walter russell mead peter berger lilia shevtsova adam garfinkle andrew a. michta
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Circumcision: Settled Science?

The technocratic imagination believes in a division of labor.  Scientists determine the facts through objective research.  Administrators and experts, who understand the science, then develop rational policy based on it.  End of story.

Not in the real world, where both science and policy struggle to give meaningful answers to even the smallest of problems.  Circumcision, for instance.

While some families circumcise their male children for religious reasons, others have done it on medical advice.  Scientists are now increasingly divided over the practice; in the New York Times we can read that after years of regular circumcision, doubts about the procedure are growing:

Circumcision “is not necessary, it’s invasive and it’s risky,” said Georganne Chapin, executive director of Intact America, an advocacy group based in Tarrytown, N.Y., that opposes routine circumcision. She notes that the sensitive foreskin is laced with nerves and blood vessels and protects the head of the penis.

Yet public health officials are mulling whether to actively encourage neonatal circumcision as part of a long-term strategy to curb the spread of AIDS in the United States. The Centers for Disease Control and Prevention will be releasing new recommendations on routine circumcision in the “near future,” a spokesman said.

The new recommendations will take into account data from clinical trials in South Africa, Kenya and Uganda, which found that adult men who were circumcised were less likely than those who were not to have been infected by an H.I.V.-positive female sex partner. Circumcision reduced their risk of infection between 55 percent and 76 percent over a two-year period.

Via Meadia has no position on this issue other than supporting the right of parents to make whatever decision they believe is in the best interest of the child whether for medical, religious or other reasons.

But we note that after thousands of years of experiment and discussion, the world still has trouble assessing the pros and cons of removing a scrap of flesh.  This suggests that both the scientific uncertainty and the lack of policy consensus over the much more complex questions like climate change will be with us for some time.

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  • Alex

    Synopsis: “Circumcision is a complex issue, and we have no opinion on it. Did we mention it was a complex issue?”

  • bill phelps

    Circumcision? What about global warming/change as an example of the interaction of science and public policy?

  • Harry Guiremand

    Characterizing a man’s most richly innervated erogenous zone as “a scrap of flesh” is expressing a viewpoint which is at variance with objective science.

    [link deleted]

    There is no scientific or ethical quandary. Only the owner of the foreskin should decide its fate.

  • steve.smith.tn

    I am struck by the number of recent incidents of old wisdom becoming new again and “settled” science being turned on its ear. Who wold have thought stone age Hebrew folk would know better than the modern head of Intact America. Similarly wasn’t there just an article recently that showed salt doesn’t contribute to high blood pressure? I read in Nature that the Earth won’t reach any “tipping point” due to global warming. Judicious use of corporal punishment is effective. Maybe we should give a little more credence to things that have been “settled” for centuries, even millennia. I think its called “tradition.” Some of them are good ones. In our rush to be modern or “progressive,” we just may make things worse.

  • Kris

    Alex (#1) and Bill (#2), why don’t the two of you talk to each other a while? You might reach some enlightenment regarding the point of the post.

  • Kris

    Let me spare Harry’s friends the trouble:

    The Foreskin is Good! Zardoz has spoken.

  • David

    Why are clinical trials in Sub-Saharan Africa required to determine the efficacy of circumcision?

    European counties do not practise circumcision, despite their intrusive rationalist systems of public healthcare. Can a comparison not be made there?

  • Corlyss

    I forwarded the item to friends in an email entitled: The Effect of Circumcision on Global Warming.

  • Nathan

    Via Meadia apparently has no idea what respect is because calling a part of the natural penis a “scrap of flesh” is insulting to males as it devalues our natrual bodies. There stance clearly shows a clear biases towards cutting parts of children’s penises off without justifiable cause and to be justifiable cause means it is medically needed.

    • Walter Russell Mead

      @Nathan: let’s hope that the shock of seeing PC moralistic language policing in an unfamiliar context will help many readers see just how absurd looks when people take undue umbrage at perfectly ordinary language.

  • Mark Lyndon

    “Via Meadia has no position on this issue other than supporting the right of parents to make whatever decision they believe is in the best interest of the child whether for medical, religious or other reasons.”

    Do you also “support the right of parents” to have “scraps of flesh” cut off baby girls too?

    HIV in Africa?!?

    From the USAID report “LEVELS AND SPREAD OF HIV SEROPREVALENCE AND ASSOCIATED FACTORS: EVIDENCE FROM NATIONAL HOUSEHOLD SURVEYS”
    “There appears no clear pattern of association between male circumcision and HIV prevalence—in 8 of 18 countries with data, HIV prevalence is lower among circumcised men, while in the remaining 10 countries it is higher.”
    http://www.measuredhs.com/pubs/pdf/CR22/CR22.pdf

    The South African National Communication Survey on HIV/AIDS, 2009 found that 15% of adults across age groups “believe that circumcised men do not need to use condoms”.
    http://www.info.gov.za/issues/hiv/survey_2009.htm

    From the committee of the South African Medical Association Human Rights, Law & Ethics Committee :
    “the Committee expressed serious concern that not enough scientifically-based evidence was available to confirm that circumcisions prevented HIV contraction and that the public at large was influenced by incorrect and misrepresented information. The Committee reiterated its view that it did not support circumcision to prevent HIV transmission.”

