The Instigator
1Devilsadvocate
Con (against)
Winning
31 Points
The Contender
FourTrouble
Pro (for)
Losing
0 Points

Parent-elective circumcision of offspring is ethically unacceptable

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Post Voting Period
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after 5 votes the winner is...
1Devilsadvocate
Voting Style: Open Point System: 7 Point
Started: 12/31/2012 Category: Society
Updated: 3 years ago Status: Post Voting Period
Viewed: 2,659 times Debate No: 28785
Debate Rounds (5)
Comments (37)
Votes (5)

 

1Devilsadvocate

Con

Parent-elective circumcision of offspring is ethically unacceptable.

This is to counter Jarhyns' debate, which he made impossible to accept.
Pro will make opening arguments in Round 1.
Con gets final word in round 5, Pro may not respond.
If Pro does respond con automatically wins.
FourTrouble

Pro

Thanks for the debate 1Devilsadvocate.

I will take the Hippocratic Oath as a starting point for this debate: DO NO HARM. This is the standard by which all medical practices should and must be measured. It turns out that all of the latest research studies indicate that circumcision is not only incredibly painful and traumatic for babies, but also circumcision poses serious clinical risks and potential medical complications. The list of problems goes on and on:

1. Circumcision is observably painful, stressful, and traumatic. During the procedure, newborns exhibit sustained elevation of heart rate, changes in blood pressure and cortisol levels, as well as high pitched cries throughout the procedure. One study was even halted because two newborns stopped breathing. Multiple behavioral changes were noted as well, including changes in sleep patterns and mother-child interactions for up to 24 hours following the procedure. [1]

2. Circumcision hurts the sex life of both men and women. The foreskin (the part of the penis surgically removed by circumcision) is the most sensitive portion of the penis and contains nearly all of its fine-touch neuroreceptors. Studies have shown that removing these nerve-endings leads to less-satisfying sex, reduced sensitivity and erectile function, difficulty with intromission, and increased premature ejaculation. [2] [3] [4] Studies have also shown that male circumcision has been associated with sexual difficulties in women, including orgasm difficulties, dyspareunia and a lack sexual fulfillment. [5] A study in the New Zealand Medical Journal explains these results by showing that circumcision exacerbates vaginal dryness, making it more difficult for women to become aroused and reach orgasm. [6]

3. Circumcision makes infection 3% more likely, excessive bleeding 9% more likely, meatitis 20% more likely, meatal stenosis 8% more likely, subcutaneous granuloma 5% more likely, balanitis 16% more likely, coronal adhesions 30% more likely, skin bridges 2% more likely, and phimosis 2% more likely. Other complications include septicemia, meningitis, Fournier gangrene, staphylococcal scalded skin syndrome, osteomyelitis, septic arthritis, tetanus, herpes simplex infection, empyema, pubic hair strangulation, denudation of the penis, glans amputation, urethral fistula, penile edema, pyogenic granulomas, acute urinary retention with acute renal failure, ruptured bladder, UTI or urine advancing in subcutaneous fascial plains, penile ischemia, pneumothorax, pseudoparaphimosis, pulmonary embolism, unilateral leg cyanosis, gastric rupture, myocardial injury and erythema multiforme. [7] Circumcision also makes newborns 12 times more likely to acquire methicillin-resistant Staphylococcus aureus infections. [8]

4. I thought I would elaborate on glans amputation since I am having trouble believing it myself: the Journal of Urology reports a "large number" of complete penile glans amputations during circumcision, numbering between 1.5% to 15%. Yes, you are reading this correctly: between 1.5% to 15% of circumcisions result in a complete penile amputation. [9]

5. Circumcision can lead to abnormal brain development and behavior. [10] Babies who undergo circumcision immediately show anti-social tendencies, shyness, anger, fear, powerlessness, distrust, low self-esteem, relationship difficulties, and sexual shame. [11]

I could go on but I think that should be enough. The five points listed above document a large number of serious medical problems with circumcision that make it an ethically unacceptable practice under the Hippocratic Oath.

There are other ethical problems with circumcising babies. Circumcision infringes on a child"s right to physical integrity. A circumcision cannot be undone. You cannot reattach a foreskin to the penis. The choice should therefore be left entirely up to the person undergoing the procedure. Parents should have no part in deciding whether their "offspring" should be circumcised or not because the procedure cannot be reversed. Indeed, while there are a large number of circumcised men who wish they had never been circumcised (too bad they will never know what they are missing), there are very few uncircumcised men who wish they were circumcised.

If it is not permissible to infringe upon the physical integrity of young girls (female genital mutilation is indeed criminal and I imagine my opponent accepts that it is unethical), why would it be permissible to infringe upon the physical integrity of young boys? As circumcision is a form of genital mutilation, it is a form of gender discrimination to give girls the right to physical integrity while denying that right to boys. If my opponent is to argue that parent-elective circumcision of offspring is ethically acceptable, then my opponent must provide a case in support of either gender discrimination or female circumcision.

Sources:
[1] http://jama.jamanetwork.com...
[2] http://www.ncbi.nlm.nih.gov...
[3] http://onlinelibrary.wiley.com...
[4] http://onlinelibrary.wiley.com...
[5] http://ije.oxfordjournals.org...
[6] http://journal.nzma.org.nz...
[7] http://www.nature.com...
[8] http://www.ncbi.nlm.nih.gov...
[9] http://www.ncbi.nlm.nih.gov...
[10] http://www.ncbi.nlm.nih.gov...
[11] http://www.cmaj.ca...
Debate Round No. 1
1Devilsadvocate

Con

Thank you Pro for accepting.

Rebuttal:

My opponents sources do not seem to jive %100 with his position:

1.
a) In the link provided there was no mention of:
"changes in sleep patterns and mother-child interactions for up to 24 hours following the procedure."

b)The Objective of the study was:
"To compare ring block, dorsal penile nerve block, a topical eutectic mixture of local anesthetics (EMLA), and topical placebo when used for neonatal circumcision."
The conclusion was:
"The ring block was equally effective through all stages of the circumcision, whereas the dorsal penile nerve block and EMLA were not..."

