MEDICAL FRAUD and the criminal assault of boys
RESPONE TO EXECUTIVE PRODUCER - THE HEALTH SHOW
March 26, 1995
Dear Mr. Suissa:
Thank you for your letter dated March 8, 1995. However, I was disappointed with your reply. Rather than dealing with the questions presented, you sent me an impressive list indicating the sources for your program. If I were naive, I would have simply accepted these as credible and that would have been the end to my query.
I have copies of most research referred to and am quite familiar with the arguments used to support circumcision. However, I have yet to find anyone who accepts these studies willing or able to discuss questions which dispute their validity. This approach is akin to anyone who claims that the world is flat but refuses to explain why people are able to fly around the world and return to their original destination. I am therefore taking the liberty of sending you another letter with the hope of receiving a more enlightened response.
Again, I believe the media has the responsibility to present the facts and not vague information which is of little value. Most parents are not in a position to make an opinion regarding medical procedures. A medical procedure either has some value, or it is unnecessary. If proper hygiene is all that is necessary in order to prevent urinary tract infections or penile cancer, this fact should be made known. Parents should not be subjected to a "mish mash "of options then be expected to make a judicial decision. If surgery is necessary and there are no other appropriate options, parents should also given this information. If certain conditions are not life threatening and can be treated in a conventional manner by antibiotics etc., most parents do not want to subject their children to unnecessary surgery.
Most doctors will readily admit that any surgery has its risks. There are untold horror stories resulting from circumcision. Several years ago, a young boy in Ontario suffered severe brain damage which resulted from routine circumcision. As a result, he will spent the rest of his life as a quadriplegic depending upon others for survival. What a tragic price to pay because some doctor failed to uphold the medical code of ethics and did not inform parents that circumcision was unnecessary.
Parents have a right to know of the dangers of surgery. In medicine, there is no place for ambiguity where parents must make the decision, and which leave doctors in a position where if something goes wrong, are shielded with the excuse that it was the parent's decision, not theirs. As professionals, medical doctors have the obligation to decide whether surgery is an absolute necessity or whether there are humane alternatives to it, and not leave this decision to parents as you have suggested.
You stated: "that the Health Show presented relevant information on either side for parents contemplating this decision for their newborn son. That there are medical advantages when that newborn grows into adulthood, and the counterviews that these advantages are of no real significance if proper hygiene is maintained".
In other words, parents are required to make a decision which is supposed to be in the best interests of their child based on ambiguous information. If I were responsible for your well being and was required to choose between the two alternatives i.e. (1) you could either undergo painful surgery or (2) practice simple hygiene which was just as beneficial; and if I were a rational and an intelligent individual, which option do you think I should choose on your behalf? Are you suggesting that it really wouldn't matter? As long as I considered the pros and cons, either decision would be acceptable? Would I not have the moral obligation to choose a procedure which was less painful, invasive and traumatic? Perhaps you would explain why it was necessary to present the pros and cons of a procedure if the final outcome doesn't matter?
Circumcision has left thousands of males with serious complications which even corrective surgery was unable to resolve. NOHARMM has recently taken a survey of adult males where the vast majority have documented permanent harm done to them as a result of infant circumcision. It is a FACT that circumcision has resulted in minor and severe penile damage, the loss of male organs, severe brain damage, and even death. Considering the dangers of surgery, even the most simplest surgery, why should parents not be truthfully told, that they need not subject their sons to a painful and unnecessary procedure when simple hygiene is just as effective? Dr. Gifford-Jones, a medical columnist, once made this remark: "There are no simple surgeries, just simple surgeons".
As an educator, may I illustrate what I mean by presenting parents with an ambiguous option.
Scenario One:
If I am instructing parents on tooth decay, I could make the following statements: It is obvious that your children may have dental problems sometimes in their lifetime. You could consider the following options. Extract your children's teeth now, preventing possible pain and disease later in life. If you don't do it now, your child will have at least a 15% chance of having it done later in life. You could also presently remove some teeth which are more likely to present problems early in life. On the other hand, your children could practice proper hygiene by brushing and flossing their teeth. If teeth should pose a problem when your children become adults, they could be filled, etc. etc. Finally when they can no longer be maintained, your children may have them extracted and replaced with false teeth. These pros and cons of dental care have been presented with the hope of enabling you their parents to make a decision as to the appropriate action to be taken. But rest assured, whatever decision you make, it will be in the best interests of your child.