    The one randomized controlled trial into male-to-female transmission showed a 54% higher rate in the group where the men had been circumcised btw:
    http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(09)60998-3/abstract

    ABC (Abstinence, Being faithful, and especially Condoms) is the way forward. Promoting genital surgery will cost African lives, not save them.

    • Walter Russell Mead

      @Mark: clearly this subject touches some deep feelings among a lot of people. Sorry that I can’t make sense of the comparisons between the two operations, nor can I empathize with the passion that clearly moves some comments on this subject. Via Meadia’s position has not changed.

  • Mark Lyndon

    It’s unlikely we’ll agree any time soon, but I would urge you to find out more about the various forms of male and female genital cutting. Some of the most common forms of female “circumcision” do a lot *less* damage than the usual form of male circumcision. Sometimes there’s just an incision with nothing actually removed, or even just a pinprick. One form just removes the clitoral hood (the female foreskin), so it’s the exact equivalent of cutting off a boy’s foreskin. In some countries, female circumcision is performed by doctors in operating theatres with anesthesia. Conversely, male circumcision is often performed as a tribal practice. Over 100 males died of circumcision in just one province of South Africa last year, and there were at least two amputations.

    Are you aware that the USA also used to practise female circumcision? Fortunately, it never caught on the same way as male circumcision, but there are middle-aged white US American women walking round today with no external clitoris because it was removed. Some of them don’t even realise what has been done to them. There are frequent references to the practice in medical literature up until at least 1959. Most of them point out the similarity with male circumcision, and suggest that it should be performed for the same reasons. Blue Cross/Blue Shield had a code for clitoridectomy till 1977.

    One victim wrote a book about it:
    Robinett, Patricia (2006). “The rape of innocence: One woman’s story of female genital mutilation in the USA.”

    Nowadays, it’s illegal even to make an incision on a girl’s genitals though, even if no tissue is removed. Why don’t boys get the same protection?

    Don’t get me wrong. I’m totally against female circumcision, and I probably spend a lot more time and money trying to stop it than most people. If people are serious about stopping female circumcision though, they also have to be against male circumcision. Even if you see a fundamental difference, the people that cut girls don’t (and they get furious if you call it “mutilation”). There are intelligent, educated, articulate women who will passionately defend it, and as well as using the exact same reasons that are used to defend male circumcision in the US, they will also point to male circumcision itself (as well as labiaplasty and breast operations), as evidence of western hypocrisy regarding female circumcision. The sooner boys are protected from genital mutilation in the west, the sooner those peoples that practice FGM will interpret western objections as something more than cultural imperialism.

  • P. Ami

    Via Meadia apparently has no idea what respect is because calling a part of the natural penis a “scrap of flesh” is insulting to males as it devalues our natrual bodies.//

    Respect is conferred in many ways. While I value my natural body, I don’t deify it. I have no problem calling a “scrap of flesh” exactly what it is, seeing that science has no difference of opinion on the skin on my elbow, or that on my heel, no matter how much more sensitive one is, or how much more blood may flow from one or the other. My jowls, my chin, my taint and the backs of my knees are each “scraps of flesh”. Perhaps the greatest respect one can give an individual is to honor that field of consciousness produced by our bundles of flesh. Or perhaps we might respect and honor that incalculable, and perhaps fictitious element that may just transcend the body and is often called the soul.

    I can’t speak to how effective circumcision is in diminishing the spread of AIDS or other diseases. I have no idea if circumcision permits a man to safely delay grooming his junk. I have no idea if circumcising young Semites helps to elevate the spiritual quality of the world. I only know that parents are the stewards of their children and while mistakes can be made, the trade off our society would be making in overriding parental judgement- when it comes to the physical, mental and spiritual care of their children- is a huge shift in how our society views it’s role as mediator of the parent-child relationship. It most certainly would infringe on the religious obligations of many good people with no strong evidence that this ritual causes any overriding harm to those who experienced them.

  • http://www.circumstitons.com Hugh7

    “Via Meadia has no position on this issue other than supporting the right of parents to make whatever decision they believe is in the best interest of the child….”
    Really? So if you hear frantic shrieking coming from next door you don’t take any notice because you “support the right of parents to make whatever decision they believe is in the best interest of the child”?

    What do you have to say about the the right of the child, and the man he grows up to become, to make decisions about the fate of his or her own normal, healthy, irreplacable, functional body parts? The law is clear when the child is female (no matter how trivial the “scrap of flesh”). No such part at all may be cut off. It is also clear once the man has survived to 18 with his body intact. What difference does their age and sex make?

    “After years of regular circumcision…” Only in the Muslim world, the US, the Philippines, South Korea, tribal Africa, Israel, parts of Melanesia and Eastern Polynesia and among Australian aboriginals. The rest of the English-speaking world tried it, found it did no good and has virtually given it up (with no ill-effects). The rest of the developed world has never done it.

  • http://www.circumstitons.com Hugh7

    “I can’t make sense of the comparisons between the two operations”
    Let’s see:
    One cuts normal, healthy, functional, irreplacable tissue off the genitals of a non-cosenting person, that they might very want to grow up to keep. And the other…

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