2.
(emphasises Mine.)
Source "[2]":
"... improved satisfaction (p = 0.04). Of the men 50% reported benefits and 38% reported harm. Overall, 62% of men were satisfied with having been circumcised."

Source "[3]":
"There were no significant differences in sexual drive, erection, ejaculation, and ejaculation latency time between circumcised and uncircumcised men..."

Source "[4]"
Aside from the fact that the study was not focused on circumcision.
" Conclusion. PE might be frequent in men attending primary care clinics. We found that erectile dysfunction, circumcision, Indian ethnicity, and frequency of sexual intercourse of =5 times per month were associated with PE. These associations need further confirmation. "

Source "[5]"
Ends off with:
"Thorough examination of these matters in areas where male circumcision is more common is warranted."
The reason is obvious, the study took place in Denmark where circumcision is viewed highly unfavorably.

3.
Source "[7]"
Where the source gave a range, Pro conveniently just wrote the highest #.
For example Pro wrote: " excessive bleeding 9% more likely".
While the source said "excessive bleeding (1–9%)". (Note that the words "more likely" were added by pro as well.)

Source "[8]"
Pro mentions that Circumcision makes newborns more likely to acquire a type of infection.
He fails to mention " Inspection revealed uncovered circumcision equipment, multiple-dose lidocaine vials, and inadequate hand hygiene practices."
In other words it wasn't the circumcision, but rather carelessness.

4.
Source "[9]"
Pro writes "1.5% to 15%"
The link did not provide any #'s.
1.5% - 15% is an abnormally large range, 10 fold difference.
The notion that 15% of of circumcisions result in a complete penile amputation, is absurd.
Where was this study done? Some 4th world country?
The basic info in the link is scant.
Pro writes:
"the Journal of Urology reports a "large number" of complete penile glans amputations during circumcision"
What the link actually says is " complications", not " penile glans amputation".

5.
Source "[10]"
The source didn't even mention the word "circumcision".

Source "[11]"
Does not say what Pro wrote.

Finally Pro gives up on sourcing claims all together & makes baseless assertions like:
"You cannot reattach a foreskin to the penis. "
& "...there are a large number of circumcised men who wish they had never been circumcised... there are very few uncircumcised men who wish they were circumcised."

FGM:
Ignoratio elenchi.
This is common relevance fallacie.

The term FGM is not a specific procedure like MGM is. FGM can refer to (1 of) several different procedures.
FGM is separate topic that is way more complex than MGM.
This argument seems to me like red herring.

"I imagine my opponent accepts that it is unethical"
Strawman.

"my opponent must provide a case in support of either gender discrimination or female circumcision."
FGM is either:
a) = to MGM, & it's Okay,
b) worse than MGM, & therefore not okay,
c) not comparable at all.

What does Gender discrimination have to do with anything? They are 2 different procedures.
It's like saying that maternity leave is Gender discrimination.
But, yes, it is permitted to perform MGM on girls as well. :)

Arguments:

1) Argument from Moral nihilism - nothing is intrinsically moral or immoral.

2) Argument from multiculturalism - Even if something could be immoral, it is nothing more than an opinion/taste, not fact.

3)Circumcision Health Benefits 'Outweigh The Risks':

Circumcision is "a treatment option for phimosis and balanoposthitis, and for chronic urinary tract infections;[2][6]A Cochrane meta-analysis of studies done on sexually active men in Africa found that circumcision reduces the infection rate of HIV among heterosexual men by 38–66% over a period of 24 months,[7] and studies have concluded it is cost-effective in sub-Saharan Africa.[8] Circumcision reduces the incidence of HSV-2 infections by 28%,[9] and is associated with reduced HPV prevalence[a] and a reduced risk of both urinary tract infections (UTIs) and penile cancer.[5]" (1)

Circumcision does not appear to have a negative impact on sexual function(1)(2)(3).

After a comprehensive review of the scientific evidence, the American Academy of Pediatrics found the health benefits of newborn male circumcision outweigh the risks, but the benefits are not great enough to recommend universal newborn circumcision. The AAP policy statement published Monday, August 27, says the final decision should still be left to parents to make in the context of their religious, ethical and cultural beliefs. (4)

The AAP also said circumcision does not have any affect on sensitivity of the penis or sexual pleasure.
The review also showed a lower risk of contracting HPV and herpes if men are circumcised. (5)

Circumcision Reduces risk of HIV by 60% (6).

Male circumcision is a common procedure, generally performed during the newborn period in the United States. In 2007, the American Academy of Pediatrics (AAP) formed a multidisciplinary task force of AAP members and other stakeholders to evaluate the recent evidence on male circumcision and update the Academy’s 1999 recommendations in this area. Evaluation of current evidence indicates that the health benefits of newborn male circumcision outweigh the risks and that the procedure’s benefits justify access to this procedure for families who choose it. Specific benefits identified included prevention of urinary tract infections, penile cancer, and transmission of some sexually transmitted infections, including HIV. The American College of Obstetricians and Gynecologists has endorsed this statement.(7)

If an uncircumcised man chooses to have the procedure done later in life, it will be much more painful (even with anesthesia) and dangerous than it would be for a newborn.(8)(9)(10)

Parental Values & Social Acceptance—Parents make health- and aesthetics-related value choices that affect their children’s bodies all the time. Should their child be vaccinated, receive orthodontia, get his or her ears pierced? Passing down these values is an important moral relationship parents have with their children. When a parent makes decisions about the bodies of their young children, it can serve as another form of care, a moral necessity for parenting.(8)

No major medical organization recommends either universal circumcision for all infant males, or banning the procedure.[25](1)

(1) http://en.wikipedia.org...
(2) http://www.ncbi.nlm.nih.gov...
(3) http://www.circs.org...
(4)http://www.aap.org...
http://pediatrics.aappublications.org...
(5) http://www.huffingtonpost.co.uk...
(6) http://www.guardian.co.uk...
http://www.scientificamerican.com...
http://aids.gov...
(7) http://pediatrics.aappublications.org...
(8) http://www.thejewishweek.com...
(9) http://www.healthychildren.org...
(10) http://www.circinfo.net...;
FourTrouble

Pro

I'll start with my sources.