Agreeably I presented a variety of solutions and was unbiased in my presentation. This was the approach used in your show. Would any rational or intelligent individual consider this presentation useful in the decision making process?
Scenario Two:
Your children may experience dental problems both as children and as adults, however, I do not recommend the extraction of part or all of the teeth until it is absolutely necessary. Problems which arise from time to time can be dealt with in a conventional manner. Tooth extraction results in a great deal of pain and discomfort. There is no purpose in enduring the pain of dental extractions until it is absolutely necessary. When the time comes when extraction becomes necessary, it can be done using an anesthetic. In the meantime, I would suggest that your child practice proper hygiene and in all likelihood, will grow to be an adult, who like 90% of the world's population, do not undergo premature tooth extraction unless absolutely necessary.
Would you not agree that this latter presentation was a more practical and responsible manner in dealing with the problem? Wouldn't the second presentation be more useful to parents who are responsible for making a decision which will have a permanent impact upon their child's life? Is this not the approach which should have been taken in the production of the segment dealing with circumcision in the Health Show?
You should be aware that because medical journals publish studies does not mean that they endorse them or acknowledge them as fact. Research is published in order to make other professionals aware of what is being done. The publication of studies in journals provides a means for other professionals to evaluate and criticize them. If the studies are indeed valid, they may be of some value. If on the other hand, flaws are found or their results cannot be replicated, they become part of the archives of information which has made little contribution to the field in which they have been published.
Unfortunately many individuals who advocate circumcision, quote these studies as being scientifically accurate and ignore the possibility that there may be serious flaws in methodology, the omission of certain factors which should be considered, are studies which would produce predictable results, retrospective in design (a desire to justify a doubtful practice), are studies which culminate with results which cannot be replicated, or produce results which are inconsistent with common knowledge. This appears to be the situation with most studies used to support circumcision. Therefore to quote many of these studies as a basis on which to recommend circumcision is redundant unless one is willing to address the concerns which are frequently ignored.
In the January edition of the Reader's Digest it was reported that in "1989 the Academy of Pediatrics stopped advising against circumcision." This is a typical example of the type of erroneous information given to the public, obviously done in order to give male circumcision more credibility. Because this statement was published in a respected publication, those reading this article would certainly believe that this statement was true. A copy of the AAP press release, however indicated that this statement was indeed false. This is a typical example of how the public is deceived into believing that circumcision has some credibility.
The media is quick to publish the results of studies which suggest that there may be some benefits to circumcision, but when the results have been discredited, unfortunately the media is seldom made aware of this information. The public is not informed that those arguments have little validity. In the meantime, these myths continue to be quoted in literature on childcare, and even in the production of educational programs.
You will find that most arguments used to promote circumcision are rejected by medical associations. They do not believe that there are valid reasons for non-medically indicated circumcisions. The positions of these medical organizations are also supported by leading medical authorities throughout the USA and the world. The following physicians have been noted for their opposition to circumcision: George Denniston , M.D. (University of Washington School of Medicine), James Snyder M.D. (Past President Virginia Urologic Society), Eugene Robin M.D. (Stanford University Medical School) , Paul Fleiss M.D. (University of Southern California Medical School), Dean Edell, M.D. (US Medical Radio and TV host), Dr. Frederick Leboyer M.D. (Author of Birth Without Violence) and Dr. Thomas J. Ritter M.D. (Author of Say No to Circumcision - 40 compelling reasons why you should respect his birthright and keep your son whole). These are just a few of the many medical experts who have joined the majority of the world's physicians in condemning male circumcision.
It was refreshing to discover, that Dr. Arnand who also appeared on your show and who holds both a MD and a Ph D was most vocal in his opposition to circumcision. I have great respect for members of the medical profession who respects the rights and dignity of their patients.
