Category: Ranting

Hanna Rosin Is Mistaken On Circumcision

Hanna Rosin, guest-blogging for Andrew Sullivan, attempts to dismiss opposition to yesterday’s news about the CDC potentially recommending infant male circumcision.

But the procedure is only “controversial” because people have emotional, psychological and religious reactions to it. Scientifically speaking, it’s not remotely controversial. …

Ms. Rosin’s statement is nonsense because she ignores the ethics of implementing the findings. Her statement is nonsense because it ignores the evidence-based reality for infant males. The child’s genitals are healthy at the moment of surgery. This is not “emotional,” it is fact. Potential benefits do not make the surgical intervention on healthy infant males any more defensible.

Ms. Rosin continues:

… The anti-circumcision sites always refer to the American Academy of Pediatrics’ 1999 policy statement on circumcision, which declined to recommend the procedure. But that statement was issued before the most compelling studies emerged about the role circumcision plays in reducing the risk for transmission of HIV and other STD’s. …

The “most compelling studies” from Africa were performed on adult volunteers, which is the key point before we get to an assessment of the significant differences in the HIV epidemics in sub-Saharan Africa and the United States. The ethical issue can’t be resolved simply by noting that American culture already values the circumcision of males. American culture gets it wrong on what should be permitted on healthy children who do not need medical intervention and can’t consent to cosmetic surgery. Proxy consent must require medical need first, and medical ethics should demand only the least-invasive effective treatment for sick children. Prophylactic infant male circumcision fails both standards.

Ms. Rosin later acknowledges the differences between Africa and the United States, but she seeks to pretend that “the evidence is still pretty strong, and even stronger for STD’s” qualifies as a rebuttal. It doesn’t. The only supported suggestion is that adult male circumcision reduces the risk of female-to-male HIV transmission. Even if that accurately described the American situation, which it doesn’t, wasting finite medical resources on infant males who will not be engaging in any sexual activity, protected or not, for many years is asinine. And unethical, since we must loop back to the evidence-based reality that healthy infant males do not need circumcision.

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At the end of her post, Ms. Rosin raises a separate issue, apparently as a “gotcha”.

Over on DoubleX, KJ Dell’Antonia makes the good feminist point. With the HPV vaccines, conservatives raise a fuss that removing the risk of STD’s will make girls more sexually promiscuous. In the circumcision debate, silence on the promiscuity front.

There’s a double standard. What does that prove with respect to justifying infant male circumcision? Because a group of people make a stupid, sexist assertion about one point, their silence on another human sexuality topic confers credibility to the intervention? Focusing on this gives the unserious nutters too much credit.

Anyway, it’s far more logical to highlight the double standard inherent in having anti-FGM laws in America that prohibit parents and doctors from altering the genitals of female minors for any reason other than medical need, including the cultural and religious claims of the parents, while leaving open the option for parents to circumcise healthy male minors for any reason. There are important caveats to raise in the differences in male and female genital cutting, but the ethical question involves basic human rights. When considering that less invasive cutting is prohibited on female minors compared to what is permitted (and potentially encouraged) on male minors, the difference is in degree, not in kind, and can’t be swept away with the same tired deference to potential benefits. But that would involve addressing the issues rather than side-stepping them to score cheap rhetorical points and declaring victory.

Because… HIV!

It’s easy to talk about “public health” as if we’re all in one giant collective, with the same needs and desires. But that’s not true. We are each an individual, with specific, unique considerations. It is foolish to pretend that one approach is sufficient for everyone. It is offensive to behave as though the recipient of that one approach is irrelevant to whether or not it should be applied. Consider:

Public health officials [at the Centers for Disease Control and Prevention] are considering promoting routine circumcision for all baby boys born in the United States to reduce the spread of H.I.V., the virus that causes AIDS.

The article is little more than the latest 6th Grade Current Events drivel churned out from the New York Times’ “Promote Infant Male Circumcision” template. Guess where the author/editor placed this paragraph in the story:

Circumcision is believed to protect men from infection with H.I.V. because …

The paragraph demonstrating that scientists do not yet understand how circumcision is supposed to reduce the risk of female-to-male HIV transmission should probably appear early, before the committed sentiments from those wishing to transfer the findings on adult volunteers in Africa to infant non-volunteers in America. Yet, it’s the last paragraph in the article. 916 words precede the significant fact that advocates do not yet know the relevant fact to support what they now wish to force on children.

