Australian statement released

[Fellow Traveler]

http://www.racp.edu.au/index.cfm?obj...6C86100E4E3E8E

[Pirogi]

That was ... tepid.

[Fyrestorm]

A bit less non committal than the AAP statement....sad really.

Understandable though...I think for medical associations, coming out strongly against it would mean them admitting that they have been doing unethical surgery on boys for many many years, They have to be afraid that kind of statement would come back to bite them.

[AFWife]

Originally Posted by Fyrestorm

A bit less non committal than the AAP statement....sad really.

Understandable though...I think for medical associations, coming out strongly against it would mean them admitting that they have been doing unethical surgery on boys for many many years, They have to be afraid that kind of statement would come back to bite them.

Can you imagine the lawsuits? It would be like when a drug turns out to be deadly...

[brant31]

This is actually the Royal Australasian College of Physicians, encompassing both New Zealand and Australia. There is also an AMA, the Australian Medical Association. The region of Australasia (literally "southern Asia") encompasses Australia, New Zealand and their outlying territories.

My take on the new statement is that it is not as bold and clear as the previous statement.

What's good: "It is recognised that the foreskin has a functional role, the operation is non-therapeutic and the infant is unable to consent."

"After reviewing the currently available evidence, the RACP believes that the frequency of diseases modifiable by circumcision, the level of protection offered by circumcision and the complication rates of circumcision do not warrant routine infant circumcision in Australia and New Zealand."

What's bad/stupid: They compared circumcision of normal, healthy boys to removal of skin lesions and surgical correction of skull deformities. Then they likened male infant circumcision to bone marrow transplants to save the life of a sibling.

The RACP will one day rue that they ever said this: "Thus infant male circumcision is not ethically unique. Physical risk to children is sometimes tolerated for the sake of psychosocial benefit to them."

The RACP's lengthy defense of the "locker room argument" was puzzling: "The physical health benefits for a male of being circumcised could largely be obtained by deferring circumcision to a much later age [but] the psychosocial benefits, including ... fitting in with family and social group norms, often cannot be obtained unless circumcision is done in the newborn period"

And this was just plain idiotic: "A boy circumcised as an infant may deeply resent this when he grows older; he may want what he cannot have – not to have been circumcised. But it is also possible that a boy not circumcised as an infant (so that he can make his own decision later), may also deeply resent this. He may also want what he cannot now have – to have been circumcised as a baby."

Proof, please, especially in a society that largely no longer circumcises?

[tennisdude23]

I think it's a good statement. I only did a quick skim but from what I read, it looked pretty decent. It was nice that they mentioned human rights, ethics, etc, and honestly, from a large, politically correct organization such as this, I don't expect much more. Interestingly, this statement is much more valid in the U.S. than in Australia, where the circumcision rate is under 10%.

[eepster]

I thought this part was interesting

The procedures utilised in the first few weeks of life do not involve a formal surgical wound
closure and depend for success on secondary wound healing. Those used subsequently
involve a formal wound closure and therefore faster healing. Plastibell circumcision in the
first few weeks of life has the advantage of being cheaper than a formal circumcision
under general anaesthetic later in life.[30] (Level 2).

I found it rather refreshing that they admitted that the actual advantage of doing it in infancy is that it is cheap, not that it has any medical advantage.

[katelove]

Originally Posted by brant31

This is actually the Royal Australasian College of Physicians, encompassing both New Zealand and Australia. There is also an AMA, the Australian Medical Association. The region of Australasia (literally "southern Asia") encompasses Australia, New Zealand and their outlying territories.

Just to clarify, the AMA is not a college but a union and political lobby group. It may have opinions on clinical matters in as much as they impact on political concerns for doctors but it doesn't officially have a role in education or clinical policy making.

[brant31]

Originally Posted by katelove

Just to clarify, the AMA is not a college but a union and political lobby group.

Do you mean the RACP rather than the AMA?

They use the word "college" in its most traditional sense, an organized group of individuals pursuing a common study, vocation or avocation. From the Latin collegium, a society.

I think both the RACP and the AMA have a very real vested interest in ensuring that their members continue to enjoy their livelihood and don't get sued for past or present activities. Hence, the contortions to stress that circumcision is unnecessary but totally legal, OK, popular, safe, interesting and sparkly.

[hakunangovi]

Originally Posted by brant31

And this was just plain idiotic: "A boy circumcised as an infant may deeply resent this when he grows older; he may want what he cannot have – not to have been circumcised. But it is also possible that a boy not circumcised as an infant (so that he can make his own decision later), may also deeply resent this. He may also want what he cannot now have – to have been circumcised as a baby."

NO KIDDING !!! "Idiotic" is a great descriptor.

[needhelpplease]

That part about a boy wanting to have been circumcised as a baby is just stupid.

[AislinCarys]

Originally Posted by Fyrestorm

A bit less non committal than the AAP statement....sad really.

Understandable though...I think for medical associations, coming out strongly against it would mean them admitting that they have been doing unethical surgery on boys for many many years, They have to be afraid that kind of statement would come back to bite them.

Yes... except in this case, neither Australia or New Zealand has a history of circumcising baby boys. Instead you see more and more articles like this:

http://www.stuff.co.nz/life-style/we...rgical-vaccine

promoting circumcision. I had heard that circumcision rates in Aussie were up, but here, it still isn't something I've heard parents debating, yet. It is very rare here, still, I think.

