Talk:Circumcision/Archive 71

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WP:UNDUE weight given to HIV section in lead

The HIV paragraph in the lead does not convey the criticism attributed to it and violates WP:NPOV standards. I suggest changing it to

Circumcision is used therapeutically, as one of the treatment options for balanitis xerotica obliterans, phimosis, balanitis, posthitis, balanoposthitis and urinary tract infections.[10][11] Conflicting evidence exist that indicates circumcision reduces the risk of HIV infection in heterosexual men by 38-66% in populations that are at high risk in conjunction with consistent safe sexual practices to maintain the protective benefit.[78] Garycompugeek (talk) 18:34, 10 February 2012 (UTC)

We've already discussed this at length, Gary. Jakew (talk) 18:40, 10 February 2012 (UTC)

I agree discussion on this lead needs to continue. A minority of authors ignored the policy based criticisms and changed it without consensus. This lead is obviously a turd and needs to be revised until we can come to consensus.Gsonnenf (talk) 04:43, 11 February 2012 (UTC)

There comes a point when endless discussion becomes unproductive, and I think we've passed that point. Jakew (talk) 09:02, 11 February 2012 (UTC)

Respectfully, it's only unproductive for the status quo. It's way past time to re-write the lede. It relies on the United Nations too much. I have a relative who's a veterinarian with the United Nations. He's really opened my eyes about the political control from the top. U.N. medical groups work for the political agenda of their bosses. Chevara (talk) 20:18, 11 February 2012 (UTC)

Regardless of your personal opinion, here on Wikipedia, the WHO is considered a high quality source, and to suggest that it is not will not get you anywhere. If you would like, you can take it up on the reliable sources noticeboard to see if you can get an agreement that the WHO is not reliable, but until that happens, we shouldn't be wasting our time even discussing the topic. Yobol (talk) 20:24, 11 February 2012 (UTC)

I am seconding Gary's suggestion. By word count, almost a quarter of the lead is dedicated to the association of circumcision and lower HIV rates in high-risk areas. By contrast, roughly 10% of the lead discusses a controversy. We still have not been given a reason why such a disproportionate amount of the weight is placed on the health benefits of HIV compared to discussion regarding controversy. Additionally, there is no acknowledgment of opposing viewpoints, even though - using jakew's own numbers - 8% of recent professional opinion opposed to the narrative of circumcision as "strong" evidence (see Talk:Circumcision/Archive_69#Paragraph_Three). Therewillbefact (talk) 22:34, 11 February 2012 (UTC)

WHO is one of many high quality source, though its generally recognized they have a higher degree of political affiliation, and there opinion should be taken in context.Gsonnenf (talk) 01:53, 12 February 2012 (UTC)

We've asked what reliable material from review articles should be added to the "controversy" part of the lede, but have yet to receive any concrete suggestions. "Higher degree of political affiliation" is meaningless in this context. The two sentences on HIV present the consensus of review articles on the efficacy of circumcision in reducing HIV rates, and size of the HIV section in the lede was recently cut almost in half; there has never been any consensus to reduce it even further. Again, it's two sentences. Jayjg ^(talk) 01:58, 12 February 2012 (UTC)

While the content may be covered in two sentences, Jayjg, these are also the longest sentences in the lead, averaging over 30 words each. The longest sentence in the lead is actually the one devoted to HIV, a word salad of 34 words. Given this, I do not think sentence count is an appropriate litmus test for weight here.