Unsurprisingly, the word ethics appears nowhere in the article. The mere suggestion of potential benefits, despite the irrefutable fact that they are not needed and the high probability that they would not be desired, is enough to take pro-infant circumcision advocates seriously when the logic of basic human rights and medical ethics demands that we dismiss them from polite company. Instead, this passes for “serious”:

But Dr. Peter Kilmarx, chief of epidemiology for the division of H.I.V./AIDS prevention at the C.D.C., said that any step that could thwart the spread of H.I.V. must be given serious consideration.

“We have a significant H.I.V. epidemic in this country, and we really need to look carefully at any potential intervention that could be another tool in the toolbox we use to address the epidemic,” Dr. Kilmarx said. “What we’ve heard from our consultants is that there would be a benefit for infants from infant circumcision, and that the benefits outweigh the risks.”

Does “any potential intervention” have any ethical limitation? Removing the boy’s penis would surely solve the transmission problem. Is that acceptable?

I am, of course, being intentionally ludicrous. Removing a boy’s penis is not what Dr. Kilmarx is suggesting. Yet, he is promoting a mentality that how he fears HIV and values prevention is the only acceptable approach. Therefore, any intervention he deems appropriate must be appropriate. Because… HIV!

It will not work, for several key reasons, all easily identifiable and critical to the process:

He and other experts acknowledged that although the clinical trials of circumcision in Africa had dramatic results, the effects of circumcision in the United States were likely to be more muted because the disease is less prevalent here, because it spreads through different routes and because the health systems are so disparate as to be incomparable.
…

There is little to no evidence that circumcision protects men who have sex with men from infection.

Another reason circumcision would have less of an impact in the United States is that some 79 percent of adult American men are already circumcised, public health officials say.

Add to that the reality that any infant male circumcised today to prevent reduce his (already low) risk of HIV will not be sexually active until approximately 2024 or beyond. When he is sexually active, he’ll still need to wear a condom. Circumcision will have added nothing to his life as an HIV prevention. It’s success, however limited it would be, depends upon the male behaving irresponsibly. An assumption that a boy will be irresponsible is not a valid justification for the surgical removal of a healthy, functioning body part.

Yet, that basic human right – the same right accepted and codified for female minors – is denied to male minors for nonsensical reasons:

The academy is revising its guidelines, however, and is likely to do away with the neutral tone in favor of a more encouraging policy stating that circumcision has health benefits even beyond H.I.V. prevention, like reducing urinary tract infections for baby boys, said Dr. Michael Brady, a consultant to the American Academy of Pediatrics.

He said the academy would probably stop short of recommending routine surgery, however. “We do have evidence to suggest there are health benefits, and families should be given an opportunity to know what they are,” he said. But, he said, the value of circumcision for H.I.V. protection in the United States is difficult to assess, adding, “Our biggest struggle is trying to figure out how to understand the true value for Americans.”

This is the coward’s path¹. They won’t recommend it, but they’ll tell parents it’s really wonderful and prevents all these scary things. They’ll dismiss the risks and ethics involved, and they’ll ignore the statistics in context. For UTIs, the statistics show that all males, circumcised and intact combined, face approximately a 1% risk of UTI in the first year of life. The majority of those UTIs are easily treated without circumcision. Those that are not are generally caused by anatomical abnormalities, not the presence of the normal foreskin. [ed. note: Links when I can find them. It’s late.]

But none of that matters to those who believe that parents should decide what is best for their family regarding their son’s foreskin. We don’t extend this appalling idea that the family owns the foreskins of its sons to the genitals of its daughters. No, a female minor’s genitals belong to her, regardless of the parents’ opinions. That’s critical in displaying the hypocrisy and cultural blinders because the advocates are only discussing opinion. They’ve established a perceived value to non-therapeutic male circumcision. They’ve endorsed that with the power of their titles to those parents who want to believe the same illogical conclusion. Because they value it, they can’t conceive that the healthy child who will be surgically altered could possibly mind. He wants it, don’t you know, because dad likes it and mom likes it and what if his classmates laugh at him or girls won’t have sex with him? He needs to have less to be enough. And because… HIV! That he could conclude that non-therapeutic circumcision performed on him as an infant is mutilation is inconceivable. The person who believes that is allegedly the fringe lunatic who rejects the public health. Because… HIV!