So rather than having to worry about the past (not many circumcised boys, so law-suits not much of an issue), this statement is instead likely to make parents who had never considered circumcision feel like their failing their son if they don't do this new, amazing, modern, technological thing for their son.

[katelove]

Originally Posted by brant31

Do you mean the RACP rather than the AMA?

They use the word "college" in its most traditional sense, an organized group of individuals pursuing a common study, vocation or avocation. From the Latin collegium, a society.

I think both the RACP and the AMA have a very real vested interest in ensuring that their members continue to enjoy their livelihood and don't get sued for past or present activities. Hence, the contortions to stress that circumcision is unnecessary but totally legal, OK, popular, safe, interesting and sparkly.

No, I meant the AMA. The RACP *is* a college. The AMA is not. It is certainly interested in protecting it's members but it does so through political and industrial activity. It is also a generalist body rather than representing a particular specialty or group of specialities as the colleges do. The colleges are responsible for training and ongoing education of doctors wishing to undertake their particular specialty. They are also the ones who create position statements and guidelines on clinical matters.

I have attached links to both the AMA and RACP statements of purpose for further clarification



http://ama.com.au/about/introducing-the-ama

http://www.racp.edu.au/page/about-racp


ETA - The RACP is the one to have released the statement on circ because they recently expanded and joined with the former College of Paediatric Surgeons. The word "physician" in this instance is not being used to describe all persons with a medical degree but a specific group of specialities. There are a number of other "Royal Australasian College[s] of..."

[brant31]

Originally Posted by AislinCarys

Yes... except in this case, neither Australia or New Zealand has a history of circumcising baby boys.

So rather than having to worry about the past (not many circumcised boys, so law-suits not much of an issue), this statement is instead likely to make parents who had never considered circumcision feel like their failing their son if they don't do this new, amazing, modern, technological thing for their son.

Both Australia and New Zealand have an intense history of circumcising baby boys, even more so than the United States or Canada. It has been estimated that New Zealand's infant circumcision rate was almost 100% from World War I right up through the mid-1960's and only began to come down with universal healthcare in the late 1960s. Virtually every male Kiwi-born doctor over 40 is likely to be himself circumcised. Ditto for Australia.

The medical profession in both countries is well-acquainted with this history.

Australia is currently struggling with keeping its infant circumcision rate down. It has risen every year for the past 5 years and is now almost 25% higher than it was earlier in the decade (from about 12% to 15%). A plausible explanation is that the rate fell so far and so fast that it eventually caused something of a panic in some of the older, circumcised population (and their spouses) and they are fighting back hard to preserve what they see as an Australian tradition.

In New Zealand male infant circumcision was largely gone by the early 1970's, so you have 40 years of intact boys and men (except for Samoans). The NZ medical society was much more closely aligned with the British Medical Association than were the Aussies, so NZ's drop in MIC more closely mirrored that of the UK 20 years earlier.

The renewed drive to "dress up" circumcision in Australasia is destined to fail, particularly in New Zealand. It is championed by a small band of die-hard circumcision proponents who are desperate to see a revival. Unfortunately for them, in this information age the ship has already sailed. There will be limited interest from parents here and there, but it will be a boiling day in Antarctica when the Aussie & Kiwi medical associations endorse male infant circumcision. Every year more and more circumcised docs retire and more intact docs enter the profession.

[brant31]

It is interesting that the RACP have produced position statements on virtually every aspect of child upbringing and health, including a specialized document on guidelines for Genital Examinations in Girls and Young Women, but not a single document on Genital Examinations in Boys. This demonstrates that they still don't "get it". Premature retraction during physical exams and at catheterization is a very important issue.

[Papai]

Confusing. The RACP and Australia have otherwise been quite progressive on this issue. Sounds like WHO may have stepped in and asked them to tone it down and play nice w/ the American POV.

[eepster]

Originally Posted by brant31

Both Australia and New Zealand have an intense history of circumcising baby boys, even more so than the United States or Canada. It has been estimated that New Zealand's infant circumcision rate was almost 100% from World War I right up through the mid-1960's and only began to come down with universal healthcare in the late 1960s. Virtually every male Kiwi-born doctor over 40 is likely to be himself circumcised. Ditto for Australia.

That's just the history of the descendants of the Anglo/Irish immigrants. A few Australian aboriginal peoples have practiced some very extreme forms of circ for possibly thousands of years.

[graceomalley]

I work with Indigenous Australians (their preferred term if you're not referring to a specific Nation/Tribe - but if you use the word Aboriginal please capitalise it ) and infant circumcision is practically unheard of (the women I'm close to often speak openly about body modification procedures, but I never initiate these conversations out of respect for their culture).

Circumcision is performed at initiation (which can start at age 12) but many are turning against it. Some forms of genital mutilation (in particular, bifurcation - where the penis itself is cut along the urethra) have become unpopular, but there are lots of other very painful body modifications (scarification is the most common) that are still frequently undertaken. Females undergo painful procedures too, it's not just the men/young boys.

As for white Australians, circumcision is becoming more popular. I keep myself up to date with the latest information so that I can debunk any misinformation and there were a few interesting facts in the statement. One I'll be using against the "it helps to prevent HIV infection" argument will be the fact that in circumcised men infected with HIV, the rate of transmission to female partners is higher. I didn't know that!