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#1 of 9 Old 10-27-2003, 08:46 PM - Thread Starter
 
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Well, here's the outline. Will it work? It's very limited(dh could probably go on for hours)unfortunately.

C I R C U M C I S I O N

Topic: Circumcision
General Purpose:To Argue
Specific Purpose:To argue that routine circumcision is unjustified.
Central Idea:Routine neonatal circumcision lacks significant medical evidence to justify it and is unethical.

Introduction

{Play Audio Tape}
{Show Picture}

I.[attention getter] Imagine having all new born baby males’ noses and fingers removed because it would prevent arthritis or sinus infections. Circumcision is performed using this same form of logic.

II.[position on issue] Routine neonatal circumcision is unjustified and lacks medical evidence to support circumcision; and routine circumcision is unethical.

III. [reason 2] Routine circumcision lacks medical evidence to support circumcision and does not overcome potential risks.

A.According to the AAP “The absolute risk of developing a UTI (Urinary Tract Infection) in an uncircumcised male infant is low (at most, ~1%) .”
1.The American Medical Association (AMA) says “approximately 100 to 200 circumcisions would need to be performed to prevent 1 UTI .”
a.The American Academy of Pediatrics and the Canadian Paediatric Society have both recently pointed out that breastfeeding has a protective effect against urinary tract infection in infants .

B.The American Cancer Society (ACS) states “researchers believe that infection by human papillomavirus (HPV) is the most important avoidable risk factor for penile cancer .”
1.ACS also states that “Circumcision alone is not the major factor preventing cancer of the penis10.”
2.ACS also states “it is important … avoiding known penile cancer risk factors – having unprotected sexual relations with multiple partners (increasing the likelihood of human papillomavirus infection) and cigarette smoke10.”
3.AMA on penile cancer says “because this disease is rare and occurs later in life, the use of circumcision as a preventive practice is not justified9.”




C.The risks for circumcision complications are virtually impossible to find since many complications occur after circumcision and are not reported as a complication, but as a separate unrelated incidence.
1.AAP says “the true incidence of complications after newborn circumcision is unknown … complications such as recurrent phimosis, wound separation, concealed penis, unsatisfactory cosmesis because of excess skin, skin bridges, urinary retention, meatitis, meatal stenosis, chordee, inclusion cysts, and retained Plastibell devices,” as well as “amputation of a portion of the glans penis, and penile necrosis8.”


IV.[reason 1] It is unethical to routinely circumcise newborns.

A.According to the book Circumcision: the Hidden Trauma as many as “33% of many obstetricians and pediatricians are personally opposed to circumcision .”
1.The book also notes that “The United States is the only country in the world that circumcises most of its male infants for nonreligious reasons2.”
B.In an article by George C. Denniston, M.D. on the ethics of circumcision, he quotes the American Medical Association 1992 statement that “it (circumcision) violates a major tenet of medical practice: First do no harm… but not least, circumcision violates all seven Principles of Medical Ethics .”
1.Every doctor after graduating medical school takes an oath to uphold the Principles of Medical Ethics.
2.The AMA is still strongly for routine circumcision often sighting a few insignificant findings on the medical benefits for routine circumcision.
C.In a document from the AAP Committee on Bioethics they state “There are clinical situations in which a persistent refusal to assent (i.e., dissent) may be ethically binding. This seems most obvious in the context of research (particularly that which has no potential to directly benefit the patient). A patient's reluctance or refusal to assent should also carry considerable weight when the proposed intervention is not essential to his or her welfare and/or can be deferred without substantial risk .”
1.In Wisconsin v Yoder, the US Supreme Court held that parental authority may be limited “if it appears that parental decisions will jeopardize the health and safety of the child .”

[Transition: The claim that routine circumcision is unethical is based on the fact that circumcision does not have medical benefits that outweigh the risks. In fact, the benefits don’t even come close.]

V.[refutative argument] “It’s just a flap of skin.”

{Show Card}

A.If laid flat, the average adult foreskin would measure approximately 3 inches by 5 inches; or about 15 square inches. An average adult foreskin comprises an area of tissue large enough to comfortably lay 15 U.S. quarters .

B.“Neuroanatomist Dr. Ashley Montagu states that an area of "normal" skin the size of a quarter (U.S. 25-cent piece) contains more than 12 feet (3.66m) of nerves and over 50 nerve endings13.”

C.In the book The Human Connection it states “Infant circumcision likely deprives the adult male of about 240 feet (73.2m) of nerves and over 1,000 nerve endings. Since Dr. Taylor's research suggests that the foreskin is more densely nerve-laden than "normal" skin, a circumcised man likely loses many times more than 1,000 nerve endings .”

