Category: Circumcision

Who told him how atheists think?

When I commented that Michael Gerson is full of wrong ideas, I didn’t expect him to so quickly be the gift that keeps giving, this time with a ramble about questions unanswerable by atheists. I am not an atheist, so Mr. Gerson’s nonsense isn’t directed at people like me. Many of his assumptions are, because the questions answered by belief in Mr. Gerson’s god rely on irrationality. For example:

But there is a problem. Human nature, in other circumstances, is also clearly constructed for cruel exploitation, uncontrollable rage, icy selfishness and a range of other less desirable traits.

So the dilemma is this: How do we choose between good and bad instincts? Theism, for several millennia, has given one answer: We should cultivate the better angels of our nature because the God we love and respect requires it. While many of us fall tragically short, the ideal remains.

How do we choose? This is a trick question, right? How about we use our subjective reasoning to decide what we value most. I could be cruel to someone weaker than me. The opportunity presents itself and it’s in human nature to act on that. Why not act on it?

Mr. Gerson knows the answers, of course, although he only offers one option for the atheist (and non-religious).

Some argue that a careful determination of our long-term interests — a fear of bad consequences — will constrain our selfishness. But this is particularly absurd. Some people are very good at the self-centered exploitation of others. Many get away with it their whole lives. By exercising the will to power, they are maximizing one element of their human nature. In a purely material universe, what possible moral basis could exist to condemn them? Atheists can be good people; they just have no objective way to judge the conduct of those who are not.

It’s not particularly absurd to claim that a fear of bad consequences influences our behavior. If a person has a marginal appreciation for what we consider ethics and morals, however and from wherever they derive, the fear of bad consequences will matter. If that person values something, but is unconcerned with taking from another to acquire it, the threat of prison looms. (Except for politicians, of course.) So he makes a choice. Society responds accordingly, if he chooses what it prohibits.

But that’s not all there is, of course. Mr. Gerson seems compelled to believe that God put in many wonderful features in human nature, yet he implicitly dismisses any concept that atheists might value these features more than the opportunity to cruelly exploit, rage uncontrollably, and so on. If atheists understand that such negatives exist, even if they believe them to be a result of evolution, surely they are capable of understanding and acting on the positives. Such evaluations are subjective. Without God, the evaluation is not doomed to embrace Lord of the Flies.

All of this leads Mr. Gerson to conclude that atheists and theists alike agree that humans “have an innate desire for morality and purpose”. Right, because it’s human nature. This is complicated? But theists are somehow acting rationally because they believe that God is in control of this. Atheists?

In a world without God, however, this desire for love and purpose is a cruel joke of nature — imprinted by evolution, but destined for disappointment, just as we are destined for oblivion, on a planet that will be consumed by fire before the sun grows dim and cold.

Do atheists never find love? Purpose? Meaning? The evidence doesn’t hold up, of course, because there are more than enough atheists to disprove Mr. Gerson’s ridiculous assumption. But it’s pleasant to know that believing in a loving god who has us all “destined for oblivion, on a planet that will be consumed by fire” because we cave to the negative temptations of human nature he presumably gave us is the only reasonable and justifiable position.

**********

Mr. Gerson makes this statement as parenthetical aside in his column, so I didn’t include it in my primary focus. Still, it’s worth mentioning because Mr. Gerson has made this error before.

… An irreverent trinity — Christopher Hitchens, Sam Harris and Richard Dawkins — has sold a lot of books accusing theism of fostering hatred, repressing sexuality and mutilating children (Hitchens doesn’t approve of male circumcision). Every miracle is a fraud. Every mystic is a madman. And this atheism is presented as a war of liberation against centuries of spiritual tyranny.

Forced genital cutting without medical indication is genital mutilation. Forget spiritual tyranny. It is physical tyranny. Mr. Gerson can advocate for the circumcision of male children as often as he likes, and dress it up with as many biblical references as he pleases to justify such mutilation. He will be wrong every time. The medical facts do not support him, but what he implicitly argues here, that circumcision is acceptable because people attach religious meaning to perpetuating it upon male infants, is irrelevant. We live in a civil society of guaranteed, inherent rights. The right to remain free of medically-unnecessary surgery without explicit consent is among those rights.

I will repeat myself as often as necessary. Any god who would demand such an abomination is not a god who deserves respect or allegiance.

There is a comparison to be made.

I hadn’t planned to offer any discussion of male circumcision from the story in yesterday’s entry about FGM. However, it’s important to highlight this description from the article.