Source 1

The article discusses both physiological changes and behavioral changes during, and immediately following, circumcision. It was noted therein that there were changes in sleep patterns and mother-child interactions for up to 24 hours following the procedure. The abstract indeed does not mention this but the article itself does. Furthermore, my opponent misrepresents the conclusion of the study: "It is our recommendation that an anesthetic should be administered to newborns prior to undergoing circumcision." In other words, circumcision is so overwhelmingly painful and traumatic for newborns that an anesthetic (itself fraught with serious clinical risks when administered to newborns) is recommended prior to the procedure. It is a lose-lose situation as newborns who undergo circumcision must experience overwhelming pain or risk their life with with an anesthetic.

Source 2

My opponent concedes that only 62% of men who choose to be circumcised are satisfied. This means approximately 40% of people who are circumcised are having serious sexual problems as a result of circumcision. It is unethical to potentially deprive one's child of a healthy sex life when the probability that the procedure will do so is 40%.

Source 3

What my opponent fails to mention is that circumcision results in decreased pleasure in 48% of respondents, and increased masturbatory difficulty in 63% of respondents. The study concludes: "There was a decrease in masturbatory pleasure and sexual enjoyment after circumcision, indicating that adult circumcision adversely affects sexual function in many men."

Source 4

The study concluded premature ejaculation was associated with circumcision.

Source 5

My opponent's argument can be turned around: circumcision in Denmark is viewed unfavorably because studies show that circumcision leads to an unfulfilled sex life.

Source 7

So what my opponent is saying is that studies have confirmed that circumcision causes excessive bleeding at least 1% of the time and up to 9% of the time. My opponent also concedes that circumcision causes meatitis 20% of the time and coronal adhesions 30% of the time, as well as all the other complications I listed.

Source 9

1.5% to 15% of circumcisions result in a complete penile amputation. To prove the numbers are correct, here is a direct link to the article:

http://www.cirp.org...

The article is titled: "Newborn penile glans amputation during circumcision and successful reattachment." My opponent is therefore wrong when he says the link says "complications" and not "penile glans amputation." The study was conducted in Marin General Hospital (San Raphael, California) by the University of California School of Medicine.

Source 10

This study is about the effects of painful and traumatic experiences early in life. It describes circumcision in particular as an overwhelmingly painful experience that has serious long-term neurobehavioral effects. Specifically, circumcision leads to increased anxiety, altered pain sensitivity, stress disorders, hyperactivity/attention deficit disorder, which all ultimately lead to impaired social skills and patterns of self-destructive behavior. The abstract of the article does not mention circumcision but the article itself certainly does. I realize now that I should have provided links directly to the articles in question. Here is a link for my opponent and readers: http://www.cirp.org...

Source 11

What I said this study says is actually said by Source 10. I made a mistake in my sourcing. Apologies. What this study does say, however, is relevant. It concludes: "Circumcision of newborns should not be routinely performed."

--

My opponent did not rebut the argument I made regarding physical integrity and choice. As readers may recall, I argued that parent-elective circumcision is unethical because it infringes on a child's right to physical integrity. My opponent has effectively conceded this argument.

--

I did not understand my opponent's response to the issue of female circumcision. If parent-elective female circumcision is unethical, then why is parent-elective male circumcision ethical? Is this not a form of gender discrimination that protects the physical integrity of girls but not boys?

--

I'll address my opponent's arguments now.

1. Moral Nihilism is a meta-ethical position that has no bearing on this debate. This position holds that morality is socially constructed. I don't see how it changes the fact that circumcision is unacceptable, especially given the dominant paradigm in our medical ethics of not doing harm (the Hippocratic Oath).

2. The argument from multiculturalism is both fallacious and lacking in impact on this debate. We do not think cannibalism or murder is ethical even though other cultures say it is. What is ethical is NOT determined by what other cultures think. It is determined by what our culture thinks. Circumcision should still be the child's choice, regardless of what any particular culture thinks.

3. If the medical benefits outweigh the risks, why doesn't a single major medical organization recommend universal infant circumcision? The answer is because the medical benefits are not clear at all.
--

STDs are transmitted by having sex. The inclusion of large numbers of religious Muslims and Jews in the data set skews all the results. This is because these groups are less likely to have pre-marital sex and therefore have no chance of contracting an STD.

Furthermore, studies show that the antibodies and lysozymes secreted by foreskin help kill viruses. Ronald Goldman claims that uncircumcised men are less likely to contract STDs than circumcised men.

Finally, none of the studies cited mention condoms even though condoms are much more effective (99%) than circumcision, less invasive, less costly, and they protect women from infection. If a condom is better than circumcision, why circumcise?

--

The overwhelming majority of males who are uncircumcised will not get any of the infections or diseases circumcision supposedly prevents. Therefore, circumcision would not give them any health benefit. The point here is that there is no reason to recommend anyone get a circumcision.

--

The AAP report is flawed:

1. It conflicts with positions from organizations in other countries that recommend against circumcision.

2. It inflates benefits. For example, it says circumcision prevents penile cancer even though the numbers show that it would require 322,000 circumcisions to prevent one case of penile cancer.

3. The effects of the pain from circumcision, including long-term changes in infant behavior, are not discussed.

4. The medical risks of circumcision are not mentioned, even though circumcision has many risks including, in rare cases, death.

5. The report attempts to shift responsibility to the parents. If the procedure is done for medical reasons, the decision should be left to physicians, not parents. The medical decision about whether or not to operate is made by the person doing the procedure.