V. [conclusion] From the evidence given routine neonatal circumcision is medically unjustified and unethical.


Thanx for all the links you guys, as always you're a big help.

Megan
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#2 of 9 Old 10-27-2003, 10:24 PM
 
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He is trying to cover a lot of material, but it's all very important.
Sounds great! Maybe he'll convince a few people to do research or at least to think before they circ.

Best of Luck!

I'm just wondering about one thing that you wrote:

<<<<The AMA is still strongly for routine circumcision often sighting a few insignificant findings on the medical benefits for routine circumcision.>>>

Is that a fact?

Because the AAP states it is unnecessary, although, they also state there are "potential benefits" (whatever that means, LOL).
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#3 of 9 Old 10-27-2003, 11:45 PM
 
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I agree with Gitti on that point... the AMA is NOT strongly FOR circumcision... what they are is extremely irresponsible in calling for an END to circumcision... but as far as promoting it- they have tried to back away quietly from that loaded gun.

I would urge you to check the phrasing of the conclusion of the AMA policy on circumcision where they allegedly examine the "decision making" of parents and reveal that parental opinions are not medical concerns and that contributes to the HIGH rate of circumcision... without coming out and saying so in itty bitty words for the population of potential circumcising parents to comprehend - the AMA says... "If parents were acting on our medical advice there would be a much lower rate of circumcision... but for some reason (sheepish shrug) they keep asking us to do them. (grinning elbow to the ribs of the high fiving circumcisers behind him)"

http://www.ama-assn.org/ama/pub/article/2036-2511.html

Quote:
Virtually all current policy statements from specialty societies and medical organizations do not recommend routine neonatal circumcision, and support the provision of accurate and unbiased information to parents to inform their choice. The recent policy revision by the American Academy of Pediatrics also states that analgesia (anesthesia) should be provided for the procedure....

.....A majority of boys born in the United States still undergo nonritual circumcisions. This occurs in large measure because parental decision-making is based on social or cultural expectations, rather than medical concerns.63-67 Studies from the 1980s suggested that the presentation of medical information on the potential advantages and disadvantages of circumcision had little influence on parents' decisions.64-66 This finding was recently confirmed.68 In another contemporary study, nearly half of those physicians performing circumcisions did not discuss the potential medical risks and benefits of elective circumcision prior to delivery of the infant son. Deferral of discussion until after birth, combined with the fact that many parents' decisions about circumcision are preconceived, contribute to the high rate of elective circumcision.67,68 Major factors in parental decision-making are the father's circumcision status, opinions of family members and friends, a desire for conformity in their son's appearance, and the belief that the circumcised penis is easier to care for with respect to local hygiene.
OK- one other point- you wrote
Quote:
B. In an article by George C. Denniston, M.D. on the ethics of circumcision, he quotes the American Medical Association 1992 statement that “it (circumcision) violates a major tenet of medical practice: First do no harm… but not least, circumcision violates all seven Principles of Medical Ethics .”
Is this factual? I'm sort of familiar with Denniston's writing, although I don't know what piece you are refering to. I think that this is a claim of Denniston, not the AMA. Denniston is the director of Doctors Opposing Circumcision and that is part of their statement. Maybe you got confused. If the AMA ever did say it was unethical- please pass the refernce on here- because I would be very happy to hear that!

One of the most "radical" statments on circumcision comes from the CPSS... out of Canada, they come very close to saying it's unethical, and if you wanted such a source, that would be the best I could think of.

http://www.cirp.org/library/statements/sask2002/
"If parents remain adamant in their preference that circumcision be performed, notwithstanding their awareness of the research on the subject, remember that you are under no obligation to perform any surgical procedure for which there are not valid medical indications. You can, and should respectfully decline to perform the procedure just as you respectfully decline to carry out other requested medical acts that you regard to be inappropriate."

...and

"Most physicians would consider it quite unethical to perform facial plastic surgery at the request of parents to make a child look more like his dad. However as a profession, we've often acquiesced to parental requests for circumcision based on nothing more substantive than this same logic."

