02:46, 10 September 2012 (UTC)
- Working on it, largely in the order you see in the table above. Hopefully you'll see the sources table have more and more strike-throughs as I remove the old sources.
- Updated...
Zad68
21:17, 3 December 2012 (UTC)
- Updated...
Medical papers become outdated when they are shown to be inaccurate by newer papers, not simply by the passage of time or an arbitrary number of years. For example. Gairdner's 1949 article "The Fate of the Foreskin" is considered to be a classic work that has withstood the test of time.
Sugarcube73 (talk) 13:14, 4 December 2012 (UTC)
- Older medical papers that use investigative methodologies that withstand scrutiny over time, and produce results that are in line with later findings, will be incorporated into the analysis and results found in newer reliable secondary sources. Per WP:MEDRS we use the newer reliable secondary sources, not the older papers.
Zad68
13:17, 4 December 2012 (UTC)
It is very concerning to me that your article holds circumcision in such high regard to HIV prevention. The study performed in Africa on circumcised and intact men and their ability to get HIV was incredibly flawed and the results from that study should be rejected. The scariest thing about this is that there are now lots of men in Africa who actually believe that circumcision makes them immune to AIDS/HIV. That study had countless statistical errors and was entirely flawed. The results were based on faulty data. Also, circumcision will not protect from penile cancer or cervical cancer. These are old claims that are simply false. The American Cancer Association states that "circumcision will not protect you from penile cancer". Please see my references below: FatStrat87 (talk) 19:20, 26 December 2012 (UTC)
Male Circumcision: A Dangerous Mistake in the HIV battle [17]
Answers to your Questions about Circumcision and AIDS [18]
Doctors Opposing Circumcision AIDS Statement: [19]
The Truth About Circumcision and HIV: [20]
DOC General Integrity Statement: [21]
Knowledge is power
- Please review WP:MEDRS to understand Wikipedia's standards for sourcing on this article. The standards are quite high. Jayjg (talk) 23:09, 26 December 2012 (UTC)
Adult Circumcision for cosmetic or aesthetic reasons -is this considered in the literature and should it get mention in the article ?
Adult Circumcision for cosmetic or aesthetic reasons -is this considered in "the literature" and should it get mention in the article either way ? Here is one of several doctors advertising cosmetic circumcision. A circumcision is perhaps the highest cosmetic calling given to a urologist.
We do several circumcisions and a few revisions here every week, as we enjoy a reputation for excellence and exactitude when it comes to cosmetically performed adult circumcisions. We operate within tolerances of 1/32" or about 1/2 mm". http://www.srsmiami.com/circumcision.html
Here is a psychology today article on cosmetic MC which also references several articles on altered function and pleasure. http://www.psychologytoday.com/articles/200803/sex-trim-the-top one other aspect considered in this article but not given mention in WP? :What's a woman's take? A study of female preferences found that the majority of women preferred cut penises, citing odor, cleanliness, and appearance. That study, however, is 20 years old and surveyed only a small sample of Midwesterners. According to a more recent paper, women reported that men without foreskins thrust harder and deeper during vaginal intercourse, while intact men are more gentle and use shorter strokes. During withdrawal, the sensitive foreskin bunches up against the sensitive glans, so the man doesn't pull out as far. Women also become dry more quickly with circumcised men. That's because the foreskin acts as a double sheath so the penis moves back and forth inside it rather than sliding against the vaginal wall, and the crown of the penis also acts as a scoop that pulls fluid out with it. Women said that with intact men they were more likely to have an orgasm and less likely to "want to get it over with." It should be noted, however, that some of the women in the study were recruited through anti-circumcision web sites."--— ⦿⨦⨀Tumadoireacht Talk/Stalk 23:22, 28 December 2012 (UTC)
- Cosmetic MC could deserve a mention, depending upon how prevalent it is. Studies not published in quality WP:SCIRS/WP:MEDRS sources don't deserve to be called studies. Studies typically have DOIs and PMIDs. Biosthmors (talk) 00:34, 29 December 2012 (UTC)
Ethical and legal issues /non physician circumcisions/ parallels with FGM ?