To the CDC: My non-therapeutic circumcision as an infant was mutilation. My parents had no legitimate authority to request it. The doctor had no legitimate authority to perform it. I do not value circumcision for me. I never will, no matter how much your unethical experts tell me I should. I have never and will never need any HIV risk reduction because I do not engage in unsafe sex. Should I encounter any of the other medical maladies discussed in relation to circumcision, I will prefer the least-invasive effective treatment available. I believe in evidence-based medicine, particularly the simple-to-understand truth that healthy genitals are evidence that no surgical intervention is ethical on a child. Not even on the genitals of American boys.

¹ It is also why appeals to the authority of an organization like the AAP are unwise. They may present a (barely) acceptable tone today, but tomorrow is always a new day to be irration
al.

Training To Do As We’re Told

I haven’t blogged nearly enough recently, or in the last year. Blah, blah, blah. The only reason I’m raising that point is because today’s the 6th anniversary of Rolling Doughnut. I’ll only remark in jest that I should wipe one of those years off, given the breaks I’ve taken recently. But that’s not fair to myself since I’ve still managed nearly 200 entries in the last year. I just need to be more consistent.

That’s a meta way to advance to today’s story, which is strangely related to my post marking last year’s anniversary. Last August 16th, you’ll remember, I had an adventure with TSA and an experimental, voluntary search that I refused because I could. They didn’t like that, not that it surprised me. But it made the point that we’re becoming a more complacent society, that we’ve agreed to stop valuing liberty when it comes to being searched. The appearance of safety is enough for most.

Today, I purchased Madden 10 at Best Buy. This should be a simple process. Instead, it involved asking for it at the register, the cashier charging me for it, me paying, the cashier giving the game to the security person at the door, and me showing my receipt to the security person. This is two¹ steps too many.

I stated my displeasure to the security person. I’ve done this before, so I knew I’d get the same explanation. Best Buy (or any store) can explain that it’s to guarantee the customer gets what he paid for, which is nonsense. Even if that’s true, my perception is that the store doesn’t trust its customers. At best it suggests they don’t trust their cashiers. If that’s the case, they should spend the time they’re wasting with me on training or different oversight.

When I told the security person all of this, he tried to deflect by saying that many stores are doing this. True, and I don’t have to shop at them or Best Buy. To this he responded: “It’s just like you have to stand in line for security at the airport.”

Buying Madden for the Xbox 360 is not like boarding an airplane. Entertaining the notion that it is demonstrates the extent to which we’ve accepted every intrusion, no matter how stupid, inefficient, and unproductive. When a business says “Line up,” we can so “no” by requesting a refund. I didn’t today, but I have in the past. I’m sure I will in the future. But that’s a low cost process. I can always go to Game Stop or Target to buy Madden. If we won’t challenge those without guns, we should expect no better treatment from those with guns.

So, yeah, I’m still here.

¹ Three, really, but I’ll skip the idiocy of the first step.

Where Does the Comparison Fail? Part Two

I compared infant male circumcision to tattooing a child based on a recent example from California. My original analysis translates to this story:

A Floyd County man has been charged with child cruelty after authorities say he tattooed his 3-year-old son.

Floyd County Police Sgt. Teri Davis said Eugene Ashley, 24, tattooed the back of his son’s right shoulder with “DB,” which stands for “Daddy’s Boy,” sometime this spring. The man told police he was intoxicated at the time, Davis said.
…

The children remain with their mother; Eugene Ashley was arrested May 21 and faces charges of child cruelty and tattooing a person younger than 18 years old, the latter being a misdemeanor, Davis said.