My last constructive criticism is that you present both sides of the story as if you are debating an issue on the internet where some wise A$$ is going to step in and call you on every little facet that you didn't make a specific point of. But in the rhealm of speach making, if you don't bring it up... it's not going to get brought up... not till the Q&A with the press... sothe UTI thing... why bother? No medical association thinks that the UTI thing is important enough to recomend circumcision... so by saying anything about UTI... you are throwing bones to the argument you are working against. Don't fill your time presenting the case against genital integrity. Don't prop up all their arguments to knock them down... instead you should state your crystal clear case from the git go. "Every human being has an inherent right to posess their whole body. " (or whatever)

Here is an example of what I am talking about- go back and read the AMA quote I just gave about parental decisions... do they ever mention the decisions of parents who DON't circumcise? Nope?! Do they ever look at OUR motivations? nope. Do they ever mention our reasons? nope. They forgot to. Whoops... big whoops.. it was no accident- the AMA purposly forgot to mention the anti circ reasons- ethics, compassion, and integrity because to even mention our reasons would be throwing us a gigantic bone right into their statement... so they pretended that we don't exist on the radar... similar idea I am proposing to you. Only you would be in the right where they are in the wrong. Your argument is above all the pro circ arguments so don't even take that question- stick to your purpose rather than be derailed by the quibbling nonsense of fractions of percentiles. Genital Integrity is above all that.

I wish I could be there to hear the speach!

Love Sarah
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#4 of 9 Old 10-28-2003, 06:22 AM
 
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Your dh's speech sounds like it's going to be great - and I'm sure it will make at least a few people sit up and actually think about this issue.

This might be a bit too graphic (and involved) for a classroom speech, but I always think it is very thought-provoking when people are actually told what the function of the foreskin is - as a protective covering for the glans, its role in intercourse, etc. I know that after reading all of that, there is no way I could EVER cut off such a clearly functional piece of someone else's body.
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#5 of 9 Old 10-28-2003, 12:53 PM - Thread Starter
 
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This is Bloobug's DH. On the issue of the Goerge C . Denniston qoute, I have it refrenced from his paper "Circumcision and the Code of Ethics." I not using that saying the AMA said it, I am qouting him directly. On the issue of "the AMA is still strongly for Circumcision..." I took that out. I agree that it shouldn't be in there.

About all the boring statistics and facts and boring crap I've put into my speech; I have to. This is an argumentative speech not a persuasive. I have to base all my information from credible sources. I would like to argue more on the ethical side, but it's hard to back that up with reports and statistics since ethics are largely based on personal opinion.

The reason I structured the speech in order of "Medical argument" and then 'Ethical argument" was to show the stupidity of the medical argument. This then gave fuel to the fire to show the ehtical question, "Is routine neonatal circumcision ethical?" I hope that I was able to make the point that it is obviously NOT ethical. LIke I said though, I have to back up what I say, and ethics is very hard to argue since it is largely opinion.

I appreciate all the constructive critisizm, it helps a lot.

Darren
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#6 of 9 Old 10-28-2003, 03:00 PM
 
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I wish I had he chance to take college courses in Ethics- the topic fascinates me. I don't think that ethics are really that subjective, they are ot morals, ethics are a set code or standard.

I am a fan of the TV show "the practice"... (what a hoot it is getting so over the top)- but the running theme of the show is Ethics in Law and the conflict of human morality... and the personal crisis each lawyer has in trying to satisfy their professional and personal expectations of themself.

So not to try to distract you from the direction you are going with this... which I think will make a great speach... I just thought I'd toss out my .02 that I happen to think medical ethics are not a matter of opinion. They are even more concrete than medical practice which is very subjective in how a Dr. might proceed given a certain set of factors...

You are familiar with Margot Sommerville? She has some great ethical quotes about circumcision
http://www.circumstitions.com/Canary.html

and there is also a paper from the BMA:

http://www.circumstitions.com/BMA-ethics.html

Just for extra reference if you need a quote.

Don't mind me Darren- keep up the good work!

Sarah
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#7 of 9 Old 10-28-2003, 10:09 PM
 
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One thing we must remember is that the AMA, AAP and ACOG are in a Catch 22 position. Any negative comments are an attack on a cash cow as well as exposing their membership to legal liability. Since the evidence against circumcision has been building for more than 50 years and other circumcising countries have already taken the lead, there is ample evidence against them. They are walking a tightrope. There is also a very large and vocal special interest group within their membership that has a a strong non-medical interest in continuing the practice unhindered and unfettered. That group will stop at nothing to continue the practice.




Frank
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#8 of 9 Old 10-30-2003, 02:41 PM
 
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Hey, maybe it's too late (and maybe I missed this, but when is this speech? and who's the audience?) but a GREAT source is "What your doctor may not tell you about routine infant circumcision" or something like that. I think it's important to get into the purpose and role of the foreskin, too, if there's time/space. Good luck!
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#9 of 9 Old 11-03-2003, 02:37 AM - Thread Starter
 
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This is Bloobug DH.

Speech is Monday Nov. 3rd.

I already timed out at 7 1/2 minutes, and I can't go over 8. Would love to get into the function of a foreskin, but the time won't allow me. Thanks for all the help everyone.

Darren
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