"It's okay, they use anesthesia now"

[KentuckyDoulaMama]

I'm in nursing school and doing an anti-circ presentation on Thursday.
I'll have 10 minutes in front of a very mainstream crowd (to give you a clue, only one student out of 48 would ever think about nursing in public...everyone else thought it was gross)

We have to have a visual of some sort to go along with our presentation so I'm trying to figure out a way to download/upload (?) the five min version of that circ video thats on the net.

I KNOW the video will really affect some of them and get them thinking BUT my instructor has worked maternity for years and still does and says that its okay for circs now because they use anesthesia and the babies dont fuss & sometimes even sleep right through it, that its not a big deal.
So, what do I say to refute that?

My best friend works maternity and says if the lidocaine is allowed to sit and take effect (she says a full three minutes is needed) then the babies dont seem to mind (btw, she is anticirc).

So, the video showing the baby in mindblowing hysterics will make a point, but what good will it do if it's just followed by the instructor saying circs arent like that anymore, the lidocaine allows them to sleep through it?

If you had 10 mins to educate a crowd, what would your main points be, what would be most important to get across?

Thanks.

[Pandora114]

Bring up the human rights aspect then.

[SunnyBabyIn2005]

Wow, I think the main point to get across would be that there are no medical benefits, no health organizations that promote it and certainly that there is no reason to alter a perfectly healthy human being. Good Luck, I did a pro homebirth presentation in college and only swayed a few people into thinking it was better than the hospital.

[KentuckyDoulaMama]

Originally Posted by Pandora114

Bring up the human rights aspect then.

Yeah, I'm gonna, but I can see their eyes glazing over now.....

A girl did a presentation today about circs and gave the standard talk about how it prevents this, that and the other disease and their is no proof that it affects sexual pleasure at all. :

[bburnie2]

Human rights aspect, the logical/ethical POV and if its ok to circ a boy then why not a girl? FGM bill.....

THOSE would be the main points I would hit. I think hitting the "its not medically nor morally ethical to remove a normal functioning part of the infants anatomy. Being that circumcision is now considered to be a cosmetic procedure, if it is legal, what other cosmetic surgeries can we legally perfomr on unconsenting minors?"

Be sure to let us know how it goes too!!!

Don't be shy, don't back down. YOUR in the right here....

[glongley]

The use of anesthesia does not make performing unnecessary surgery on an unconsenting individual right! Any more than slipping an amnesic drug in a woman''s drink makes it OK to rape her (she won't feel or remember anything).

Make it clear the the foreskin is a normal, healthy, and sexually functional body part. This is a big gap in most people's understanding. (See the anatomy handout at: www.coloradoNOCIRC.org/pamphlets.php) Then hit them with this quote from Margaret Sommerville, bioethicist from McGill University in Montreal, Canada, in her book The Ethical Canary:
"If we view a child's foreskin as having a valid function, we are no more justified in amputating it than any other part of the chil's body, unless the operation is medically required treatment and the least harmful way to provide that treatment."

Also, WRT those who would tout the "medical benefits" of circumcision, read to them the conclusions of the major medical organizations - all of whom agree that it is not medically necessary, that any alleged/potential benefits do NOT outweigh the risks, and none of whom recommend it as a routine procedure. See: Medical position statements summary at www.coloradoNOCIRC.org/pamphlets.php

SInce it's not medically necessary, the bottom line is the ethics (i.e. that it's not OK to remove normal, healthy, sexually functional tissue from an individual who cannot give his consent.) The best medical position statement discussion of the ethics is from the College of Physicians and Surgeons of British Columbia. https://www.cpsbc.ca/cps/physician_r...ual/malecircum

BTW, I'm an RN, AND I grew up in Kentucky! Nurses need to hear this info. Thank you for sharing your knowledge. It WILL make a difference!

Gillian

[Quirky]

Could you show part of the video from Doctors Opposing Circumcision on the functions of the prepuce? www.doctorsopposingcircumcision.org

I definitely think it's good to stay away from the pain argument since that's so clearly refutable. Go for the functions of the foreskin and how much is lost to circ.

Refer to the Cold and Taylor papers from the British Journal of Urology, and discuss the ridged band -- see http://research.cirp.org

You could also throw in some quotes somewhere about how circ should be used to cure masturbation, etc. from the good old days == remind everyone that this is still a procedure in search of a disease to cure. First masturbation, then epilepsy, then TB, then syphilis, then HPV, now HIV -- anyone see a trend here?

See www.circumcisionquotes.com for a whole lot of quotes from doctors past.

Don't forget to mention that ANY female genital cutting is a federal offense -- why do boys get less protection when the foreskin derives from the exact same tissue in both boy and girl fetuses?

[aira]

I'll be your guest speaker about the sexual aspect... Doesn't affect it at all, my *ss. : Let me guess, she's probably about 20?

[bri276]

Stories from mothers whose infants developed infections/died after circ (available on the internet). I don't know how anyone with a heart or conscience can support circ after hearing those.