The term female circumcision [sic] covers a range of procedures from minor symbolic cuts to the genitals to attacks that involve the complete amputation of external body parts.

That matches what the WHO says about FGM. The question is obvious, but almost everyone wants to ignore it. Why is even a minor symbolic cut on the genitals of a female minor always unacceptable [ed. note: it is], but undeniably more destructive cutting on males is okay?

Because we can look into the future and find potential benefits? Because we pretty up the surgery with religious or cultural significance? Those can be valid reasons for an adult choosing it for himself (or herself), but when applied to children (of either gender), they are nonsense.

Before anyone gets upset, yes, this matters when comparing female to male genital cutting:

Police said instruments such as rusty tin can lids, razor blades and broken glass have been used to cut them, and thorns used to stitch up the wounds.

I’ve always acknowledged that the difference in degree between female and male genital cutting is significant. FGM is also often done to repress or eliminate female sexual pleasure. I readily concede both points.

But neither point is always the case when a female’s genitals are cut. The justifications can be similar. When those non-medical reasons are applied to females, we dismiss them, often labeling them misogynistic. We see through the irrationality.

With males, we are blind. As I’ve said before, it takes more than a clean operating room and good intentions to justify genital surgery on children. Gender should be irrelevant. This is an issue of cutting the genitals of a child without medical indication.

Fighting FGM in Western Countries

Regardless how many laws we make against an activity, that doesn’t mean the activity will cease. The Female Genital Mutilation Act prohibits all medically unnecessary genital cutting on female minors in the United States. Such a law is appropriate and should’ve arisen the first time lawmakers became aware of such barbarism. That it took until the middle of the 1990s is absurd. Still, I am not naive enough to think FGM doesn’t occur either in America or to American girls taken outside the country.

Britain is no different, so London police are making a direct effort to bring attention to FGM:

A £20,000 reward has been offered to bring the first person in the UK to justice for performing female circumcision.
…

A clinic in London is treating up to 500 women every year for health problems linked to female circumcision.
…

[Metropolitan Police’s child abuse unit] warned that many children are taken overseas during the summer holiday to undergo the procedure.

I’m saddened that we live in a world where police have to offer a reward for people to bring such criminals to justice. If that’s what it takes, though, so be it. I don’t imagine we’d find much resistance in the U.S. to such a tactic by police.

Spot the error.

Ronald A. Williams, Aetna’s chairman and CEO, and Troyen A. Brennan, Aetna’s chief medical officer, have an op-ed in today’s Washington Post regarding health-care reform. See if you can spot the flaw here:

…we do not pay for care that is unnecessary according to the best evidence-based guidelines produced by medicine.

Now, journey over to the Aetna’s list of eligible health care expenses and scroll down to the blurb on circumcision, where you’ll find an “X” under “Covered”:

Amounts paid for infant circumcision are qualified medical expenses, even when performed by a rabbi in the home.

According to Aetna, performing unnecessary surgery on children is somehow “evidence-based”. The absence of medical need is somehow “evidence-based”. Parental preference because the foreskin is “icky” or “ugly” or any other irrational opinion parents may have about the body of their child, the patient, it’s still “evidence-based”.

Medically unnecessary genital cutting of infants is not evidence-based, no matter how many potential benefits Mr. Williams and Mr. Brennan can name. (Or how many potential complications and actual results they can ignore.) If they believe there’s evidence to support routine infant circumcision, it’s clear that their medical incompetence extends to ethical incompetence. It’s irrational to place the lack of medical need to the patient (i.e. the one having his genitals cut unnecessarily) below the desire to accommodate parental whims.

Let’s debate, but using only my arguments.

Via Radley Balko comes a bizarre, uninformed attack on libertarians from Amanda Marcotte, at Pandagon. At the entry is a bingo card designed to poke fun at libertarians, except each space is little more than a boiler-plate attack based on uninformed assumptions about libertarians. Mr. Balko calls it trite, which is the perfect description.

I can’t say I’m surprised, though. I had my first introduction to Pandagon and Ms. Marcotte a couple of weeks ago when she blogged her reaction after Egypt banned FGM. We obviously agree on the merits of banning FGM, although I was (and remain) less optimistic about this law’s effectiveness. What irked me then is the same lack of intellectual thoroughness evident in the libertarian bingo card. Her post:

Counting down to the “WHAT ABOUT TEH MEN?!” trolls who want to equate male circumcision with female genital mutilation. Look, you can oppose the former without blowing it all out of proportion. Dan Savage did a bang-up job in The Kid, for one instance of arguing against the practice of circumcision without drawing parallels to a much more horrific practice. And that’s just the first that comes to mind.