Aside from the two sentences you are referring to, the only other sentence with a length of over 22 words is actually the one dedicated to controversy. As of today, this is the only sentence dedicated to controversy surrounding circumcision in the lead. There might have been two sentences regarding controversy yesterday, but this was cut in half today - please keep this mind during our discussion. Right now, the amount of content regarding HIV and circumcision outnumbers that of controversy by over 2:1 in word count, and 2:1 using your own barometer, sentence count. Again, we haven't seen an explanation of why this disparate difference in content weight is appropriate yet. Therewillbefact (talk) 11:42, 12 February 2012 (UTC)

Again, several people have asked what material from review articles should be added to the controversies material in the lede, but not gotten any specific suggestions. In addition, you haven't explained why "2:1" is an "inappropriate content weight" - just claiming it is isn't good enough. And finally (to repeat something I've pointed out many times), word count is a purely mechanistic method of analyzing a lede, and one which is neither appropriate nor supported by guideline or policy. Jayjg ^(talk) 17:16, 12 February 2012 (UTC)

I oppose this suggestion. Probably more effective to put it forth as a RfC though.Doc James (talk · contribs · email) 17:02, 12 February 2012 (UTC)

The current Lede weights too heavily with United Nations and World Health Organization recommendations intended for Third World nations. The World Health Organization Member States are grouped into six regions. Each region has a regional office that has established an HIV Regional Action Plan through 2015. Only the Regional Office for Africa and the Regional Office for the Eastern Mediterranean (Islamic) recommend male circumcision in their regional plans. The Regional Offices for the Americas, South-East Asia, Europe, and the Western Pacific do not mention circumcision in their HIV Regional Action Plans. Chevara (talk) 19:02, 12 February 2012 (UTC)

Assuming that's true, I'm afraid I can't quite see the relevance. Given that more than a billion people live in Africa, recommendations involving those people are hardly insignificant in global terms. And in fact much of the recent literature on circumcision discusses this population. Jakew (talk) 20:02, 12 February 2012 (UTC)

This is my first time visiting this particular Wikipedia page, but I agree that the opening paragraph's discussion of circumcision HIV is bizarrely out of place. There is already a later section discussing in detail the role that some medical professionals believe circumcision might have in disease prevention, so anything more than a brief mention of disease in the intro is overkill. Also, the use of the phrase "strong evidence" is not NPOV, since there is actually debate about the biological significance of circumcision in HIV prevention among scientists and physicians, and there is poor correlation between circumcision and HIV prevalence worldwide. Now, I don't think we need to go into that controversy until the later section of the article, either. — Preceding unsigned comment added by ScienceGalKK (talk • contribs) 15:46, 19 February 2012 (UTC)

Each World Health Organization Regional Office has its own website. http://www.who.int/about/regions/en/index.html Does everyone stipulate to the following statement of fact: "The World Health Organization Member States are grouped into six regions. Each region has a regional office that has established an HIV Regional Action Plan through 2015. Only the Regional Office for Africa and the Regional Office for the Eastern Mediterranean (Islamic) recommend male circumcision in their regional plans. The Regional Offices for the Americas, South-East Asia, Europe, and the Western Pacific do not mention circumcision in their HIV Regional Action Plans." Chevara (talk) 17:25, 13 February 2012 (UTC)

Please quote the reliable source that makes that claim. Jayjg ^(talk) 23:51, 13 February 2012 (UTC)

1. European Action Plan for HIV/AIDS 2012-2015 2011, v + 72 pages ISBN 978 92 890 0252 3 http://www.euro.who.int/__data/assets/pdf_file/0011/153875/e95953.pdf (No Mention of Circumcision in the 72 page European Action Plan for HIV/AIDS 2012-2015) From p. 72 - "The primary audience for the European Action Plan for HIV/AIDS 2012–2015 is the national authorities in the WHO European Region responsible for HIV diagnosis, prevention, treatment, care and support, including health ministries and other government bodies responsible for health. The Action Plan is also intended for national authorities and ministries other than those directly responsible for health, including finance, education, social welfare, child protection, transportation, infrastructure, criminal justice, labour, immigration, development, defence, and foreign affairs, as well as associations, professional bodies, researchers, academics, civil society, advocacy groups, trade unions, the private sector, and international and global partners, including bilateral and multilateral donors."