6. The report states: "The pediatrician's responsibilities to his or her patient exist independent of parental desires or proxy consent."

7. The report is influenced by personal, cultural, financial, and professional conflicts of interest. These factors include committee members' circumcision status and religious background.

--

The foreskin protects the penile head, enhances sexual pleasure, and facilitates intercourse. It violates medical ethics to cut off a natural, healthy, functioning body part. It is not acceptable for parents to surgically remove their infant's hand. Therefore, it is not acceptable for parents to surgically remove their infant's foreskin.

I am out of space. In the next round, I will discuss the following article: http://www.cirp.org...
It shows that circumcision violates all the principles of medical ethics.
Debate Round No. 2
1Devilsadvocate

Con



Rebuttal:

Main Point: Much of pros sources are vague, inconclusive, contradictory, contradicted, & fraudulent:

Source 1:
I want to point out that the article is not contained in the link, & cannot be read without paying for it.
Pro describes the anesthesia as "fraught with serious clinical risks " & "risk their life".
Circumcision does not use general anesthesia, but rather local anesthesia which temporarily numbs some of the nerves in a specific area not the body as a whole.

Source 2:
"My opponent concedes that only 62% of men who choose to be circumcised are satisfied."
Strawman. I did not concede anything, I merely pointed out what that particular study which pro brought, concluded. Even according to that study the majority were happy with the procedure.
But if you take a look at the very next study (& numerous others) you find:
"PURPOSE: Claims of superior sexual sensitivity and satisfaction for uncircumcised males have never been substantiated in a prospective fashion in the medical literature. We performed such a study to investigate these assertions. ...
CONCLUSIONS: Circumcision does not appear to have adverse, clinically important effects on male sexual function in sexually active adults who undergo the procedure." (1)

In fact if we take a look at Pro's own source/study we find:

"PURPOSE: Evidence concerning the effect of circumcision on sexual function is lacking...
COLUSIONS: ...Prospective studies are needed to better understand the relationship between circumcision and sexual function."


Source 4:
This study breaks a fundamental rule in that it use multiple variables, uniform test groups, & bunched several factors together.
Perhaps that's why it concluded "These associations need further confirmation. "

Source 5:
This source too had enough integrity to say:
"Thorough examination of these matters in areas where male circumcision is more common is warranted."


Source 7:
My opponent does not deny that he exaggerated the #s.
But there seems to me to be a bigger problem here, that problem is with pros source itself.
As far as I can tell, the source that pro quoted simply made up many claims without sourcing, & what was sourced was not found in the supposed study.
I asked pro about this in the comment section, I received no answer.

source "[9]"
I appreciate that Pro has now sited an accessible source for this claim, & I find the source very revealing.

"Although not technically difficult, it results in a large number of reported and unreported complications annually."
"The fairly high rate (1.5 to 15%) reflects the fact that the procedure is often performed by an inexperienced individual without attention to basic surgical principles."

My conclusion from this is that the procedure is not inherently risky, but rather the problem is that
"the procedure is often performed by an inexperienced individual without attention to basic surgical principles."

"The article is titled: "Newborn penile glans amputation during circumcision and successful reattachment." My opponent is therefore wrong when he says the link says "complications" and not "penile glans amputation.""
Well, lets quote the actual article, specifically were it gives the stat.:
"The potential for complications during circumcision is real and ranges from the insignificant to the tragic. The fairly high rate (1.5 to 15%) reflects the fact that the procedure is often performed by an inexperienced individual without attention to basic surgical principles.3 Bleeding is common and can often be, controlled by pressure...
The stat. is not referring to amputations specifically, but rather " complications" in general, Which includes things as minor as Bleeding.

But it gets better:
" Excision of the penile glans is not common with only 1 previous case of penile excision, with successful repair reported.16"

The paper ends off:
"Most circumcision injuries, including glans amputation, can be successfully managed with aggressive treatment."

Source "[10]
Again I scanned all those pages, & did not find circumcision mentioned even once.
I asked my opponent in the comment section to point out were it mentions circumcision.
He has not replied as of this posting.

Source [11]
Pro admits that it doesn't say what he quoted, but rather it comes from source 10,
As I pointed out source 10 doesn't mention circumcision.

My opponent does point out that source 11 says :
"Circumcision of newborns should not be routinely performed." ( emphasis mine)

The object of the study was "Whether to recommend the routine circumcision of newborn male infants."
Not recommending that it be routinely performed =/= Should not be performed/ it's unethical to perform.

The study says that one of the factors taken into account was "is it cost-effective".
It being cost effective or not, does not impact it's being "ethically unacceptable".

Regarding "physical integrity":
This is a typical "If it can't be done with factual arguments rely on some catch phrase that sounds good".
As I pointed out before pro based his "physical integrity" argument on unsourced statements.
As such I need not respond. I will respond a bit any way:
Pro writes:
"circumcision cannot be undone"
It can & has been done for thousands of years:
"Then certain of the people ... built a place of exercise at Jerusalem according to the customs of the heathen: And made themselves uncircumcised...(2)
To the present day(3).

The idea that pro mentioned:
" Indeed, while there are a large number of circumcised men who wish they had never been circumcised (too bad they will never know what they are missing), there are very few uncircumcised men who wish they were circumcised."
Is unsourced & in my opinion false. Especially when done in certain cultures/sects for religious reasons, the vast vast majority are happy that it was done, & would be extremely upset if it hadn't.