Like father, like son. Right? Or is there some limit to parental consent and imposition? Again, both a tattoo and a circumcision are a permanent mark on the child’s body without the child’s consent. There is justifiably a law against tattooing, but there are more dangerous risks – bleeding, infection, amputation, death – involved in circumcision, an unnecessary surgical procedure. This is a double standard with no justifiable defense.

As I wrote in my initial entry:

None of these possible exemptions satisfies the primary ethical flaw in either violation. The act is forced upon the child without his consent. Necessity requires an acceptance of limited proxy parental consent for infant male circumcision that does not exist for tattooing because the probability of a medical need for circumcision is not equal to zero. But when the surgery is unnecessary to the child’s health, circumcision is the same violation, a permanent change to the child’s body without his consent. The disparity in protecting the rights of children is obvious and inexcusable.

For a few opinions on this story, read through the mind-numbing comments at Momania, Theresa Walsh Giarrusso’s blog hosted at the Atlanta Journal-Constitution. Is it informed to have an opinion no deeper than “what we do is good, what we don’t do is bad”?

Yeah, do we get tasers and tear gas?

Via Boing Boing here’s a video of police officers dealing with a naked man at the Coachella music festival. (Link only because the video contains nudity.) The man seems under the influence of something. There is also a large crowd surrounding them defending the naked man. The situation could descend into chaos. These are important caveats suggesting a quick, definitive resolution will be best. They begin with the most reasonable, least problematic solution by giving the man clothing. Only when it’s clear he will not cooperate, they escalate. They’re doing their job.

Once it becomes clear that some level of exertion will be necessary, however, the video shows that the cops opt instead for the Taser. The video demonstrates they chose the lazy route, and they use it – and other harsh techniques – before fully attempting to subdue the individual. At approximately the 2:30 mark, the police wrestle the man to the ground. He continues resisting. Some level of force is necessary and what they’re doing isn’t enough. Their actions become unacceptable at this point. Two officers struggle with him while another officer stands around holding the garment the man refused to wear. There is no obvious reason this officer should stand idly by. It’s clear the man will not voluntarily cover himself, and he’s involved in an active struggle. One of the two officers struggling with the man gets up and prepares his Taser. The previously idle officer now joins the struggle by pouncing on the man, driving his knee into him. Then, the previous officer tasers the man multiple times. They subdue and cover him.

I’m willing to assume they avoided wrestling with him as long as they did because the man was naked and not because they had an urge to ultimately rough him up. Neither is flattering to the police because dealing with this is their job, even if he’s naked. But it’s understandable. Yet, to avoid the physical effort required by their job once they’d committed to arresting the man, they used unnecessary force (repeatedly). And, although they did not trigger crowd involvement beyond words, they pushed the situation closer to what they tried to avoid in the beginning than they should have. This is an example where police used the Taser as an alternative to effort rather than as an alternative to deadly force. They wouldn’t shoot the man for not cooperating. They shouldn’t have tasered him.

Do Children Have Any Rights?

Any point in the long line of events leading to the Supreme Court hearing a case on the strip search of students by school officials demonstrates that we’ve collectively lost our minds. It’s easy enough to shout “Will no one think of the children,” and I will. Will no one think of the children? Not as an emotional plea, although that is valid. This is a demand for recognition that children are individuals, as well, with the same complement of rights protected by the Constitution. We can debate the degree to which they are fully vested versus held in “trust” (e.g. free speech), and that’s a useful debate. This is not that.

None of the lawyers had a particularly easy time of it. Matthew W. Wright, representing the school district, said that intimate searches should be allowed even for the most common over-the-counter drugs.

“At some point it gets silly,” Justice David H. Souter said. “Having an aspirin tablet does not present a health and safety risk.”

Mr. Wright did draw the line at searches of students’ body cavities, but only on the practical ground that school officials are not trained to conduct such searches. Mr. Wright said there was no legal obstacle to such a search.

Mr. Wright, and the government, may have a legal point on this topic using strict semantics. But the moral question is clear. These children own their bodies. They are due the same respect and dignity we offer to adults. (We violate the rights of adults. The point is that we violate the rights of children more.) Anyone who would propose that school officials could legitimately perform a body cavity search on a student if properly trained has lost his way.