"The WHO Regional Office for Europe is one of six regional offices throughout the world, each with its own programme geared to the particular health conditions of the countries it serves. Albania Andorra Armenia Austria Azerbaijan Belarus Belgium Bosnia and Herzegovina Bulgaria Croatia Cyprus Czech Republic Denmark Estonia Finland France Georgia Germany Greece Hungary Iceland Ireland Israel Italy Kazakhstan Kyrgyzstan Latvia Lithuania Luxembourg Malta Monaco Montenegro Netherlands Norway Poland Portugal Republic of Moldova Romania Russian Federation San Marino Serbia Slovakia Slovenia Spain Sweden Switzerland Tajikistan The former Yugoslav Republic of Macedonia Turkey Turkmenistan Ukraine United Kingdom Uzbekistan"

Regional Office for the Americas Pan American Health Organization Region Office of the World Health Organization 2. Regional HIV/STI Plan for the Health Sector 2006-2015 http://new.paho.org/hq/dmdocuments/2008/HIV_Regional_Plan_2006-2015_eng.pdf (No Mention of circumcision) Countries in the WHO Region of the Americas: Antigua and Barbuda Argentina Bahamas Barbados Belize Bolivia (Plurinational State of) Brazil Canada Chile Colombia Costa Rica Cuba Dominica Dominican Republic Ecuador El Salvador Grenada Guatemala Guyana Haiti Honduras Jamaica Mexico Nicaragua Panama Paraguay Peru Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Suriname Trinidad and Tobago United States of America Uruguay Venezuela (Bolivarian Republic of)

World Health Organization Regional Office for South-East Asia 3. REGIONAL HEALTH SECTOR STRATEGY ON HIV, 2011–2015 (41 pages) http://www.searo.who.int/LinkFiles/HIV-AIDS_Reg_Health_Sector_Strategy_HIV_2011-2015.pdf (No Mention of Circumcision)

4. Remarks by Dr Shin Young-soo WHO Regional Director for the Western Pacific at the 10th International Congress on AIDS in Asia and the Pacific Busan, Republic of Korea 26 August 2011 http://www.wpro.who.int/regional_director/speeches/speech_20110826a.htm

Message of WHO Regional Director for the Western Pacific, Dr Shin Young-soo, on World AIDS Day, 1 December 2011 http://www.wpro.who.int/regional_director/speeches/message_20111130.htm (No Mention of Circumcision for Western Pacific Region in documents or Regional Director's remarks.)

5.Joint Strategic Action Framework to Accelerate the Scale-Up of Voluntary Medical Male Circumcision for HIV Prevention in Eastern and Southern Africa 2012–2016 http://www.pepfar.gov/documents/organization/178294.pdf

World Health Organization Regional Office for the Eastern Mediterranean http://www.emro.who.int/asd/elements_circumcision.htm 6. HIV/TB strategy for the Eastern Mediterranean Region An HIV/TB strategy for the Eastern Mediterranean Region 2006–2010 Document forthcoming http://www.emro.who.int/asd/plan_hiv_tb.htm

Jayjg, you'll note that only the African and Eastern Mediterranean Regions have adopted or mentioned circumcision in their strategic HIV plans. The other four regions ignore circumcision in their Action Plans. Chevara (talk) 02:57, 14 February 2012 (UTC)

So there are no reliable sources that state this, this is all based on your own original research? Jayjg ^(talk) 15:09, 14 February 2012 (UTC)

Jayjg, for Wikipedia, the prohibition against OR means that all material added to articles must be attributable to a reliable published source, even if not actually attributed. I'm not suggesting that we include the European or Americas HIV Action Plans in the article. These WHO Action Plans are certainly relevant to our discussion on this page, whether the Lede weighs too heavily on the African Action Plan for HIV/AIDS, and ignores the majority of WHO Regions' policy, and especially the Regional HIV Action Plans for the nations of most editors here. Chevara (talk) 16:57, 14 February 2012 (UTC)

First, the prohibition against OR applies to talk pages too, albeit not to quite the same extent; see WP:TALK#Maintain Wikipedia policy. Second, the lead doesn't even mention an African Action Plan, so it is difficult to see how it would be weighted too heavily, and thirdly you still haven't responded to the points I raised in my post dated 20:02, 12 February 2012. Jakew (talk) 17:03, 14 February 2012 (UTC)