That’s a very typical response I encounter. Unfortunately, it’s a weak argument that seems to indicate a willingness to shout down debate rather than engage in a debate open to ideas.

I’ve never said anything contrary to the fact that FGM is almost always worse than male genital mutilation. It’s important that almost always doesn’t get lost in the focus on worse. It does. The World Health Organization recognizes four types of FGM. Not all are more severe than MGM. And not all are practiced specifically to reduce or eliminate the female’s capacity for sexual pleasure. (The outcome doesn’t depend on good intentions, but that could be said about male circumcision, too.) The overwhelming majority of cases are worse, of course, and many are done specifically to affect the female’s capacity for sexual pleasure. But we must not ignore the exceptions. Our ignorance permits us, as a society, to turn a blind eye. That is wrong.

Intellectually, the argument is obvious. Forced genital cutting for non-medical reasons on a non-consenting invdividual is wrong. The violence involved is still violence, and the mutilation is still mutilation, no matter how much the cut individual eventually likes the result or how much society approves. Gender is irrelevant.

Disagreeing is understandable and the precursor to enlightening debate. But squashing dissent before it arrives is little more than forced intellectual conformity. Such non-thinking stifles progress.

To her credit Ms. Marcotte makes several statements in the comments – where the comparison did erupt, to much bandying of the term troll – that she doesn’t support male circumcision, labeling it “a mildly barbaric practice that is cruelty to children”. She is open to more than just what our society believes about cutting the genitals of children. That’s what makes the original statement in her entry so frustrating, and what makes several of her other remarks in the comments section disconnected. For example:

Ah, I figured the false equivalence trolls would come out. Shameless. They probably think cutting off the foreskin is worse that slicing girls apart and letting many die, but they at least know better than to say that. Instead, they just equate the two and imply that anything less than calling circumcision the worst crime ever is supporting the practice.

No, I don’t think cutting off the foreskin is worse than slicing girls apart and letting many die. But that’s not really a fair comparison, is it? As I mentioned, not all forms of FGM are worse than MGM. But where they are, I’m not making a quantitative comparison. We don’t judge whether an action is wrong on the amount of wrong. It is or it isn’t. Qualitatively, genital cutting is genital cutting. That’s the argument, and why there is no “false” equivalence.

In the same comment where she labeled male circumcision “mildly barbaric”, she offered this:

It also troubles me to describe circumcised penises as mutilated when so many owners of them like them that way. Again, they don’t know any different and I think that they should stop to consider that they might be prejudiced, but still, it’s hardly mutilation to the same degree as FGM. …

… I think the proper analogy is to other minor cosmetic surgeries, like Botox injections. My opposition to it is that it’s better to leave well enough alone when the results of interference are dubious at best.

Ms. Marcotte’s absurd comparison to Botox aside, I don’t need to convince happily circumcised men that they’re damaged. If they like it, great. But mutilation is still mutilation. Not everyone is happy with it, and most who aren’t wouldn’t dream of having it done. That and it’s almost universal lack of medical necessity are enough for us to know that both are wrong. Again, both are wrong because they are the same action, medically unnecessary genital cutting forced on a non-consenting individual.

Well, hello (again)

A few stories to catch up from my unplanned absence.

First, Don Boudreaux offered a fascinating comparison of Sen. Barack Obama’s fund-raising and economic populism.

… Last quarter Sen. Obama raised, as the Times puts it, “a whopping $31 million.”

These funds, of course, are all voluntarily contributed. The fact that I, personally, do not care for much of what Sen. Obama espouses is irrelevant: lots of people like what he says. They like it enough to contribute to his campaign. The result, designed by no one, is a huge campaign chest for Sen. Obama. He will be well-financed to pursue his ambition. (In my opinion, this ambition is an especially greedy and venal one, but that’s just my opinion.)

In May, however, the very same Sen. Obama called for Senate hearings into allegedly excessive pay for CEOs of corporations.

The rest of Mr. Boudreaux’s analysis is perfect. When someone earns achieves superior results through voluntary exchange, any action to alter those results by a third party is wrong. “Too much” success notwithstanding.

As I think I’ve mentioned before, I will not be voting for Sen. Obama if he wins the Democratic nomination precisely because he is an economic populist. I did not vote Democratic in the last election to institute economic populism. Severe displeasure at the current administration and climate should not be seen as an overwhelming desire to be economically stupid.