Even though medical organizations are aware of the sources of information quoted by you, they do not accept these as having any validity because: (1) Many studies quoted have serious flaws in them i.e. in the manner in which they were conducted, or (2) because these studies did not take into consideration important factors such as age of the participants. Statistics regarding penile cancer in males in countries where circumcision is not practiced, indicates that penile cancer is no more prevalent in younger males than it is in the USA where most males are circumcised. (3) The conclusions of many of these studies are not supported by common knowledge. If circumcision does indeed prevent STD or AIDS as some would have us believe, then why are these conditions so prevalent in the USA where most males are circumcised, while less common in other countries where circumcision is virtually unheard of? (4) Reputable members of the medical profession acknowledge that most diseases are etiologic in nature ( have a cause and can be treated using standard medical procedures). (5) It is not a mandate of medicine to amputate normal, healthy body parts on non-consenting individuals in order to prevent disease, facilitate hygiene, to resemble one's father or his peers, or merely just because a parent requests it. Parents can only legally consent to medically necessary treatment and not to the amputation of normal or healthy body parts. (6) Doctors have the moral and professional obligation to respect and protect the rights of all their patients (to do no harm according to the Hippocratic Oath) regardless of age and sex. Just as it would be professionally untenable to perform female circumcisions for any reason, they must also respect the rights of males.
Medical organizations have been frustrated in their dealings with male circumcision. The practice has become so widespread that it is almost futile to speak out against it. However, the situation has recently deteriorated to a very serious level when people of other cultures came to Canada and requested doctors to perform female circumcision. It was greatly feared that unscrupulous practitioners who see nothing ethically wrong in performing male circumcisions would also perform female circumcisions, just because parents requested it, or for traditional reasons. Intervention by governments and medical organizations was unfortunately necessary in order to prevent the genital mutilation of females. It is a tragic indeed when we cannot trust doctors to live up to their professional ethics and must prevent them from performing mutilating and unnecessary surgery by threatening them with disciplinary actions or a law suit. If doctors would perform female circumcisions at the requests of the parents, is it not surprising that we are having such a battle ending male circumcision?
You had made the comment that circumcision was a "highly controversial and impassioned subject". May I suggest to you that if circumcision were a legitimate practice, such controversy would not exist. Something is seriously wrong with a society which permits abusive medical procedures such as those involving genital mutilation under the pretense that there is some justification for it.
The commission in Ontario which investigated sexual assault by physicians received submissions by male victims of circumcision who objected to the unwanted intrusions upon their body, and the lack of respect physicians had for their rights as infants. Circumcision was included as a form of sexual abuse by physicians, and we agree with this decision.
While watching the CBS network news (March 9, 1995) with Connie Chung, a commentator described a similar frustration. He stated that whenever the issue of male rights was presented, the issues were seldom addressed. It was usually the habit of those being questioned to focus the attention to some other topic which they deemed to be of greater importance. For example, if a male objects to circumcision, they are told that they should be more concerned with female genital mutilation because this procedure is more abusive, or that their concern should be about the starving in Africa. The commentator concluded that until people are willing to acknowledge that males have similar rights and the same respect demanded by females, we need not expect males to be genuinely concerned about the rights and issues of others.
1. You stated: "To circumcise or not to circumcise is a question of personal choice and our intention was to present relevant information on either side for parents contemplating this decision for their newborn son."
Again my question: why a chauvinistic position? Whose body is it anyway? Is there really a choice? And if so, does this choice also provide parents with the right to opt for female circumcision? Is the amputation of normal and healthy body parts on non-consenting individuals really the mandate of medicine? Or should not the goal of medicine be to preserve each part of the human body as long as possible, by finding medical solutions in the curing of diseases, instead of by the amputation of normal body parts? If so, to what extend do we carry this lunacy, just the foreskin? Does the possibility that a individual may receive some medical benefit from this irreversible surgery take precedence over his/her civil rights?
2. Urinary Tract Infections
The studies of Thomas Wiswell were published in the Journal of the American Medical Association in which Thomas Wiswell made claims that that the "lack of circumcision increases the risk of urinary tract infections in young men." The studies by Dr. Wiswell did in fact get the attention of the media and has been responsible for increasing the circumcision rates over the past decade. However his studies have since been thoroughly refuted and have little credibility with medical organizations throughout the world. Therefore why is the prevention of UTI still used as an argument for circumcision?
In the press release on March 6, 1989, regarding the Wiswell study on UTI, the AAP stated: "Since 1971, the AAP has maintained the position that there was no absolute medical indication for routine circumcision of the newborn". It also made the following comments regarding the findings of the Wiswell study: "It should be noted that these studies in Army hospitals are retrospective in design and may have methodologic flaws." As you see, the AAP does not give its unconditional approval for the Wiswell study. They merely acknowledge that such a study exists.