• As far as I've seen, all evidence of circumcision being a preventative of HIV transmission are based on heterosexual vaginal-penile transmission. Given that the AIDS epidemic in the Americas, Europe, and other areas are primarily based on transmission other than vaginal-penile transmission (e.g., homosexual, IV drug use, blood transfusions and other iatrogenic transmissions), it shouldn't surprise anyone that no mention is made in several areas of WHO, but it's omission also proves nothing about WHO's ideas about whether circumcision ought be tried to stem heterosexual vaginal-penile transmission. Carlossuarez46 (talk) 08:28, 15 February 2012 (UTC)

A number of editors have acknowledged the WHO's different Regional Action Plans for HIV without being disturbed by the implications. Are we writing this article for non-English speakers from Africa, to make sure they have the latest World health HIV prevention guidelines for their specific region. Does a regional study, adopted nowhere else, belong in the Lede? Anyone familiar with a bureaucracy realizes that four of the six WHO regions dumped the HIV/circ studies in the waste basket. We put it in Wikipedia. Chevara (talk) 03:43, 17 February 2012 (UTC)

Wikipedia is written with a global perspective (see WP:NPOVFAQ#Anglo-American focus), on the basis of the emphasis given in reliable sources. A brief look at the PubMed database, for example, will reveal that a large amount of emphasis is currently given to circumcision in Africa alone. Thus, it's important. Your conclusion that WHO regions "dumped the HIV/circ studies in the waste basket" is original research, and is inconsistent with the fact that WHO's recommendations are to employ circumcision in areas with high HIV rates and low circumcision rates. It should therefore be unsurprising that regions with a large number of countries matching that description (eg., Africa) are paying more attention to circumcision than regions such as Europe, which have few. Jakew (talk) 09:29, 17 February 2012 (UTC)

Chevara has demonstrated that even other WHO offices around the world disregard this HIV recommendation and Jake is also correct that it only applies to a very limited scope so I ask again why we place so much weight on this? Is it lead worthy? No not at all. Garycompugeek (talk) 15:21, 17 February 2012 (UTC)

No, Chevara has not demonstrated that. We place considerable weight on it because sources do. Jakew (talk) 16:01, 17 February 2012 (UTC)

I think Chevara has shown insight into what sources are not giving it considerable weight, and those are important sources considering how much HIV affects them. Gsonnenf (talk) 22:22, 19 February 2012 (UTC)

Please review WP:NOR. Jayjg ^(talk) 17:10, 20 February 2012 (UTC)

Not very helpful considering we have plenty of sources that take issue with the African HIV trails. What you meant was WP:ICANTHEARYOU. Garycompugeek (talk) 19:37, 21 February 2012 (UTC)

I'm not aware of "plenty" of reliable secondary sources that "take issue with the African HIV trails". Are there any review articles that come to that conclusion? Also, your accusation of "WP:ICANTHEARYOU" is highly uncivil. Jayjg ^(talk) 01:14, 22 February 2012 (UTC)

When you talk about uncivil behavior, I have to believe you are joking. There is an expression, "Those who live in glass houses shouldn't throw stones. There are editors who would be wise to practice what they preach Tftobin (talk) 12:55, 22 February 2012 (UTC)

I don't see what your comment has to do with article content. Please review WP:NPA and WP:TPYES. Jayjg ^(talk) 23:09, 22 February 2012 (UTC)

WP:NOR applies to article content. wiki authors must do research and aggregation to determine what weight a source should be given. Please stop improperly applying wiki policy. The standard procedure is to aggregate reliable and dominant sources and identify what is the majority view. Chevara has gone above and beyond, doing an excellent job of determining what the majority view is and you should respect his findings instead of trying to wiki lawyer them away. Gsonnenf (talk) 03:56, 24 February 2012 (UTC)