Next, I still think public money for this is questionable, at best, but I like the approach this writer uses to explain proposed funding for circumcision as an HIV prevention.

One of the suggested health campaigns reviewed by the Global Health Program is provision of adult male circumcision to decrease individual likelihood of sexually acquiring HIV infection. Some recently published studies performed in Africa suggest circumcision may offer an impressive 60 percent margin of protection against HIV infection, which is well below consistent condom use and complete sexual abstinence, but far better than any other currently available interventions for men. Ambassador Mark Dybul, who runs the PEPFAR program, told the Council that he would provide funds for circumcision programs if the governments of the 15 countries PEPFAR works with requested such support. But strong concerns have been raised regarding the quantity and skill level of medical personnel required to perform this bloody surgical procedure. Though the procedure itself is inexpensive, adult circumcision risks exposing both healthcare workers and patients to blood-borne infections, including HIV. Diverting scarce health talent to large circumcision campaigns could impede other public health and clinical efforts.

In that context, my only concern is the public financing. The writer mentioned all the key aspects of circumcision as an HIV prevention technique. It should be up to the adult male, it’s effectiveness is significantly outpaced by non-invasive methods, and there are considerable risks to be addressed before applying it to African countries facing a severe epidemic. Radical solutions should be tied to real-world facts, considerations, and consequences.

Speaking of radical solutions needing to be tied to real-world facts, I haven’t seen Sicko yet. I don’t make it a priority to pay for propaganda. Anyway, I’m fairly certain what my opinion will be when I get around to it. I imagine it’ll be something like Kurt Loder’s opinion. (Someone else deserves credit here, but I can’t remember where I saw this link.) The entire piece is worth reading, but I like this best:

Moore’s most ardent enthusiasm is reserved for the French health care system, which he portrays as the crowning glory of a Gallic lifestyle far superior to our own. The French! They work only 35 hours a week, by law. They get at least five weeks’ vacation every year. Their health care is free, and they can take an unlimited number of sick days. It is here that Moore shoots himself in the foot. He introduces us to a young man who’s reached the end of three months of paid sick leave and is asked by his doctor if he’s finally ready to return to work. No, not yet, he says. So the doctor gives him another three months of paid leave — and the young man immediately decamps for the South of France, where we see him lounging on the sunny Riviera, chatting up babes and generally enjoying what would be for most people a very expensive vacation. Moore apparently expects us to witness this dumbfounding spectacle and ask why we can’t have such a great health care system, too. I think a more common response would be, how can any country afford such economic insanity?

I guess we’re supposed to fall back on the argument that it’s somehow free. No need to trouble ourselves with economic laws or evidence that demonstrates those laws or even the nuances of any argument that millions of Americans don’t have health insurance. The facts, although interesting, are irrelevant. Right?

I will see Sicko at some point, if only to understand what stupid people are believing. I don’t really want to give Moore any money, but I’m thinking back to how people paid for a different movie and saw Fahrenheit 9/11 instead. It’s tempting as a “gotcha”, but I wouldn’t do it. Unlike Moore, I consider honesty an asset. Whatever small price he’ll get from my (matinée) viewing is surely worth remaining above his level.

I have more faith in intellect than steel.

Let’s just keep pretending that not can we predict the future, but we also know that future definitively will not contain better treatments for HIV. Or even possibly a cure:

In a breakthrough that could potentially lead to a cure for HIV infection, scientists have discovered a way to remove the virus from infected cells, a study released Thursday said.

The scientists engineered an enzyme which attacks the DNA of the HIV virus and cuts it out of the infected cell, according to the study published in Science magazine.

The enzyme is still far from being ready to use as a treatment, the authors warned, but it offers a glimmer of hope for the more than 40 million people infected worldwide.

Clearly any sense of optimism that the human mind can discover better treatments or a cure is irrational. The only caring action to stave off the inevitable horror of HIV for all humankind is to circumcise infant males shortly after they arrive from the womb. If he’s not circumcised at birth, he won’t live long after he becomes sexually active. He’ll be thankful.

How does one develop a mind closed enough to believe that?

Link via Fark.

P.S. How many more of these articles do we need before people stop believing the unfounded sentiments expressed by a reader’s e-mail to Andrew Sullivan?

Will it be enforced?

Egypt finally banned female genital mutilation. This is a pleasant surprise, and should be commended.