[Quirky]

Originally Posted by KentuckyDoulaMama

Yeah, I'm gonna, but I can see their eyes glazing over now.....

A girl did a presentation today about circs and gave the standard talk about how it prevents this, that and the other disease and their is no proof that it affects sexual pleasure at all. :

I would DEFINITELY bring up the Taylor/Cold & Taylor papers. British Journal of Urology papers discussing highly specialized sensitive tissues that are lost to circ. You can get them by searching on Taylor at www.cirp.org or at the BJU website.

Also note that the so-called "studies" of circed vs. intact have been of penises wiht the foreskin retracted. Well, duh. Shows that circed researchers can't get around the idea that perhaps the glans is not the be all and end all of sexual sensation.

[Quirky]

Here's a great link on the disease front:

http://pediatrics.aappublications.or...18/5/1971#4694

[ollineeba]

Good luck with your presentation. What you're doing is SO important!
I'm starting nursing school soon and I'm dreading stuff like this.. the 'circ is fine' attitude
Let us know how it goes!

[+stella+]

might dig up some info on how it hurts the early breastfeedeing relationship. I cannot tell you how many people I know did fine the first few days of bf-ing and it all went down hill after circ. I think in the list at the top of the forum there are links on info on that. How it harms bf.

[bburnie2]

Originally Posted by +stella+

might dig up some info on how it hurts the early breastfeedeing relationship. I cannot tell you how many people I know did fine the first few days of bf-ing and it all went down hill after circ. I think in the list at the top of the forum there are links on info on that. How it harms bf.

I disagree- I agree it harms bfeeding, but I disagree that she should mention this- she has 10 minutes to CONVINCE or at the least get ppl thinking about it. The bfeeding issue can be easily refuted and/or argued.

The ethical aspect is one area that NO ONE can refute or argue with. They might try but they won't get far. Whereas circ affects bfeeding, but whats disrupted can and often does fix itself within a few short days or weeks...so ppl who alreayd think circ is ok are not going to be that impressed with something that *is* correctable in time... hope that makes sense....

If it were me I would hit hard on:

Functions of the Foreskin
Medical organizations and what they say-
Circ is cosmetic
Ethics of a cosmetic surgery on an unconsenting infant where normal, healthy tissue is removed.

These alone could take up 30+ minutes.....

[Acksiom]

My suggestion would be to point out the fundamental standing inherent flaw to all attempts to justify the routine 'medical' prepucectomy of male neonates: the complete and utter absence of any objective support whatsoever for the 'automatically disposable' status which is uniquely, out of all other body parts, applied to the male prepuce.

This is the fundamental wrongful assumption upon which all 'medical' male neonatal prepucectomy necessarily rests, and it has absolutely no objective standing in research or observation whatsoever. None.

I would hammer that point home as much and as hard as possible. And in support of it, I would mention this, of which I was recently reminded:

http://www.stopinfantcircumcision.or...ionArticle.htm

Everybody should read that, if they haven't already. Money quote: "We were told that while male circumcision was legal under all circumstances in Canada, any attempt to study the adverse effects of circumcision was strictly prohibited by the ethical regulations."

Just. . .wow.

Also, come to think of it. . .does anybody have a cite handy for the cost/benefits analysis that was done which found that routine neonatal prepucectomy was always a health and finances loss?

[kaylee18]

Also, the two major options for "anesthesia" for circumcision in newborns are

(1) lidocaine injections (the most effective application being a series of four separate injections in a ring around the penis, called a "ring block;" a less effective procedure involves 2 injections, called the "dorsal penile nerve block"). Lidocaine injections are extremely painful: not just the needle jab, but much more the solution itself, prior to the numbing effect. I had no idea how painful until I was prepped for surgery and given lidocaine injections prior to IV insertion attempts. Each shot was like a nasty hornet sting multiplied by 50, and lasted at least 30 seconds before slowly numbing down. By the time they tried the 4th place, I was hyperventilating from the repeated pain. And I was not being injected in particularly sensitive places. Tell them to experience a series of lidocaine shots firsthand before claiming that anesthesia can make the process painless.

(2) EMLA cream (not as effective in providing anesthesia for the circ as lidocaine in the one comparison study). EMLA is controversial for use in newborns since they don't have a well-functioning system to deal with the methemoglobinaemia it causes. It also has to be applied and covered for 90 minutes or longer in order to take effect. Since EMLA contains both prilocaine and lidocaine, I doubt it could be used in combination with lidocaine shots, and certainly have seen no reports or studies of a combination being tried. EMLA works very well to numb the pain of IV's, blood draws, and shots, but it does not penetrate well enough to provide sufficient numbing for procedures such as heel lancing. It's painless to apply and better than nothing, but doesn't fit into hospital scheduling and does not provide full anesthesia.

I expect that straight topical lidocaine cream may also be used for "anesthesia" though it is pretty much useless for any pain beyond that of mild sunburn.

By the way, the researchers of the lidocaine/EMLA/placebo trial also compared the pain of lidocaine injection with the pain of non-anesthetized circumcision and concluded that, although lidocaine caused severe pain, it was less pain than the amount experienced during non-anesthetized circs. Hardly a ringing endorsement for better living through chemistry.