"Those who live in glass houses shouldn't throw stones" etc. are statements that have nothing to do with WP:NOR or any other policy; in fact, they have nothing to do with article content at all. The banned sockpuppet Chevara made claims about the WHO by doing original research on primary sources and an argument from silence. Wikipedia content is based on reliable secondary sources, and in the case of articles like this, review articles. Please make more accurate Talk: page statements. Jayjg ^(talk) 05:02, 24 February 2012 (UTC)

I was obviously commenting on this: Please review WP:NOR. Jayjg (talk) 17:10, 20 February 2012 (UTC). which you made a few lines up. In wikipedia we read many sources complied by WP:RELIABLE, and often use the guidline WP:MEDRS for medical research. We ALL agree to that. But to determine WP:WEIGHT we look at many sources and find the trend to determine what is the majority view and what is WP:UNDUE. That is what was done here and it is not a violation of WP:NOR. Gsonnenf (talk) 05:38, 24 February 2012 (UTC)

It was hardly obvious that you were responding to a comment I made three comments earlier, rather than to the comment under which you directly placed your response. The rest of your comment regarding WP:UNDUE is not relevant to what I posted, since Chevara's comments did not in any way determine "what is the majority view". Rather, Chevara in effect claimed that "internally the WHO doesn't actually agree with its stated public positions and programs on HIV and circumcision" - a claim that is, at best, absurd, and which, at the very least, requires reliable secondary sources also making that claim to be given any degree of credibility. Please provide the reliable secondary sources that agree with or support Chevara's claims. Jayjg ^(talk) 07:31, 24 February 2012 (UTC)

Your argument is not applicable. We do not need a secondary sources for determining the stated policy of an organization, especially when considering it for determining weight of an opinion. It is clear from the previous arguments their is UNDUE weight given to the HIV lead and the sources you want to suppress that establish this are relevant. If you have a source that shows HIV should keep its current weight, please present it.Gsonnenf (talk) 07:02, 27 February 2012 (UTC)

No sources have been provided to the contrary, so in the absence of any other evidence, it's logical to assume that WHO's policy is what they say it is. Jakew (talk) 09:14, 27 February 2012 (UTC)

Yep. Gsonnenf, if you have any reliable secondary sources stating that the WHO's policy on HIV is not what it says, or that the WHO is riven by internal dissent on this issue, please present them. Jayjg ^(talk) 13:16, 27 February 2012 (UTC)

No one is contesting the recommendation of the main WHO body. You need to recognize that WHO regional offices set their own policy and the majority of their HIV plans do not recommend circumcision. This helps establish WP:UNDUE as follows:

1. There is no evidence that the WHO opinion should be weighted above that of other organizations. On the contrary, there is evidence it is undue, as the majority of WHO regional offices, who can set their own independent policies, have chosen to give the main body's opinion no weight or recommendation in there HIV prevention plans. It is not recommended by WHO regional offices for most regions and should be weighted accordingly. This argument has already been made, and I restate it.Gsonnenf (talk) 08:04, 28 February 2012 (UTC)

Are you able to cite any reliable sources in support of that claim? Jakew (talk) 09:09, 28 February 2012 (UTC)

arbitrary break 1

The WHO is a relatively small medical association and division of the UN. The UN itself is is a small political body (relative to national governments) used primarily for diplomacy. The WHO (budget: ~$842 Million - 2003) is much smaller than organizations such as the CDC (budget: $8.8 Billion - 2008). Their are many other medical associations with a much broader base such as the AMA with 215,000 members or BMA with 191,000 members. Because WHO is a relatively small organization, it's opinion as our articles lead HIV opinion is WP:UNDUE.