Unfortunately, a recent case in Egypt reveals a key flaw in medical thinking that dismisses complications from unnecessary genital cutting, whether on girls or boys.

In the latest fatality, 12-year-old Bedur Ahmed Shaker was taken by her mother to a private clinic in Minya, a town on the Nile south of Cairo, for the operation. She died before she could be transferred to hospital.

Her mother accused the woman doctor of negligence, charging that her daughter’s death was linked to the anaesthetic and not the removal of the clitoris, for which she had paid 50 pounds. Police have arrested both women.

Any time you read of more serious circumcision complications in America, it’s almost always attributed to some other factor. Claims of negative reactions to anesthetic are common, and probably factually true in most, if not all, cases. But when the cutting is not medically necessary, it is ethically wrong to blame only the anesthetic. If we don’t allow the unnecessary genital cutting, there would be no reason to use anesthetic.

Parents are not psychics.

Familydoc has a frustrating post discussing the medical facts surrounding circumcision. I don’t have any general opposition to the information, and was surprised that Familydoc acknowledged that the medical issue is “a tie”. That’s why I’m stuck to understand how that leaves the decision to parents to choose based on their “religious, cultural, esthetic, but not medical” reasons. Familydoc offers this as an explanation of parental “rights” to justify allowing them to choose non-medically necessary cosmetic surgery.

Since American law accepts that parents have a right to abort their unborn fetuses, as well as to decide where, what, when, and how their born children eat, sleep, get an education, it seems logical that the decision to circumcise or not rests with the parents – as long as circumcision is not intrinsically harmful.

I’m not an attorney, but I can see how that logic is flawed. A right to abortion is about control over one’s own body, unless I’m mistaken. Imposing circumcision on an infant is about control over another’s body. Quite different. And the decision about where, what, when, and how their born children eat, sleep, and get an education do not involve permanent physical changes to a child. If I didn’t get a good education, I have the option to get one later in life. If I was forced to eat food I didn’t like, I have the option to now be vegan. If I was forced to go to bed at 8:30, I now have the option to stay up to watch Stephen Colbert. I’ll add one. If I wasn’t allowed to play with certain kids who didn’t meet my parents approval, I can now hang out all night with those bad elements.

I do not have the option to replace my now-permanently-gone, healthy foreskin.

I left a long comment on Familydoc’s entry discussing the ethics and harm of infant circumcision, so I won’t address those (or the rest of the entry) in great detail here. However, it should be obvious that the harm of circumcision can be subjective, since Familydoc acknowledges that harm occurs. I’m just not dismissive of subjective criteria. Individuals have different, impossible-to-predict preferences. Even on the supposedly insignificant criteria of aesthetic value, the individual’s opinion is what matters.

In society we rightly grant parents the power to make medical decisions by proxy. They can and should work to the child’s (i.e. the patient) best interest. However, when journeying beyond the limited boundaries of immediate medical need, the criteria for allowing such decision-making power must get significantly tougher. As in baseball where the tie goes to the runner, in medicine, the tie must go to the patient, who we can and should assume would demand the least invasive stance necessary. Routine infant circumcision is the most invasive stance, a solution in search of a problem.

Ethics matter. Anything else treats children as their parents’ property.

Via Everyone Needs Therapy as a recommendation following on an earlier post¹.

¹ TherapyDoc’s earlier post, a commentary on an article about Jewish parents opting not to circumcise their sons, lacked a sufficient discussion of the ethics of infant circumcision. TherapyDoc relied on the argument that Jewish identity and culture would diminish, if not disappear, without infant circumcision. I disagree. More importantly, it’s irrelevant in a civil society where inherent individual rights are guaranteed.

A Question Worth Asking

Continuing on the theme of my previous post, comes another unfortunate story:

A 15-year-old boy has died in the Eastern Cape after being circumcised, allegedly by an 18-year-old, the province’s health department said on Friday.
…

Earlier this week another eight unregistered surgeons were arrested for circumcising boys in the Transkei.

I want to make sure I have this right. Circumcision is “good” because it reduces the risk of HIV. We must convince African men, particularly fathers, on the benefits of circumcision. When those circumcisions are done “illegally”, we must be angry and stop it. The approach to stop this type of “illegal” circumcision by traditional healers is to educate communities about the necessity to perform “legal” circumcisions. We have faith that this will work. I think I got it.

So why will education work to teach African men to perform circumcisions correctly but it won’t work to have them learn safe sex practices?