FGM:
Pro again brings up FGM, but he doesn't specify which type, as I pointed out in R2 there are several different types. I am not as familiar with FGM as MGM, & thus hesitate to discus it, as it is not really the subject of the debate.
I will mention this:

"Female circumcision is not required by any religious group and is a traditional practice prevalent in Africa, Southeast Asia and South America.
It's far more disfiguring, disabling and potentially dangerous than male circumcision so cannot be viewed in the same light. The original author fully supports the World Health Organisation's policy that this procedure should cease throughout the world."(4)

My arguments:

1- Moral nihilism - It seems that pro does not understand what moral nihilism is.
Moral nihilism (also known as ethical nihilism) is the meta-ethical view that nothing is intrinsically moral or immoral. (5)
If nothing is intrinsically moral the resolution "Parent-elective circumcision of offspring is ethically unacceptable" is cannot be true.

2- Multiculturalism -
" What is ethical is NOT determined by what other cultures think. It is determined by what our culture thinks. "
1st of all, what's this, "our culture", our culture is composed of many subcultures, lets say I were Muslim.
2nd of all Pro assumes that our culture considers circumcision unethical, but brings no evidence.
The fact of the matter is the opposite.(6)

I'm running out of space.

3 -
I've shown that Pro's own statements & sources are far from perfect.
They certainly cannot compare to fact that, The American Academy of Paediatrics, looking at multiple studies & factors, concluded that "overall the health benefits of newborn male circumcision outweigh the risks."

I'm just about out of letters.


(1)http://www.restoringtally.com...
(2)Maccabees 1, 13-15 (KJV) c200 BCE
(3) http://www.netdoctor.co.uk...
(4) http://www.ncbi.nlm.nih.gov...
(5) http://en.wikipedia.org...
(6) http://pediatrics.aappublications.org... - Section2 - "EPIDEMIOLOGY"
FourTrouble

Pro

I'll start with rebuttals this time:

Moral Nihilism

Con has not provided any reason to believe moral nihilism is correct. But supposing it is correct and nothing is intrinsically moral, then it follows that our moral codes are socially constructed. I have no problem accepting this because it does not change the fact that, within the dominant moral paradigm of the medical community (the Hippocratic Oath), circumcision is unethical.

Multiculturalism

Our medical culture (this is what matters for this debate) is ruled by a pragmatic ethics, specifically the notion of not doing harm. If this paradigm is applied to the issue of circumcision, it becomes quite clear that infant circumcision is unethical, regardless of what other cultures believe. Other cultures think murder is ethical, but that does not mean doctors have the right to murder their patients.

Medical Benefits

If the medical benefits outweigh the risks, why doesn't a single major medical organization recommend routine infant circumcision?

It is because the medical benefits are in fact far from clear. Con basically concedes this point by dropping the entirety of my case against the AAP.

I'll say that again: Con has simply repeated what the AAP has concluded without addressing all the points I brought up against the AAP report.

Sources

1. A general anesthesia poses serious health risks to newborns and should be administered. A local anesthesia also poses health risks, and moreover, it is not sufficient to mitigate the pain and trauma associated with circumcision.

2. My opponent has not challenged the facts: 40% of the men who are circumcised are unhappy with the result. They report decreased sexual satisfaction. My opponent says the majority of men are satisfied. The language in which my opponent frames the issue simplifies the facts and in doing so loses sight of the issue at stake. However my opponent wants to spin it, 40% of people who undergo circumcision will be unhappy. Why take the risk without the consent of the patient when there is a 40% chance that the procedure will produce unacceptable results?

3. My opponent does not address my third source. What he has cited seems fabricated, since it is not written in my source nor is it written in the source that my opponent directly cites under the label (1).

4. I am not sure what my opponent means when he says this study breaks fundamental rules of methodology. It took a group of circumcised men and uncircumcised men and compared their sex lives. It also took a group of men who had been uncircumcised and later were circumcised, and asked them about the change. The subjects and methods are explained very clearly in the study, and they make perfect sense. My opponent should expalin exactly what is wrong with the study. For the record, the study concluded:

"We conclude that adult circumcision adversely affects sexual function in a significant number of men, possibly because of loss of nerve endings. In addition, ≈ 9% of the circumcised men reported severe scarring of their penises, and this population probably overlaps with those who reported insufficient skin resulting in uncomfortable erections, penile curvature from uneven skin loss, and pain and bleeding upon erection/manipulation."

5. My opponent does not provide any reason to doubt the accuracy of the study itself. Instead, my opponent simply points out that the authors believe further examination should be carried out. This is generally what most studies say, as it helps confirm their results. It is the rhetoric of academic studies, but it does not mean the study itself is any less trustworthy.

6. My opponent says nothing of this source.

7. The numbers are not exaggerated and the source does have references for the things it says.

9. The single case of penile excision refers to the specific trials done in the study. The study states: "In our case circumcision was performed by a specialist (although a nonurologist) with experience of more than 300 circumcisions." The point is, the circumcision was performed by a specialist and the penis had to be amputated.

10. The study discusses the long-term behavioral effects of pain on newborns. Circumcision is cited as one form of pain that can lead to these effects. The study is not directly about circumcision, although circumcision is discussed briefly. The point I'm making is that circumcision is painful, and if it is painful, then it leads to the adverse behavioral changes listed in this study.

11. Not recommending routine male circumcisions means the medical benefits of circumcision do not outweigh the risks. The only time circumcision can and should be performed is when a physician (not a parent) decides it is necessary to avoid further medical complications. The difference here has to do with who is deciding whether to circumcise - parents or physicians.

Choice

My opponent has still not addressed the argument I made regarding choice. This is now two rounds in a row that my opponent leaves this argument unaddressed. The argument was simple and I'll repeat it here again: a chile has a right to physical integrity which should not be infringed upon by their parents. Parent-elective circumcision infringes on a child's right to physical integrity by not giving them a choice in the matter.

Undoing Circumcision

My opponent cites the bible as evidence that circumcision can be undone. I would like evidence that it can be undone in our society, by our medical professionals, at the current moment in time. Truth is, our medical technology does not currently allow us to reverse a circumcision.

FGM

I am saying female genital mutilation is not any different than male genital mutilation: they both remove a large number of fine-touch neuroreceptors - in the case of the penis, it removes 30-50% of the tissue, and as such, these are both unethical practices. The fact that FGM is considered unethical should be a sign that MGM is also unethical.