I know enough to understand that the questions asked by Justices are not necessarily indicative of the eventual outcome. With that caveat:

Without intimating a view on the ickiness of what Mr. Wolf had described, Chief Justice John G. Roberts Jr. suggested that the law might treat different undergarments differently. “The issue here covers the brassiere as well,” he said, “which doesn’t seem as outlandish as the underpants.”

Not as outlandish, perhaps, but according to whom? The student, or does her (or his) opinion not matter? I know, DRUGS!@#$!@!!!. But, is there any room for the consideration that the person searched might find exploring her brassiere outlandish? If we extend this to even younger students, as a ruling in the school’s favor surely would over a short period of time, would a female student who develops breasts earlier than her classmates be self-conscious of this fact? Could it be mortifying to have her brassiere searched? Is there a “breast-no breasts” exception to the Fourth Amendment, or just a general view that children have no rights?

“My thought process,” Justice Souter said, “is I would rather have the kid embarrassed by a strip search, if we can’t find anything short of that, than to have some other kids dead because the stuff is distributed at lunchtime and things go awry.”

Notice that Justice Souter states what he would rather have when comparing the strip search of a minor and an event that has no verifiable examples. This is the same idiocy that states that pre-emptive, legalized torture is acceptable because there might be a ticking time bomb. What is done is subservient to why the actor does it because DRUGS!@#$!@!!!.

Radley Balko sums it up best:

It’s a little troubling to see how comfortable these old men (Ginsburg isn’t quoted in the article) seem to be with allowing school administrators access to the genitalia of school children based on nothing more than a hunch that they might be “crotching” some ibuprofen.

At this point, the drug war really can’t be parodied, can it?

This is madness.

John Cole offers a good summary of this case, titled “I’m Not a Lawyer or a Constitutional Scholar”:

And as such, will probably not understand the legal intricacies of this case that was debated in the Supreme Court yesterday. However, I can state that as someone with an IQ over room temperature, the fact that we are debating whether it is appropriate for school authorities to strip search kids is a sure sign that something has gone horribly, horribly wrong with this country and our sense of perspective, and I blame the war on drugs.

That’s succinct to the point of perfection.

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I got the Balloon Juice link from Doug Mataconis at Below The Beltway. I no longer read Balloon Juice, even though Mr. Cole provides excellent commentary like the quote above. His update to the post reminds me why I no longer read. After an excerpt from a linked summary he introduces with “Government by old men afraid of advil is disgusting”, Mr. Cole writes:

Where is the outrage? Oh, yeah. They are too busy protesting the fact that Bill Gate’s taxes are going to go up 3%! Tyranny!

Link to examples, if they exist. I’m sure they do. But it is shrill and unfair to mock – out-of-context – someone’s opposition to another issue and imply that agitating for one issue makes having a coherent position on another topic is impossible. This is common, as I’ve experienced, but it’s a pathetic tactic in any context. If someone has made up his mind on a topic, that’s okay. I have, for example. But that person should be prepared to defend himself if he brings up the topic. If not, don’t bring up the topic. Doing so is the sign of an incurious, closed mind.

“Buck Up, Little Camper”

Last week when the government finally released the torture memos, Ta-Nehisi Coates discussed this:

Mr. Obama condemned what he called a “dark and painful chapter in our history” and said that the interrogation techniques would never be used again. But he also repeated his opposition to a lengthy inquiry into the program, saying that “nothing will be gained by spending our time and energy laying blame for the past.”

Obama’s stance is the standard cowardice of politics. Holding criminals accountable for their behavior is an ongoing campaign tactic, applied only to those who are not one’s peers. But it is nonsense if we are to avoid a repeat of this in the future.

Mr. Coates stated why:

I think this is wrong. More than that I think it’s dismissive, silly and bordering on insult to any literate human being. In point of fact “spending our time and energy laying blame for the past” is exactly what the justice system does. By Obama’s logic murderers would go free in the streets. The real question is not whether you’re going to lay blame for the past, but who your [sic] going to lay it on, and for which past. What Obama is really saying in this statement is he won’t hold this particular group accountable, for this particular past.