In a report published by Swedish pediatricians, they were indeed skeptical of the Wiswell study. A similar study conducted in Sweden failed to confirm UTI in uncircumcised males. In a Swedish publication, pediatricians stated it was unlikely "that the extirpation of a piece of normal, healthy tissue of universal occurrence in males would prevent UTI. That the prepuce is a mistake of nature seems improbable." The study in Sweden however confirmed the study by Martin Altschul MD, M Sc. who was unable to find a single case of UTI in a normal male infant. All the confirmed cases occurred in infants who had clear-cut urinary birth defects. Dr. Altschul made the following comments regarding Wiswell's studies: "Does Dr. Wiswell suggest that circumcision could prevent a disorder that a child had at birth? Such a conclusion would defy all human logic." However, Wiswell's research ( inspite of that fact that it was refuted by two other comprehensive studies) is quoted in almost every publication, notably that circumcision prevents UTI in younger males. As quoted from the film JFK, "the greater the lie, the more likely the American people to believe it".
Those doing legitimate research should be prepared to answer questions regarding their motives for the study, and be willing to offer explanations as to why this study was necessary, or why UTI in males cannot be treated in a similar manner as they are in females. Furthermore, older males develop UTI even though they have been circumcised. If circumcision does not prevent UTI nor pose a threat to older males, then the obvious question is why is surgery necessary in order to prevent UTI in younger males?
Urinary tract infections are very common in females and there is no devastating effect. My question is the ethics of circumcising millions of baby boys in order to prevent a few treatable cases if UTI, even if they did occur? Do not males respond to antibiotics in the same manner as females, or is circumcision, the preferred option? If so why?
3. Penile Cancer
You quoted Pediatrics (August 1989) and The Health News (June 1993)..."this condition occurs exclusively in uncircumcised men' and that Dr. June Engel quotes a figure of 2.2 per 100,000 in the uncircumcised but only 3 isolated cases have been reported among circumcised men in the last 20 years."
Edward Wallerstein author of "Circumcision: An American Health Fallacy" (1980) did extensive comparative studies of penile cancer in countries where circumcision was widely practiced and in countries where circumcision was virtually zero. He found no significant differences in the numbers of justify circumcision. He stated that penile cancer is a rare disease; rare in countries where circumcision is practiced, and about equally rare in countries where circumcision was not practiced.
Dr. James Snyder, past President of the Virginia Urological Society, (Snyder JL. "The problem of circumcision in America". The Truth Seeker 1989; 1(3); 40 notes that the low incidence of penile cancer in the United States is not due to circumcision because "...the population of American men born before 1940, now in the group at risk for this cancer, is a group of predominantly UNCIRCUMCISED men. Research indicates that good hygiene prevents penile cancer" and, according to Dr. Sydney Gellis, (Gellis SS. Circumcision. Am. J. Dis. Child 1978; 132:1168-9) "It is an incontestable fact ...there are more deaths from circumcision each year than from cancer of the penis".
The statement regarding penile cancer that "this condition occurs almost exclusively in circumcised men" without reference to the age factor is misleading. The fact is, that penile cancer is seldom found in younger males, regardless of status. Penile cancer is an age related condition. Most males who are vulnerable to penile cancer are 70+ years and older. When the group of circumcised males reach this vulnerable age, can they be certain that they too will not develop penile cancer? Is Dr. June Engel prepared to give circumcised males a positive guarantee that when they reach the vulnerable age, the results will not parallel those predictions of prostate cancer? Even if circumcision did prevent penile cancer, why would the mass amputations of millions of foreskins be necessary in order to prevent a few cases of penile cancer in males in North America? Quoting statistics out of context is a deceptive method used to coerce parents into circumcising their sons.
4. Sexually Transmitted Diseases
The journal of Sexually Transmitted Diseases (July-August 1994) states: "a substantial body of evidence links non-circumcised men with the risk of HIV infection ..consideration should be given to make circumcision an intervention to reduce HIV transmission."
Perhaps you would indicate what numbers of AIDS cases or STD could be prevented by circumcision according to this substantial body of evidence. The current epidemic of AIDS and STD in the US where the majority of males are circumcised hardly support these claims. Perhaps you would explain the correlation of what is happening now in the USA, with the study done in Nairobi, Kenya (regarding uncircumcised males involved with prostitutes and which claims that circumcision prevents the spread of the HIV virus).