This section in the article makes no mention of the circumcisions conducted by people other than physicians. Is this a weakness ? Is there existing research giving the figures for non medical staff circumcisions worldwide. A thread running through much of the research already comfortably cited is that complication rates are higher when the circumcisions are conducted by nurses or particularly by lay people rather than doctors. This sentence "There are three parties involved in the decision to circumcise a minor: the minor as the patient, the parents (or other guardians), and the physician." presumes a model that may not apply in many cases.
Also consideration of the sharp contrast in attitude to male and female circumcision goes unconsidered in the article- Is this the section where it ought to be mentioned ?--— ⦿⨦⨀Tumadoireacht Talk/Stalk 22:49, 24 December 2012 (UTC)
- Where do you get the idea that "complication rates are higher when the circumcisions are conducted by nurses or particularly by lay people rather than doctors"?82.113.121.238 (talk) 23:38, 24 December 2012 (UTC)
Reference 14 in article--— ⦿⨦⨀Tumadoireacht Talk/Stalk 01:03, 25 December 2012 (UTC)
- As of a minute ago, reference 14 in the article was a paper by Weiss, Larke, Halperin, Schenker. There, I found this sentence: "Traditional circumcision as a rite of passage is associated with substantially greater risks, more severe complications than medical circumcision or traditional circumcision among neonates."
- Tuma, please be a lot more accurate when paraphrasing, or people will be highly suspicious of your claims as a matter of principle.--82.113.121.234 (talk) 12:25, 25 December 2012 (UTC)
- As of a minute ago the article is still written by the same authors; here are some other other selective quotes "complications were most frequent when the procedure was performed by nurses rather than doctors or traditional circumcisers" "Three circumcisions had been performed by a traditional birth attendant, and all three had resultant complications" "Table Table55 summarizes the five studies of complications following circumcision by non-medically trained providers. In these studies, frequencies of adverse events are generally higher, and complications more serious, even including penile amputation" " Most (68%) had been circumcised by non-medical personnel, and 60% of participants reported post-circumcision complications" et cetera --— ⦿⨦⨀Tumadoireacht Talk/Stalk 13:13, 25 December 2012 (UTC)
Tumadoireacht, as explained above, this is a summary-style article, see WP:SUMMARY. Zad68
01:09, 25 December 2012 (UTC)
- If we fail to consider non clinical MC in proportion to its prominence then it is also a poor summary-style article -as I have already pointed out there is already a WP article devoted to MC procedure. This one is the overview article or it could be reposted as presently set out with a different title "Physician MC ?--— ⦿⨦⨀Tumadoireacht Talk/Stalk 01:37, 25 December 2012 (UTC)
- According to Wikipedia policy, the relative emphasis we give to each aspect of a topic is roughly in line with the proportion of coverage found in reliable sources. If you do a search, for example, for "circumcision" on Google Scholar, you'll see the results overwhelmingly are discussion of circumcision as a medical procedure. I count the first page of 10 results doesn't mention anything other than circumcision as a medical procedure. The article at present is in very good balance with the proportions found in reliable sources.