This is a dangerous course because it doesn’t simply not “lay blame for the past,” it shrugs off arguably the solemn responsibility of safeguarding the future. The price of doing nothing, of not enforcing laws, is the implicit statement that it really is OK to torture, that the most you’ll face is a wag of the finger. The concern isn’t mere vengeance.

This is exactly right. It is obvious that the United States tortured prisoners during the Bush administration. Yes it will be uncomfortable to prosecute high-ranking officials, including a former president. But justice is important if we are to walk back from the insanity of the Bush years. The difficulty in effort and emotion is not a sufficient reason to avoid the necessary task.

Mr. Coates contemplates this difficulty:

All of that said, what really disturbs me about all of this, is that most Americans still don’t think torture is a big deal. I think in the case of Bush, particularly after 2004, we–the American people–got the government we deserved. I think Bush said a lot about who we were post-9/11. I’d like to see some exploration into how to make this torture argument directly to the people. Maybe we can’t. Maybe people really don’t care that much. But if we’re wondering why Obama isn’t willing to press forward, I think it’s fair to also wonder why the people aren’t pressing him to press forward.

I’m not wondering why Obama isn’t willing to press forward. However, the readiness of so many to look away or actively encourage this behavior is disgusting. I suspect I won’t like the answer if we press forward with prosecution. But I’d rather know that people think this than pretend they don’t.

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The title of this post is a reference from here about this:

“Don’t be discouraged by what’s happened in the last few weeks,” he told [CIA] employees. “Don’t be discouraged that we have to acknowledge potentially we’ve made some mistakes. That’s how we learn. But the fact that we are willing to acknowledge them and then move forward, that is precisely why I am proud to be president of the United States and that’s why you should be proud to be members of the C.I.A.”

This way is not moving forward. It is moving sideways until the next time this happens.

From the Archives: The Ethics of Vanity, Part III

The madness continues [emphasis added]:

About 150 patients in the U.K. have already received injections of Vavelta, a foreskin-derived skin treatment aimed at rejuvenating and smoothing skin withered with age or damaged by scarring from acne, burns and surgical incisions, according to a spokesperson for Intercytex, PLC, the Cambridge, England-based company that makes the product. The U.S. Food and Drug Administration (FDA) has not approved Vavelta, nor have any other federal agencies outside the U.K., where it was introduced in June 2007.
…

The fibroblasts in Vavelta are isolated from the foreskins taken from baby boys [ed. note: healthy baby boys], given several months to grow and multiply in the lab, and then packaged into treatment vials that are shipped to a select group of U.K. physicians. Each vial costs approximately 750 pounds, or $1,000], according to the company spokesperson.

I discussed Vavelta in November.

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Last week I saw news links similar to discussed before. And, while I’m happy an ethical issue appeared in the article…

There are also ethical issues to consider, especially if the folks behind Vavelta start paying parents for their sons’ severed sheaths.

… it hints at the wrong ethical issue. Parents do not own their sons’ foreskins. That’s why they don’t have the right to cut them off, much less demand payment for them. If a similar value worked for freshly circumcised adult foreskins, adult males should be free to sell for the highest price. They’re not, because the state thinks selling parts of your body is “wrong”. But taking healthy, functioning body parts from a child for no objective reason without his consent? That’s somehow a valid parental choice. It’s madness.

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There was more in the original post, but it’s not necessary to repeat for this. I’ll add that discarded foreskins from adult males do not work well for this procedure. That changes nothing surrounding the ethical argument that demands stopping this practice.

AIDS relief does not redefine moral behavior.

Although I largely ignore Michael Gerson’s columns because I know it’s going to be feel-good, big government social conservatism, I will defend him on one point from his column today defending ousted PEPFAR coordinator Dr. Mark Dybul and condemning the method of his ouster. Primarily, Gerson states:

A few radical “reproductive rights” groups — the fringe of a fringe — accused Dybul of advocating “abstinence only” programs in AIDS prevention. It was always a lie. Dybul consistently supported comprehensive prevention efforts that include abstinence, faithfulness and condom use — the approach that African governments themselves developed. …

I conducted a quick search to find proof on what I know about PEPFAR and found this quote from the New York Times, from December 14, 2006:

[Dr. Dybul] also warned that it was only one new weapon in the fight, adding, ”Prevention efforts must reinforce the A.B.C. approach — abstain, be faithful, and correct and consistent use of condoms.”