Post-operative pain relief is also not offered. That's at least 3 days of an open wound on a penis with no anesthesia.

See http://www.cirp.org/library/pain/ for a comprehensive discussion of the pain aspect.

[SammyJr]

Put things in perspective and show the hypocracy.

UTIs (and other infections) are typically not life threatening and not a problem if they do not recur. Little girls get UTIs more often than any boys but no preemptive surgery is offered. Girls and circumcised boys receive antibiotic care for UTIs, why can't intact boys? If there is a surgical option offered to girls and circumcised boys, it is not (additional) genital amputation.

Penile cancer is extremely rare. It is more rare than male breast cancer. Women get breast cancer at a rate of 1 in 9 or so. Would we consider removing the breasts of baby girls to reduce their future cancer risk? The American Cancer Society does not recommend circumcision to prevent any cancer.

Cervical cancer is largely caused by the HPV virus, an STD. Other risk factors include smoking. The American Cancer Society does not recommend circumcision to prevent any cancer. If the removal of part of a woman's genitals were to be shown to reduce the risk of cervical cancer, would you perform that surgery at birth?

STDs are largely a product of behavior. If one practices safe sex, their risk of STDs is reduced for both men and women. Even if circumcision does offer a degree of STD protection, a condom is still required. If removal of a part of a woman's genitals were to offer STD protection, would you perform that surgery at birth? Why is a man not allowed to determine if this alleged reduction is right for him when he is older? After all, he might be an avid safe sex enthusiast or wait until he is married to have sex.

What other parts of a baby's body can be removed without a medical reason? Why is the foreskin considered disposable? Why isn't this decision left to the man? Why don't we remove earlobes?

Talk to your peers. Find out what other myths and legends they believe and put it in perspective!

[PJJ]

The video on prepuce

I think the video on the function of the prepuce is very convincing to medical folks since it is meant for them and many nursing students are accustomed to this time of video.

Good Luck!

Your instructor will be the hardest sell, since she will have to admit to being wrong for many years.

Folks find it hard to be wrong.

[Electra375]

There is a list out there on syber space of the states who's medicaid programs no long pay for Circing. That should gather some attention. The AAP statement that is is not longer considered necessary... The human rights issues boys vs girls -- that is a good one.

I hope it goes well, but don't be disappointed if it doesn't. 1 out 48 things NIP is gross!!! That is a tough crowd.

[Blarg]

I have three potentially overly-complicated possibilities.

1.

I don't know how formal these presentations are supposed to be, or if they already know what you're presenting on, but you could start out listing all the benefits of amputating a boy's nipples (you'd have to make them up, of course, but you could make them analogous to current purported benefits of circumcision).
Make it sound like that's what you're presentation is actually about. Then part way through fess up to it all being BS. Then simply ask them if they thought any of those things would justify the excision of a baby boy's male nipples even if they were absolutely true.
Then ask: if it's not okay for nipples, why it is okay for the foreskin?

You'll offend a lot of people, but you'll get them thinking. :-P

2.

Alternatively, you could start out by posing the question: is it ethical to amputate a part of someone's body without their consent and without acute medical reason? Keep it general.

It's easy to move on from there. If they know your presentation is about circumcision, many will probably try to get around the question and psuedo-answer it in a way that makes circumcision seem like a valid exception. Don't let them. Make sure they answer the question as stated. Yes, no, or "it depends".

If someone answers, "It depends," ask them what the criteria are for exceptions. Make sure to have a list of comparable amputations for the criteria they will likely answer with (including hypothetical ones, with those benefits, such as, "So if removing the labia minora presented such and such benefits, then it would be okay?").

Dunno, it would be a much more interactive approach.

3.

Alternatively, if you want to (or are required to) avoid interactivity, you could could pose that first question, but in this case not to be answered by the audience. Then you could keep asking questions and answering them yourself.
So, for instance:

Is it okay to excise healthy tissue from a non-consenting person? I think no, but just for the sake of argument, let's say that it depends.

What criteria might we come up with to determine if a particular case is acceptable or not? Well, how about if it presents medical benefits?

What degree of medical benefits would be needed? What if it cut the chances of UTI's by a factor of three? Well, then circumcision would be okay, if we used those criteria.

But what if removing the labia of girls did the same thing? Would it then be okay to amputate a girl's labia?


Anyway, the whole presentation could be a big "thought experiment" on medical ethics and how it applies to circumcision. You could cover medical reasons, social reasons, etc. and refute them with hypothetical (or real, if you can find them) equivalents that people would find unacceptable.

Anyway, those are my shoot-my-mouth-off-and-think-later ideas. Hope this helps.

Also, keep in mind that you're not going to be able to convince die-hard pro-circ people. So please don't worry about them. Your goal is to convince the people that are open to listening in the first place, even if they are currently pro-circ.
The die-hard pro-circ people won't listen, no matter what you say, so don't worry about them. Your presentation should not be for them.