Zad68
03:44, 25 December 2012 (UTC)- If the definition of reliable sources is strictly limited to medical journals and a large proportion of circumcisions are done by non medical people( charmingly referred to in the article above as "the informal medical sector") then the article may suffer by cutting itself off from or ignoring a large part of the actual practice and consequences of circumcision globally. Putting the physician centre stage may be inaccurate. For instance only 34% of the world population have internet access. How many boys of those circumcised have access to a competent surgeon working in sterile conditions to do the job ? If we give prominence to low complication stats from USA clinic conducted MC are we painting an inaccurate global picture ? The main article on Female Genital Mutilation readily quotes Amnesty International. This unpassed Amnesty resolution on genital cutting of both sexes here http://www.mgmbill.org/aiusa2005wrcmgmresolution.pdf is notable.--— ⦿⨦⨀Tumadoireacht Talk/Stalk 13:51, 25 December 2012 (UTC)
- This appears to be a proposal made by a regional group of the American chapter of AI in 2005, and which was not passed. I can't see the significance. Jayjg (talk) 16:15, 25 December 2012 (UTC)
- Maybe a paragraph on the ethical and legal considerations of non-medical circumcisions would be due weight. I assume they still have a responsibility/expectation to use sterile equipment? Has anyone looked for sources on this? Biosthmors (talk) 20:03, 27 December 2012 (UTC)
- Here is the well respected Mayo Clinic on MC.http://www.mayoclinic.com/health/circumcision/MY01023/DSECTION=why-its-done The tone and emphasis is in sharp marked contrast to our WP article here.--— ⦿⨦⨀Tumadoireacht Talk/Stalk 02:12, 28 December 2012 (UTC)
- How so? Are you on a different subject than ethical and legal considerations now? Biosthmors (talk) 03:51, 28 December 2012 (UTC)
- Tuma, this article has been under constant review for many years now. In my opinion, it is remarkably consistent with Wikipedia's requirements that prevent disproportionate emphasis. Actually, it is probably due to the constant revisiting of the issues that keeps the proportions in accord with what is in the general, English-speaking, universe. However, that does mean that the article cannot, and should not, be used as a platform for pro- or anti-circumcision people alike. That includes the recurring movement to conflate FGM with circumcision—something that has not been the case in maintstream English dialog for centuries, and appears to be a recent attempt by genital integritists to change the language, and thus culture. While that is certainly within their right to attempt, Wikipedia cannot be the vehicle for that. -- Avi (talk) 04:24, 28 December 2012 (UTC)
- Here is the well respected Mayo Clinic on MC.http://www.mayoclinic.com/health/circumcision/MY01023/DSECTION=why-its-done The tone and emphasis is in sharp marked contrast to our WP article here.--— ⦿⨦⨀Tumadoireacht Talk/Stalk 02:12, 28 December 2012 (UTC)
- Maybe a paragraph on the ethical and legal considerations of non-medical circumcisions would be due weight. I assume they still have a responsibility/expectation to use sterile equipment? Has anyone looked for sources on this? Biosthmors (talk) 20:03, 27 December 2012 (UTC)
- This appears to be a proposal made by a regional group of the American chapter of AI in 2005, and which was not passed. I can't see the significance. Jayjg (talk) 16:15, 25 December 2012 (UTC)
- If the definition of reliable sources is strictly limited to medical journals and a large proportion of circumcisions are done by non medical people( charmingly referred to in the article above as "the informal medical sector") then the article may suffer by cutting itself off from or ignoring a large part of the actual practice and consequences of circumcision globally. Putting the physician centre stage may be inaccurate. For instance only 34% of the world population have internet access. How many boys of those circumcised have access to a competent surgeon working in sterile conditions to do the job ? If we give prominence to low complication stats from USA clinic conducted MC are we painting an inaccurate global picture ? The main article on Female Genital Mutilation readily quotes Amnesty International. This unpassed Amnesty resolution on genital cutting of both sexes here http://www.mgmbill.org/aiusa2005wrcmgmresolution.pdf is notable.--— ⦿⨦⨀Tumadoireacht Talk/Stalk 13:51, 25 December 2012 (UTC)
- According to Wikipedia policy, the relative emphasis we give to each aspect of a topic is roughly in line with the proportion of coverage found in reliable sources. If you do a search, for example, for "circumcision" on Google Scholar, you'll see the results overwhelmingly are discussion of circumcision as a medical procedure. I count the first page of 10 results doesn't mention anything other than circumcision as a medical procedure. The article at present is in very good balance with the proportions found in reliable sources.
First, Wikipedia and Mayo Clinic's website have different purposes. Wikipedia is a general encyclopedia; the Mayo Clinic is a medical provider. Wikipedia is not allowed to give medical advice; the Mayo Clinic should and does.