STDs

My opponent drops my argument showing that circumcision does not prevent STDs. It should be noted that my opponent also drops my argument showing that circumcision is not a good form of preventative medicine. As I wrote in the previous round:

"The overwhelming majority of males who are uncircumcised will not get any of the infections or diseases circumcision supposedly prevents. Therefore, circumcision would not give them any health benefit. The point here is that there is no reason to recommend anyone get a circumcision."

Function of the Foreskin

My opponent has not addressed my argument that the foreskin has a function. It "protects the penile head, enhances sexual pleasure, and facilitates intercourse. It violates medical ethics to cut off a natural, healthy, functioning body part." As such, parents have no right to surgically remove their infant's foreskin, as it is a healthy and functioning body part.
Debate Round No. 3
1Devilsadvocate

Con


Moral nihilism-
Unless evidence that ethics do exist is provided, there is no reason to assume that it exists.
Pro then confuses Moral nihilism with moral relativism.

Multiculturalism-
"Our medical culture (this is what matters for this debate)..."
Says who?

"flaws" with AAP:
1. It conflicts with other organizations.
That's a flaw? Why are the other organizations not flawed because AAP contradicts them?
Furthermore, I do not recall pro quoting a single major organization that recommend against circumcision.

2.It says circumcision prevents penile cancer even though the numbers show that it would require 322,000 circumcisions to prevent one case of penile cancer.

It does say how rare it is.
I'm not sure were pro got his # from, the anti-circumcision propaganda says 909- 322,000, & base the #'s on the AAP.

"3. The effects of the pain from circumcision including long-term changes in infant behavior, are not discussed."

False. Pain is discussed See the section called ANALGESIA.

"long-term changes in infant behavior" aren't mentioned, because there aren't any.

"4. The medical risks of circumcision are not mentioned..."

False again. See "COMPLICATIONS OF THE CIRCUMCISION PROCEDURE"

Pros' Sources:

"1.A general anesthesia poses serious health risks to newborns and should be administered."
Strawman. No one suggests using general anesthesia for newborn circumcision. All three options compared in the study pro mentioned, are local anesthesia.

"A local anesthesia also poses health risks, and moreover, it is not sufficient to mitigate the pain and trauma associated with circumcision."
Both of these assertions are baseless.

"2. My opponent has not challenged the facts: 40% of the men who are circumcised are unhappy with the result. They report decreased sexual satisfaction..."

False.

In R2 I wrote:
"Circumcision does not appear to have a negative impact on sexual function(1)(2)(3)."
"The AAP also said circumcision does not have any affect on sensitivity of the penis or sexual pleasure...(5)"

In R3 I Directly addressed pros source #2, in great detail.

One more major problem with that study (& other similar studies) is:

"Mean age of responders was 42 years at circumcision and 46 years at survey."
Didn't it occur to anyone that the results might have something to do with the fact that the participants were comparing age 46 sex to age 42 sex.

"3. My opponent does not address my third source. What he has cited seems fabricated, since it is not written in my source..."

Hypocritical lie. What I sited is in pros source, right at the beginning of the section entitled "results".

"4. I am not sure what my opponent means when he says this study breaks fundamental rules of methodology..."
cum hoc ergo propter hoc.
One major problem is that the tested population is not uniform, & they were testing multiple variables at once including ethnicity.
The studied population, consisted of multiple ethnicities, some ethnicities naturally have higher rates of PE due to genetics, if those ethnicities also practice circumcision, it will come out looking like circumcision is the cause when it's really genetic. This is a fundamental rule, only test one variable at a time, & keep the subjects uniform except for the one variable being tested. This study broke that rule.
The conclusion (thus) ended off: "These associations need further confirmation."

"It also took a group of men who had been uncircumcised and later were circumcised, and asked them about the change..."

No it did not. http://onlinelibrary.wiley.com... .

" For the record, the study concluded:"We conclude that adult circumcision adversely affects sexual function in a significant number of men...""

No it did not. see link above.

"5. My opponent does not provide any reason to doubt the accuracy of the study itself..."

False.
I already explained in R2.
The paper admitted that a biased population, Denmark, was used.
& thus ended off:
"Thorough examination of these matters in areas where male circumcision is more common is warranted."

6.
As I pointed out earlier, there are multiple studies that contradict this one.
The fact that this one is New Zeland (which like Denmark has an anti circumcision population) based, may have something to do with that.

"7. The numbers are not exaggerated ..."
Where the source gave a range, Pro conveniently just wrote the highest #. That's exaggerating.

"and the source does have references for the things it says."

The reference of the source does not match what the source wrote:
1)The source listed a # of obscure possible complications that arise, but the reference only mentions staph. infections.
2)The rate of staph. infections stated by the source, was not mentioned in the reference.
I pointed this out to pro, & pro has yet to explain.
Also of note the study said that the infections were a result of carelessness.

Pro's source 8, is actually the reference that was used by his source 7.

"9. The single case of penile excision..."
Exactly. This is a classic informal fallacy, known as hasty generalization, AKA , the "I know of a case where..." fallacy.
One case - out of millions.
Furthermore the tool used in that case is long out of use.

"10. The study is not directly about circumcision..."

Thank you you for acknowledging that.

Furthermore:
a) The paper & Abstract repeatedly says things like:
"our understanding of the underlying mechanisms remains rudimentary"
&
"Little is known about the effects of full-term pain in neonates."
b) When the paper & abstract refer to pain they specify "repetitive pain".
c) As has been mentioned numerous times there are anesthetics for circumcision.

11. Not recommending routine male circumcisions means the medical benefits of circumcision do not outweigh the risks.

a) Not recommending routine M.C. =/= Recommending not to perform M.C.. Or that M.C. is unethical.

b) The paper used cost as a factor, it was discussing if it's worth the $.