One has to question what the relationship of uncircumcised men in Kenya and their involvement with prostitutes has to do with American males. Why should millions of males be circumcised when in all likelihood they will never be involved with prostitutes or place themselves in this position of risk? Or should they be circumcised in order to reduce their risk of contracting AIDS in the event of indulging in such a questionable relationship? Is it the prime concern of the researchers for the few who may get involved with prostitutes, or should not their concern be for the right of males (most who will never get involved in this type of risk) to enjoy undiminished sexual pleasures which is one of the benefits enjoyed by males who are fortunate to retain their foreskin?
Would you not agree that males who deliberately place themselves at risk are likely to contract the HIV virus or STD regardless of their status? Furthermore, does circumcision positively guarantee that these males will not contract the HIV virus and finally develop AIDS? Do people who engage in activities with prostitutes, unlike smokers, and others who indulge in activities which may harm them, not have some responsibility for their own actions? If so, how does one justify subjecting thousands of males (even if there is a slight benefit) to a painful and unnecessary procedure because of a few reckless individuals? Have the lunatics really taken over the asylum?
If circumcision prevents AIDS, as these studies suggest, then how does one account for the fact that recently the US Center of Disease Control in Atlanta Georgia has reported that AIDS is now the leading cause of deaths of American men between the ages of 20 and 45? The USA accounted for the greatest and the most rapid increase in the number of AIDS cases in the world. The prevalency of STD in the USA also does not support these claims. The area formerly known as West Germany and Britain, where circumcision is virtually unknown, were among European countries reporting below-average increases. Countries where circumcision is not practiced should be devastated with AIDS. Again this is not the case.
Obviously the spread of AIDS and STD has little to do with circumcision but rather with practices of unsafe sex, sharing of contaminated needles and a multiplicity of sexual partners. Perhaps the researchers of the Nairobi study should explain why their studies do not corroborate the actual facts. Would they recommend that most males in the USA undergo a second circumcision because the first circumcision was inadequate? If these researchers doing the Kenya study should have the opportunity of doing further studies, one can only wonder how many normal and vital body parts may be the next target for amputation.
It was reported by an Israeli newspaper (Leader Post Feb. 1993) that a prostitute in Tel Aviv infected with the AIDS virus and had sex with thousands of men. (Obviously most of them circumcised) If the study (regarding AIDS and men) happened to be conducted in this location in Israel (instead of Kenya) and it was discovered that the vast numbers of males who conducted AIDS were circumcised, would the logical conclusion be that circumcision contributes to AIDS, and therefore we should conclude that uncircumcised men were less likely to contract AIDS? If the ludicrous conclusion from the Kenya study is used to indicate that uncircumcised males are more likely to contract the AIDS virus, could not a similar study (hypothetically) in Israel be used to support the opposite conclusion?
5. Cervical Cancer
You stated that "Contrary to your position, the causation for cervical cancer and the link with sexually transmitted disease and the link between increased incidence of certain STD's and uncircumcised men is a debate that has not died down or been dispelled in the last decade."
I did not argue that there was no link (a common virus which may be responsible for these) between cervical cancer, penile cancer and sexually transmitted diseases. Nor do I disagree that this debate has not died down or been dispelled in the last decade". I disagreed with the statement that circumcision prevents STD or cancer of the cervix. I stated that cervical cancer was prevalent in the USA even though the majority of males are circumcised, and that even lesbians get cervical cancer. There are approximately 20 000 new cases of cervical cancer in the USA each year, and that 4% of the female deaths from cancer result from cervical cancer. If circumcision prevented cervical cancer, as you indicated, they perhaps you could account for the prevalence of cervical cancer particularly in the USA? Why has circumcision not prevented this condition?