Even so, because I was curious, I did a comparison breakdown of the two treatments. I pulled the text from each, categorized the content, and compared the relative amounts of space devoted to each topic, and each type of topic (specifically, medical vs. non-medical). I find that nearly 75% of the Mayo Clinic's treatment is devoted purely to medical aspects; more than double the 35% that the body of the Wikipedia article devotes to it. More than half (55%) of the body of the Wikipedia article is devoted to non-medical topics like history, ethical and legal issues, and cultures and religions. And, again, be reminded that Wikipedia has entire articles devoted solely to each one of those topics.
Based on this data, my finding is that Wikipedia gives far more emphasis to non-medical aspects than the Mayo Clinic does, and, in fact, the Wikipedia article is probably giving far too much emphasis to non-medical aspects of the procedure in comparison to the actual proportions found in the reliable sources. As a result, I feel the concerns raised by Tumadoireacht are not grounded in fact.
Zad68
17:06, 28 December 2012 (UTC)- Mayo Clinic
Definition......For some families, circumcision is a religious ritual. Circumcision can also be a matter of family tradition, personal hygiene or preventive health care. For others, however, circumcision seems unnecessary or disfiguring...... Why it's done By Mayo Clinic staff Circumcision is a religious or cultural ritual for many Jewish and Islamic families, as well as certain aboriginal tribes in Africa and Australia. Circumcision can also be a matter of family tradition, personal hygiene or preventive health care..........Circumcision might have various health benefits, including.......For newborn circumcision, your son will lie on his back with his arms and legs restrained. As I said different emphasis and different tone.--— ⦿⨦⨀Tumadoireacht Talk/Stalk 22:54, 28 December 2012 (UTC)
- Thanks for the highlights. I'll take on your might emphasis. "Might" might not reflect the secondary literature. The Mayo site is a tertiary source. We are a tertiary source. We clearly have different methods we use to get there. Mayo does not explicitly use WP:MEDRS, aim to follow WP:MEDMOS, WP:SS, WP:NPOV, and WP:SECONDARY. We do. If you're suggesting this article is biased when it comes to a medical claim, please back up your claim with a random sample of recent secondary WP:MEDRS. Otherwise I think your insinuation is without substantial merit. Thanks for being more specific, but it doesn't establish much to point to another tertiary source. What would help are recent secondary reliable medical sources. That's how we build our encyclopedia articles on medical topics. Best. Biosthmors (talk) 23:02, 28 December 2012 (UTC)
(watch)
- ^ http://www.cirp.org/pages/parents/lostlist/
- ^ http://www.intactamerica.org/learnmore
- ^ http://www.notjustskin.org/node/7
- ^ http://www.circumstitions.com/Functions.html
- ^ http://www.doctorsopposingcircumcision.org/
- ^ http://arclaw.org/
- ^ http://www.nocirc.org/
- ^ http://www.intactamerica.org/
- ^ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2807391/
- ^ http://www.doctorsopposingcircumcision.org/
- ^ http://pediatrics.aappublications.org/content/103/3/686.full#sec-5
- ^ http://onlinelibrary.wiley.com/doi/10.1111/j.1464-410X.2006.06646.x/abstract
- ^ http://pediatrics.aappublications.org/content/130/3/585.full
- ^ http://knmg.artsennet.nl/Publicaties/KNMGpublicatie/Nontherapeutic-circumcision-of-male-minors-2010.htm
- ^ http://www.doctorsopposingcircumcision.org/DOC/statement0.html
- ^ http://www.nocirc.org/touch-test/bju_6685.pdf
- ^ http://www.icgi.org/Downloads/HIVSummary.pdf
- ^ http://www.nocirc.org/publish/11-HIV.pdf
- ^ http://www.doctorsopposingcircumcision.org/info/HIVStatement.html
- ^ http://www.nocirc.org/2008-07_Mothering-Fauntleroy.pdf
- ^ http://www.doctorsopposingcircumcision.org/DOC/statement03.html