I can actually flip pro's argument, & say, from the fact that the paper did not advise against circumcision, implies that it is not a bad choice from a health perspective
It's just might not be worth the money.

& finally I'll point out again that others such as AAP say clearly that "the health benefits of newborn male circumcision outweigh the risks"

"a chile [sic] has a right to physical integrity which should not be infringed upon by their parents."
Again there are many factors here, just throwing out a term like "physical integrity", is not a reason in & of itself. If one must wait, it will be much more painful (even with anesthesia), dangerous, expensive, etc. than it would be for a newborn (R1).
Parents have a right & obligation to do what is best for the child.
Take a religious Jew for example, by not circumcising now, the child will almost definitely go through a much more dangerous & painful circumcision. The parent should have a right to protect the child from that added pain & risk.
We allow parents to make all kinds of decisions regarding children, ear piercing, braces, vacenies,
Driving with a child in a car is not any less risky than circumcision, No one out laws it.

"Undoing Circumcision:
http://www.restoringtally.com... http://www.foregen.org...

"FGM
I am saying female genital mutilation is not any different than male genital mutilation..."
That's the problem. This is called Mind projection fallacy.
The fact of the matter is that:
"It's far more disfiguring, disabling and potentially dangerous than male circumcision so cannot be viewed in the same light." http://www.netdoctor.co.uk...

STD:
My opponent claims the studies are "skewed" because Jews & Muslims are more careful about sex.
Studies were done in Africa.

My opponent says people can use condoms.
That is irrelevant. What is relevant is that people are still getting STD. & circumcision reduces that likelihood.

Out of Characters.
FourTrouble

Pro

FourTrouble forfeited this round.
Debate Round No. 4
1Devilsadvocate

Con

Benefits:

Due to space I’ll focus on 2:

HIV:

About 50,000 Americans are newly infected with HIV each year
http://www.cdc.gov...

The AAP technical report on circumcision cites 14 studies which found evidence that circumcision is protective against HIV.

Circumcision Reduces Risk of AIDS Virus Infection
http://report.nih.gov...
http://www.cdc.gov...

The World Health Organization/Joint United Nations Program on HIV/AIDS - The specialized agency of the United Nations (UN) that is concerned with international public health - describes the efficacy of circumcision as "proved beyond reasonable doubt".
http://www.who.int...

Male circumcision significantly reduced the incidence of HIV in three clinical trials.
http://www.nejm.org...

3 randomized trials have evaluated male circumcision for prevention of sexually transmitted infections. The trials found that circumcision decreases HIV acquisition by 53% to 60%.
http://www.ncbi.nlm.nih.gov...
http://www.jhsph.edu...


Cancer:

The risk of cancer of the penis in an uncircumcised man is one in 600 in the U.S.
http://www.medicinenet.com...
http://www.ncbi.nlm.nih.gov...

The most recent American Cancer Society estimates for penile cancer in the United States are for 2012:
About 1,570 new cases of penile cancer will be diagnosed
About 310 men will die of penile cancer
http://www.cancer.org...

Note regarding the following statistics, that a large majority of Americans are circumcised.
(About 80% - http://en.wikipedia.org...)
"In five major studies in the USA, starting in 1932 [13], not one man with invasive penile cancer had been circumcised neonatal [3]. Another report noted 50,000 cases of penile cancer in the USA from 1930 to 1990, resulting in 10,000 deaths [14]. Only 10 of the cases occurred in circumcised men, but all of these men had been circumcised later in life. Penile cancer is in fact so rare in a man circumcised in infancy, that when it does occur it can be the subject of a published case report [15]. The finite residual risk is greater in those circumcised after the newborn period but is still less than for men who are not circumcised [16]."
http://www.hindawi.com...


The Point Is - CIRCUMCISION CAN & DOES SAVE LIVES.

Risk:

"The generally accepted rate of complications is between 0.2% and 0.6% of operations.[1,65- 66] The most common complications are bleeding and local infection.[65- 66] The bleeding, which is usually a slight oozing, is most often controlled with pressure, and the infection is treated with wound care or antibiotics.[67] While other complications such as phimosis and concealed penis, adhesion's, fistula, meatitis, metal stenosis, and injury to the glans may occur,[68] they are extremely rare.[1,65- 67]
http://www.ncbi.nlm.nih.gov...
-
"Complication rates depend on a # of factors such as competency, equipment, & age of patient.
(In non-infants the rates are greater).
In large studies of infant circumcision in the United States, reported inpatient complication rates are approximately 0.2% [1, 40, 41]. The most common complications are bleeding and infection, which are usually minor and easily managed [1, 40-43].
A recent meta-analysis of 16 prospective studies from diverse settings worldwide that evaluated complications following neonatal, infant, and child male circumcision found that median frequency of severe adverse events was 0% (range, 0%-2%). The median frequency of any complication was 1.5% (range, 0%-16%). Male circumcision by medical providers on children tended to be associated with more complications (median frequency, 6%; range, 2%-14%) than for neonates and infants [44].
In the three African trials of adult circumcision, complication rates for adult male circumcision ranged from 2% to 8%. The most commonly reported complications were pain, bleeding, infection, and unsatisfactory appearance. There were no reported deaths or long-term sequelae documented [16, 17, 18, 45, 46]."
http://www.cdc.gov...

http://www.circinfo.net...;- see chart pg. 1148

Pain:

Local Anastasia - No Pain, No Risk.

Pleasure:

"In addition, particularly in the past 3 to 4 years, objective studies comparing sensitivity and sexual pleasure in circumcised versus uncircumcised men and evaluating measures of sexual pleasure before and after adult circumcision [35–38] have concluded that no clinically significant difference exists between the circumcised and uncircumcised states. This result should come as no surprise in view of the complex psychological, neurologic, chemical, hormonal, and circulatory cascade involved in sexual activity." http://www.pediatricsdigest.mobi...