Edward Wallerstein, in Circumcision: An American Health Fallacy ( cervical cancer-pages 91 - 99 ) quoted statistics obtained from the American Cancer Society which indicates that there is very little correlation between cervical cancer and circumcision. Statistical records from other countries also provides an interesting comparison. Women in France have approximately one half the rate of cervical cancer per 100, 000 as women in the USA. Sweden and Norway, where male circumcision is not practiced, also have a significantly lower rates of cervical cancer than females in the USA. An article published in the Time Magazine, on April 5 , 1954 "Circumcision and Cancer", is quoted as stating that "..a low rate of correlation exists between sexual activity, promiscuity, number and spacing of children etc., but not circumcision." Rosemary Romberg in : Circumcision: The Painful Dilemma (Bergin and Garvey - 1985) quoted several studies regarding cervical cancer in the USA which involved American non-jewish women. These compared women who had cervical cancer with the status of their husbands, circumcised vs. uncircumcised. The studies were unanimous in their conclusion that there appears to be no differences in the rates of cervical cancer between those married to circumcised husbands and those married to intact husbands. Other factors such as genetics, personal hygiene, the numbers of sexual partners, were more likely to determine that rate of cervical cancer. Unfortunately, we still have ignorant journalists who live in a vacuum, have not done any extensive research, and are quite content to "parrot" obsolete arguments for circumcision, even though they have long been discredited by knowledgeable members of the medical community.
My contention has to do with the attitude of females towards cervical cancer. If smoking does indeed contribute to cervical cancer (as recent studies have concluded), and if females are so concerned about cervical cancer, that they are willing to accept the circumcision of males as a means to prevent it, then why the increase in smoking among females? Their concerns should be obviously demonstrated by using a preventative measure which they can indeed take, such as to stop smoking or limit the number of partners with whom they have sex. Would females be prepared to amputate a part of their bodies, if it was believed to contribute to some condition such as penile cancer in males? If not, then why should we accept this is a justifiable reason for male circumcision?
Furthermore, there are perhaps hundreds of thousands of females who have demanded that their sons be circumcised, many for "so-called health benefits", and then subjected them to second hand smoke for the next 17 years of their lives. One can only wonder why this contradiction or lack of concern which has a far greater devastating effect on their sons than lack of circumcision.
6. 15% of uncircumcised men will eventually require circumcision later in life
Is it logical to perform any surgery because an individual may require it later? Do we perform routine mastectomies on young girls or women because they may require it later? Do we perform routine appendectomies on young children because they may require it later? Is it equally logically to circumcise millions males because they may require it later? If so, how far do we carry this lunacy? Just the foreskin?
Why should males have the certainty of having painful surgery now, because there may be some remote possibility of having it done later in life? Would it not be preferable to endure pain only if the surgery was required and when it can be performed with the used of anesthetics? There are numerous parts of the body which create far more serious problems. Why should any male be subjected to the amputation of a part of his body which in all likelihood may never pose a single problem during his entire lifetime? Does the possibility that one may require surgery of a normal and healthy part of his body, whether it be 15% or 5%, really have any bearing on the necessity of surgery because he/she may require it later? If so how many different body parts does one propose to amputate? Just the foreskin?
If a child in Canada or the United States is not circumcised at birth, what are the chances of his being circumcised later? These are two separate questions: The chances of getting a circumcision and the chances of needing one. This question was addressed by Wallerstein (Wallerstein, E. Circumcision: An American Health Fallacy, New York, Springer Co. 1980, Chapter 13) . "In dozens of countries in Europe and Asia , the question of post-born circumcision was answered "rarely" or "very rarely". the Finnish National Board of Health in 1970 showed that O.023% of males required hospitalization for foreskin problems (99.977% of Finish males did not.) The US rate is at least 50 times or 5 000 % that of Finland. The question of an uncircumcised child requiring later circumcision is used as as scare tactic - only in the United States. (and Canada) The question is not foreskin problems," Wallerstein states, "but the attitude of the American medical profession in pushing what most physicians throughout the world consider unnecessary surgery. Worldwide, foreskin problems are treated medically, rarely surgically. The question is why physicians in the United States soon opt for surgery when rarely is this medically necessary". A tight foreskin can be easily stretched. Infections can be treated with antibiotics.
Recently a mother related an incident where her son fell and bruised his foreskin. She took him to a physician who recommended immediate circumcision. She refused to follow his advice and took her son home. In a few days he recovered without any medical attention. This attitude is typical of many doctors who view circumcision as the only solution, regardless of the nature of the problem.
