Tuesday, January 19, 2010

When, exactly, did Scientific American become Circumcised Americans Magazine?

Is Scientific American exhibiting the sort of bias found generally in American culture regarding circumcision?

First they bought hook-line-and-sinker a new boogeyman, "anaerobic bacteria." More of one class of bacteria (and less of another) became a preventative for HIV with nothing more than an amputative genital surgery, motivated speculation (1), and a gentlemen's agreement to never test or imagine such a hypothesis for females (to whom HIV is equally deadly).

Science shows the most sensitive parts of the genitals are removed by circumcision (Sorrells, et al.). Still waiting for that article.

And now, another data point. Circumcised Americans Magazine writes up a "cost-effectiveness" study concluding that a small African country can circumcise more people for the same money (and, allegedly, ultimately reduce HIV) if they target people who can neither volunteer nor refuse, and on whom the intervention has not been studied: newborns. So much cheaper would newborn circumcisions be, in fact, that the sexually active adults who would (again, allegedly) die of AIDS because they're left intact are acceptable casualties. Why does SciAm fail to note that these models rely on the untested and unproven speculation that newborn circumcision will impact future adult HIV rates? Where is the critical thinking? Where is the science?

This paper reports no hard science. It advocates policy based on economics using speculative models. Despite its policy advocacy, there is no mention of ethics or consent. An accompanying paper, which likens those who question the ethics of removing body parts from non-consenting children to "antiscience and antimedicine extremists" ignores all ethical concerns, too. Circumcised Americans Magazine plays along (just the science, M'am), pretending there are no ethical issues whatsoever.

Scientific Canadian of British Columbia just rejected the idea that this data means their newborns should be circumcised. Scientific Australian is entirely unconvinced newborns under their purview can avoid HIV by having this surgery. Both statements consider the ethical implications extensively. Scientific Brit, Scientific Frenchman, Scientific Swede, Scientific Dane, and Scientific Netherlander all do not believe circumcising their newborns makes any sense after reviewing this data. That is, if the physicians groups in all these countries can be relied upon to review the scientific evidence (as the American Academy of Pediatrics seems poised to do for Americans).

But Scientific American, hailing from the land of modified penises, staffed (one could reasonably guess) predominately by non-intact men (and those who know and love non-intact men) is quite intrigued by the idea of circumcision, at any age, in any place where the dispassionate science shall lead!

Onward, Scientific American! Let microbes which fare better in dry circumcised penises thrive, and let there be no safe quarter for those "oxygen hating" menaces which prefer intact male (and presumably female) anatomy!

Onward, Circumcised Americans! Let no lack of data on newborn circumcision keep us from the tiny, ethically neutral steps from adult volunteers in Africa, to non-adult non-volunteers in Africa, to non-adult non-volunteers in non-Africa (like most American Circumcisees!)

And remember: Observational facts like much higher rates of both circumcision and HIV in Americans, versus much lower rates of both circumcision and HIV in Europeans may be discarded because they are not randomized trials.

And the randomized trials? Don't forget, the stated conclusions of the American researchers who conducted them are so beyond doubt that they can never, ever, ethically be replicated! Not in Africa, and certainly not in the United States! Even if it were ethical, there simply is NO TIME to wait for adult outcomes to newborn circumcisions!

Scientific American? I'd like to believe that. But when it comes to circumcision, where is the evidence?


(1) Guus Roeselers calls it "merely a causation hypothesis that was not experimentally addressed in this study."

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