Explaining Claims of Medical Benefits

Our science is affected by our cultural values


claimsCircumcision is the only surgery in history ever advocated as a widespread means of preventing disease. In the last fifty years, circumcision proponents in the medical profession have promoted various claims. One medical claim for circumcision is that it decreases the incidence of urinary tract infection (UTI) in the first year of life. However, the UTI studies this position is based on have been criticized by other physicians, most notably by the American Academy of Pediatrics (AAP). They concluded that the test designs and methods of these studies may have “flaws.” A similar study found no confirmed cases of UTI in intact male infants without urinary birth defects. Furthermore, the UTI defense of circumcision is weak, not just because the methods are flawed, but because the logic and reasoning leading to the conclusion are flawed.

The UTI studies do not justify routine infant circumcision for the following reasons:

  1. Even according to the questionable studies, the overwhelming majority (96-99 percent) of intact male infants do not get UTIs in the first year. It is not reasonable to subject them to circumcision and the associated pain without demonstrable benefit.
  2. The studies do not consider the potential harm caused by circumcision. The rate of surgical complications is reported to be from 0.2 to 38 percent. (The higher rate included complications reported during the infants’ first year.) There are at least twenty different complications including hemorrhage, infection, surgical injury, and in rare cases, death. Other harm includes loss of the foreskin and behavioral consequences.
  3. Circumcision involves cutting off normal, healthy, functioning tissue to prevent potential UTI problems in the future. There is no disease or infection present at the time of surgery. If we were to apply this principle in trying to prevent other potential problems, then we would be pulling healthy teeth to prevent cavities. Clearly, this principle is irrational.
  4. UTI is treatable with antibiotics. If good medical practice requires the least intrusive form of effective treatment, then circumcision is not justified. Circumcision is a radical surgical treatment.
  5. Females have a higher UTI rate than males, yet no doctor advocates genital surgery to reduce female UTI.

Most of these arguments would be applicable to any claimed medical benefit. Circumcision advocates can only make the dubious claim that an unlikely or rare condition will be less likely to occur in the circumcised male. This benefit is sufficient justification for many people partly because circumcision is a surgical procedure that is done on someone else. It is pertinent to ask: Would you voluntarily submit to an unanesthetized surgical procedure on your healthy genitals for this “benefit”? The answer is also evident from the fact that intact male adults are not generally seeking to have themselves circumcised. Upon closer inspection, it becomes clear that the flawed reasoning of supposedly reputable studies has contributed to the confusion on the circumcision issue.

Indeed, the medical community itself has acknowledged that it has not maintained very high standards in its published work. Researchers and authors Charles and Daphne Maurer cite an editorial published in the Journal of the American Medical Association:

In a study of 149 articles selected at random from ten widely read and highly regarded medical periodicals … less than 28% have sufficient statistical support for drawn conclusions.

Maurer and Maurer explain why so much “nonsense” is published: (1) Experimental design and statistical analysis are not typically taught in medical school; and (2) medical schools discourage questioning of authorities.

Our science is affected by our cultural values. Circumcision reflects a cultural value, and a principal method for preserving cultural values is to disguise them as truths that are based on scientific research. This “research” can then be used to support medical practices. This explains the claimed medical “benefits” of circumcision.

Blind acceptance of science and belief in “objective” reality is imprudent. There is no such thing as objective observation, because observations are made by people who have inherent theories and expectations about how things should be. Studies defending circumcision make this clear by ignoring vital information (such as the Functions of the Foreskin) that conflicts with observations, results, and conclusions.

Because it is unnecessary surgery, the burden of proof in the circumcision debate rests with those who advocate it. They must show that it is both safe and effective. Neither has been demonstrated.