In an article published in Nursing BC/August-September 1994, Advocacy:Rhetoric or Practice by Iva Phillips, it was reported that in 1992 only 37 circumcisions were medically required in British Columbia. There were 23, 509 males born in BC in 1992. This hardly equates to the 15% indicated by Dr. Katz. The fact is that few medical necessary circumcisions are actually required. Circumcision should be the last resort in the treatment of conditions and not the preferred option of many physicians.
You had indicated that 15% was an arbitrary figure. If so, then why was this not stated on your program? You also had suggested that this figure was proposed by Dr. Katz. It obviously indicates his level of the approval of circumcision by producing an inflated figure which is hardly consistent to the actual number of medically indicated circumcision performed each year. An estimate of this magnitude would certainly be more likely to persuade parents into circumcising their sons than a small percentage such as 1% or less.
7. Conclusion
Neither the Canadian Pediatrics Association nor the Canadian Medical Association support routine circumcision. As stated on your program The Canadian Pediatrics Association has stated that circumcision was unnecessary, too drastic a procedure, and even it it did prevent any future diseases, these conditions did not pose a threat to the individual and could be treated in a conventional manner. Medical organizations throughout the world support this view. If most medical organizations do not view circumcision as medically necessary, then why are we wasting time in the discussion of the pros and cons of an unnecessary medical procedure?
The following are a few frequently asked questions advocates of circumcision have been able to answer:
Is it the medical opinions of the medical organizations which are in error, or is it the moral and professional ethics of those who continue to circumcise which must be brought into question? Do doctors not have the moral and professional obligation to uphold the Hippocratic Oath and respect the rights of all their patients regardless of their sex or age? Including the rights of infant boys?
Why has the circumcision of males virtually declined to zero in almost every democratic and civilized nation of the world , while only in North America, much ignorance surrounding the practices of circumcision exists? Medical doctors in other countries are appalled that the practice of circumcision still continues in North America. Dr. George C. Denniston from Seattle, Washington stated: "I believe that physicians who continue to perform routine circumcisions are not only harming infants but are also harming the integrity of the medical profession."
What about the concerns of hundreds and thousands of males who are angry and resentful over the violation of their rights and the amputation of their bodies without their consent? As a group of former high school students once stated to me: "Why should we respect the rights of others when our own rights have been so blatantly violated." Are such statements of no concern to the advocates of circumcision? Are we not morally obligated to take these concerns seriously? Does not the fact that many males are seeking to restore their body not suggest that perhaps circumcision is not as innocuous as most advocates of circumcision would have us believe? Will doctors keep on circumcising even if the vast majority of males eventually decide to seek the restoration of a part of their body which they resent being amputated without their permission?
In conclusion, I would appreciate a response to some very serious questions directed to you and those involved in the production of the segment on circumcision for the Health Show. If you believe that the sources you quoted were indeed factual, then I am sure that you should have no difficulty in supporting and defending them. You should be able to explain why the alternatives to circumcision, such as treating UTI with antibiotics is not the preferred option to mass circumcisions. Also why the omission of certain factors such as the importance of the foreskin, complications as a result of circumcision experienced by infants and adult males, and why the human rights and the legal aspect of non-therapeutic surgery on non-consenting individuals was overlooked? Do parents legally have the right to consent to non-medically necessary surgery? If so, where is this right provided in the Canadian Charter of Rights and Freedoms or the Criminal Code of Canada?
I feel that as a producer of the show, it is your obligation to deal with these questions and not shoulder the responsibility to the Ombudsman. If you should conclude that you did not have the time or the opportunity to do extensive research, I can also understand that. I too have taught students from all levels, including high school and college. The fact that any individual has made an error or had insufficient time to cover the topic adequately does not mean that he/she is less intelligent or responsible. It is very difficulties to keep with with the latest research and the vast volumes of new information arising from day to day. I have had many former students and staff members who delighted in pointing out my errors. It is not one's errors which are important, but rather the action taken in order to correct them which really matters. Staff members who refused to admit their errors seldom gained the respect of their students.
Members of the media are outraged when they are denied access to court proceedings or information which they feel should be made public. In their quest for truth, I believe that they have the obligation to present the truth on all occasions and not take "the middle of the road approach." Do you not agree? May I hear from you?
Thanks again, and my kindest regards.
Sincerely,
John Sawkey
Director
Medical Ethics Network Inc.
cc: CBC Ombudsman
Linda McKeown - Host of The Health Show