So Gerson’s point that Dr Dybul is being unfairly attacked on these grounds is accurate.

However, the “it” Dr. Dybul refers derives from the previous paragraph in the New York Times story, an angle I knew I’d find in my research.

Dr. Mark Dybul, executive director of President Bush’s $15 billion Emergency Plan for AIDS Relief, said in a statement that his agency ”will support implementation of safe medical male circumcision for H.I.V./AIDS prevention” if world health agencies recommend it.

From PEPFAR’s male circumcision brief, updated January 2009, here is a sample of PEPFAR’s work:

In Zambia, PEPFAR continues to support a broad approach to prevention which includes male circumcision. Safe and effective medical male circumcision services are now provided at various sites to reduce new HIV infections and other sexually transmitted diseases. Working with the Ministry of Health, male circumcision is offered at the University Teaching Hospital in Lusaka and the General Hospital in Livingstone, as well as through satellite facilities. PEPFAR is also supporting training, public health evaluation on neonatal circumcision, and the development of comprehensive prevention messages to accompany medical male circumcision services. [emphasis added]

This is an action overseen by an individual Gerson describes as “a great humanitarian physician — a man of faith and conscience”. I have no reason to question the second claim, but one and three are demonstrably false.

I do not expect anything better from the Obama administration’s eventual pick to replace Dr. Dybul. Always remember that when public health officials talk about voluntary, adult male circumcision, they never mean voluntary, adult. Never.

Creating a Market in Coupons for Dead Technology

For those who can’t wait to have government take over health care and make it super fantastical and free, maybe another example will demonstrate the fallacy of this idea. The ongoing stupid party surrounding the subsidization of television as a right inherent in Congressional action protecting consumers from the forced national conversion to digital television continues with a new twist: Consumers have already demanded more $40 coupons than Congress authorized.

As of this past Sunday, consumers who request a $40 coupon to help offset the cost of a converter box are being placed on a waiting list. They may not receive the coupons before Feb. 17, when full-power television stations will shut off traditional analog broadcasts and transmit only digital signals.

Members of Congress are now scrambling to find ways to allocate more money to the program.

“We saw a massive spike in coupons in the past six weeks,” said Meredith Atwell Baker, head of the National Telecommunications and Information Administration, an agency within the Commerce Department that runs the coupon program. She said a record 7.2 million coupons were ordered in December, while the agency was expecting roughly 4 million requests. She urged consumers to make sure at least one television set is ready for the transition, with or without a coupon.

The government guessed incorrectly in its attempt to centrally plan the American television viewing method and failed to fund nearly half the unsurprising demand. When something is “free” (i.e. offered below market value), consumers will demand the service or good more than they would at the market price. Who knew? Yet, Congress is competent to predict exactly how many doctors we need? It can accurately predict how many maternity beds we need?

“[NTA has] left us precious little time to respond,” said Rep. Edward J. Markey (D-Mass), chairman of the House Commerce subcommittee on telecommunications and the Internet. “They’ve created a mess by not admitting that there was not sufficient funding until the very last minute. So now we’re looking for creative ways of solving the problem.”

Perhaps if the market could respond to a signal as clear as rising demand, the price could rise to compensate for a finite supply. Nope. Just get in line and pray enough coupons expire. Or find more money for every critical demand, since every demand is critical. Somewhere.

It’s clear that Congress doesn’t understand the inevitable, arbitrary rationing that results when artificial demand intersects with finite supply. But health care will be different. Somehow.

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Want to know why I’m not a big fan of consumer advocacy groups?

“NTIA is going to stop processing coupons precisely at the time when people need them the most,” said Joel Kelsey, policy analyst for Consumers Union. “Whatever Congress decides to do, it needs to be done as soon as possible to help people through this complicated transition,” he said.

When people need them most. Congress is throwing money around recklessly, with a potential $1,000,000,000,000 deficit for the fiscal year, and we’re discussing television as a need worthy of public subsidy. There is no way to advocate for that, unless the system is broken.