"Several studies conducted among men after adult circumcision suggest that few men report their sexual functioning is worse after circumcision; most report either improvement or no change [49-52]. The three African trials found high levels of satisfaction among the men after circumcision [16,17, 18, 46]." http://www.cdc.gov...

"A recent controlled study published in the January issue of BJU International, the British Journal of Urology, looked at nearly 4,500 Ugandan men, ages 15 to 49, who were all sexually experienced. Researchers randomly selected half to undergo circumcision, and half to have a circumcision in 24 months. They compared the two groups at six, 12 and 24 months to measure sexual satisfaction and performance.
The circumcised group's rate of sexual satisfaction remained constant, with 98.5% reporting sexual satisfaction before circumcision, and 98.4% reporting so two years after the procedure."
http://articles.latimes.com...

This link lists over 10 supporting quotations:
http://dbp.idebate.org...

-----------------------------------------------

The take away - The potential benefits out way potential risks. - As the APA concluded.

These Potential benefits include life.

Parents should have a right to reduce the risk of their child dieing.

It is certainly not unethical to do something where the benefits out way the risk, & those benefits include life.
--------------------------------------------------

Medical professionals, especially those engaged in setting policy such as bioethicists, must take as their starting point the fact that reasonable people will disagree about what is valuable and what is harmful. They have an obligation to construct institutional norms and policies that do not presuppose or enforce a particular moral or political doctrine. There is a need to differentiate between rituals and practices that are in fact grievously harmful and those which relate to the enhancement of a child’s religious and cultural identity.

In summary, the case against allowing parents to choose whether circumcision is or is not in their son’s interest has not been conclusively made. In our pluralistic society, there will be marked diversity between reasonable conceptions of the good concerning what interventions are valuable or promote a child’s welfare. Even in contexts when such interventions are medical in nature, the potential benefits or risks associated with the child’s welfare concerns will often involve medical, social, and cultural factors. As it presently stands, there is an absence of sufficient evidence or persuasive argumentation to warrant changing the current policy—that parents should have the freedom to make an informed and well deliberated choice as to what's best for their child. http://jme.bmj.com...
FourTrouble

Pro

FourTrouble forfeited this round.
Debate Round No. 5
37 comments have been posted on this debate. Showing 1 through 10 records.
Posted by 1Devilsadvocate 3 years ago
1Devilsadvocate
He skiped round 4 too.
Posted by Maikuru 3 years ago
Maikuru
Why did people vote against Pro because of the forfeit? Round 1 said he was to skip Round 5.
Posted by bladerunner060 3 years ago
bladerunner060
Sorry, in that last paragraph the "it's" is "doing circumcision on an adult who has made the choice"
Posted by bladerunner060 3 years ago
bladerunner060
I'm unclear as to the purpose of the question...I'm saying that children SHOULDN'T be different than adults. An ER doc can intervene in a life saving capacity, but cannot do optional procedures without proven, specific benefits on an unconscious pt. It's called "standard of care".

They might not mind. But what if they do? What if they mind a lot? You're advocating the total removal of a choice based on non-fully-causally-established correlative evidence.

And you cannot deny it's an option. It's not as pleasant an option, perhaps, but thems the breaks when you're dealing with peoples' rights.
Posted by 1Devilsadvocate 3 years ago
1Devilsadvocate
Why should children be different from adults?

& There's also cancer.

& to do It when they're older is not a good option. At that age it's more; risky, dangerous, expensive, uncomfortable, loss of valuable time, embarrassing, painful, etc.
(Not to mention the fact that they might not do it now for a verity of reasons, but wouldn't have minded if it was done as an infant.)
Posted by 1Devilsadvocate 3 years ago
1Devilsadvocate
"and argue that a person's right to bodily integrity is meaningless. If such a right does not exist, then there is no difference between the cutting off of the foreskin and the cutting off of a pinky, because without accepting a right to bodily integrity, there's no reason to prevent a parent from doing it."

How about the fact that it harms the child for no reason.

"bodily integrity" is not needed to explain why harm without reason is wrong.

Harm without reason is inherintly wrong, even if it doesn't involve bodily integrity.

"bodily integrity" is needed to explain why it should be wrong to do somthing to a persons body, even if it's not harmful, & even if it's for a reason.
Posted by bladerunner060 3 years ago
bladerunner060
Do you have a rigorous study of molested children that shows their incidence of HIV is lower if circumcised than not?

I would wager a great deal of money, if I had a great deal of money, that no such study exists.
Posted by 1Devilsadvocate 3 years ago
1Devilsadvocate
"The health reasons do not become an issue until after the child has attained an age of reason"

Are you sure?
Posted by bladerunner060 3 years ago
bladerunner060
On the plus side, it looks like this is going to be a win for you no matter what.
Posted by bladerunner060 3 years ago
bladerunner060
The religious reasons are not valid; I do not find it a compelling argument, as I do not feel that parents have a right to make permanent decisions on religion for their children.

The health reasons do not become an issue until after the child has attained an age of reason, at which point they can make the decision for themselves. You are advocating parents make a permanent decision that is not necessary, that has little to no benefit at the time its made; you advocate that based on STDs (again, I do not think parents should be making sexual decisions for their children), and argue that a person's right to bodily integrity is meaningless. If such a right does not exist, then there is no difference between the cutting off of the foreskin and the cutting off of a pinky, because without accepting a right to bodily integrity, there's no reason to prevent a parent from doing it.

Once a right to bodily integrity is accepted, it seems to me that parents' reasoning must be clear and compelling when the decision is permanent. Considering it is possible to get circumcised later in life when it is actually an issue (although, granted, there are more complications), there seems no compelling reason to ignore the child's rights. I would call your attention to the fact that doctors are forced to get consent for any surgery if the patient is conscious, even if the delay for consent takes precious and necessary time away from the procedure. If you're having a heart attack that's such that you NEED to go to a cath lab or you WILL die, if you're conscious they have to wait until you consent, they don't get to just make the decision for you.
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