Luckily, I have a forum to grind my axe.

Via Kevin, M.D. I read a recap from a doctor who had to amputate a patient’s finger. It’s an interesting enough story, but something caught my eye in the middle of the story.

… there’s a deeply ingrained taboo that prohibits me from causing permanent damage.

If you read Rolling Doughnut, you won’t be surprised at what immediately popped into my mind. I wonder what this doctor thinks about unnecessary infant circumcision? Based on experience, I guess the answer. I find it, precisely as guessed, here, from three years ago (about a topic I discussed last year):

Note to anti-circumcision trolls: I will ruthlessly delete or negatively alter your screeds about how awful regluar circumcision is, etc. I fully support circumcision done under normal hygenic circumstances. If you desire to grind your axe, do so elsewhere.

I wouldn’t have posted on the entry if I’d seen it in 2004, but I’ve been called an anti-circumcision troll a few times. It’s always a misguided smear offered at the end of a debate by the advocate of routine infant circumcision when his or her only fair response would be to admit defeat in defending the indefensible. The desire to excuse the unnecessary cutting of children is too deep for that, of course.

Wishful thinking about all the possible horrors the child will presumably no longer face – which he most likely wouldn’t have faced anyway, without circumcision, and almost never to an extent requiring surgery – are irrelevant, as are claims about the religious validity of this unnecessary surgery. If anyone should get this, it should be a doctor. Unfortunately, that too often flops in practice. From the 2004 entry, GruntDoc stated this about infant circumcision:

… I believe it is painful to the infant. So is falling down, hitting the coffee table, slamming a finger in a car door. Since I have never read about an infant describing his circumcision, it’s one of those things I think is best done as soon as possible (ask any adult who’s had a circ: it’s like chickenpox, the younger you have it the better off you are).

One painful incident is not like the others in his example.

It’s anti-intellectual to claim that not remembering pain is relevant to the discussion. The surgery is medically unnecessary; no further excuse-seeking is justified. If we factor in the child’s ability to not remember the pain as valid, we may excuse any number of surgical interventions with a potential to prevent future disease. Just look at the prevalence of breast cancer in males. Should we think of the good that can be done for those few men if we remove the breast tissue from the majority of newborn males? They won’t remember it! The thought is absurd, of course. Circumcision is the same. But circumcision advocacy isn’t about facts in context.

As to his last point, I can direct anyone interested to men circumcised as adults who don’t think it’s better. They think they’ve made a tragically stupid mistake. I can also point anyone interested to men circumcised as adults who state that the pain was less than it’s made out to be by the fear-mongers. Are those examples subjective? Of course. But so is the nonsense that all men are happy with being circumcised as infants or that the subjective preference of parents for potential benefits is superior to the subjective preference of the male when there is no medical indication for intervention.

Also, forgive me if I don’t cheer the logic of defending the 100% guarantee of pain imposition on an infant who hasn’t consented, no matter how well forgotten, over the low-single-digit risk that the male would need circumcision later in life, with pain that would be better managed through more effective pain relief techniques. I sympathize with the pain men who need adult circumcision will feel, but life has risks. That’s part of the deal. And the men who merely choose it will get no sympathy because they clearly value whatever benefit they perceive more than avoiding the pain. Yet, I’m supposed to value both equally – to the detriment of infants – through crude analysis implying that delayed pain, however unlikely or unnecessary, is worse than pain now. I will not because I am not irrational. Those few who need or choose adult circumcision should not dictate what happens to healthy infants.

For example:

My main argument for it is hygeine. Yes, many many men take good care of themselves, but you only need to see a couple of men with severe balanitis or penile CA, and the argument gets better. I was once told by a urologist that after a slew of penile cancers / amps following WWI (hard to keep clean in a trench), circ became mainstream more as a preventive med thing than an act of religious faith.

Typically, we (allegedly) must also factor in that a few men will face some consequence from being intact as an excuse to circumcise. Those many many men who take good care of themselves are not to be rewarded for their common sense and ability with an intact body. They are to sacrifice for the good of the few who will be delinquent or incompetent in their hygiene. After all, parents can’t know in advance if their son will practice good hygiene, and they can’t teach him good hygiene. Why assume that he will figure it out? There’s only so much a parent can do. Obviously. Being the good parents they are, they should opt to have his genitals cut, even though it exposes him to the risk of surgery. They’re responsible in a way he could never be.

From GruntDoc’s entry about amputating a finger:

Only after telling myself several times that this was actually no longer a finger was I able to take the sharp implement and cut off most of a finger.

How similar is the descent from reason that permits a doctor to remove the healthy, functioning foreskin from his patient at the request of his patient’s parents?