We have shown that the WHO is a small organization within the context of other medical associations, and that its opinion on circumcision for HIV prevention is rejected by the most regional offices. As such inclusion in the lead is WP:UNDUE. Many authors agree with this, but we do not have consensus. Those disagreeing, please make a clear concision argument about why you believe the WHO opinion should be the most weighted opinion, so we can either find a compromise or go to RFC.Gsonnenf (talk) 08:04, 28 February 2012 (UTC)

The size of the organisation is of limited importance compared with their influence. WHO is an extremely influential organisation, as is evidenced by the fact that much of Sub-Saharan Africa has responded to their recommendations. Jakew (talk) 09:09, 28 February 2012 (UTC)

This is part of the problem, for me. Their influence is far beyond their numbers, or the depth of their scientific analysis, and skews impressions worldwide disproportionately. They have the ability to mobilize vast amounts of resources, when checking to see that the data is actually correct is left wanting in the eyes of some of the more scientifically minded. This does not prevent the WHO from running with it, and calling for action, when perhaps a different course could be more effective. There has not been too much of an attempt to see if real life outcomes match computer models. Sub-Saharan Africa has responded, with a 'WHO knows best' view for the most part, and is only now questioning the WHO's conclusions in their local press. Tftobin (talk) 17:22, 28 February 2012 (UTC)

The WHO has very limited influence in developed countries. The WHO main body has influence but not authority in Africa where governments are dysfunctional or non-existent. The WHO is comparable to the Bill and Melinda Gates association (Medical Budget: $800 million) in terms of influence in Africa. It has very low influence compared to government associations and large medical associations. Government associations such as the CDC have legal authority to enforce wherein the WHO must hope even there regional offices accept there recommendation which many do not. Gsonnenf (talk) 21:44, 28 February 2012 (UTC)

None of this personal opinion is relevant to the discussion at hand. By the way, a Google news search shows 2,940 references to the World Health Organization in the past day alone, 1,840,000 on Google scholar, 4,240,000 mentions on Google books, and 34,500,000 general Google hits. For an organization with "limited influence in developed countries", it sure gets an awful lot of attention in English language sources. Jayjg ^(talk) 22:02, 28 February 2012 (UTC)

Oh, and by comparison, the Royal Dutch Medical Association gets 0 Google news hits in the past day, 952 Google scholar hits, 2,060 Google books hits, and 26,700 general Google hits. That's about 2,000 to 1 for the WHO vs. the RDMA/KNMG. If we're looking for a "small organization" that has "limited influence in developed countries" and WP:UNDUE attention paid to it in the lead, the Royal Dutch Medical Association would seem to be the winner hands-down. Jayjg ^(talk) 22:08, 28 February 2012 (UTC)

One difference is that the KNMG is an association of doctors. The WHO is not, necessarily. Popularity is no judge of anything. Are you implying that KNMG should be ignored, and WHO referenced, because WHO gets more attention on the web, even though they are not a medical organization? Would this make the WHO's opinions more correct? How is the results of Google search germane to the discussion? Would this make Britney Spears a better source? Tftobin (talk) 00:08, 29 February 2012 (UTC)

Sorry Jayjg, google mining is not an argument accepted by Wikipedia. the WHO is very controversially and political and breeds lots of news. Similarly the westboro baptist church also breeds a great deal of news. I accept that the WHO is a very relevant medical association, but it has far from majority weight, especially on this particular policy. Budget comparisons are not personal opinions. Membership numbers are not personal opinions. Authority granted to medical associations are also not personal opinions. The KNMG view already passed RFC because it is inclusive of majority views such as from the CDC and AMA. This has already been discussed in the RFC, don't beat a dead horse.Gsonnenf (talk) 01:59, 29 February 2012 (UTC)

When it comes to fighting global diseases like HIV/AIDS, a significant difference between the World Health Organization and Britney Spears and/or the Westboro Baptist Church is that the World Health Organization is the most important international body concerned with international public health. In the future, please make more relevant analogies. Jayjg ^(talk) 04:22, 29 February 2012 (UTC)

At the end of the day, what matters in Wikipedia is the amount of weight given in reliable sources, and as Jayjg has indicated through search results, which give a very rough measure of that, the views of the WHO actually get given a great deal of weight. Having looked at Google Scholar, I see that 1,700,000 articles refer to the WHO. For perspective, compare with 959,000 for the AMA, 99,600 for the BMA, 5,740 for the RACP, and 952 for the KNMG. Claims that the WHO "has very low influence compared to government associations and large medical associations" appear to be untenable. Jakew (talk) 11:03, 29 February 2012 (UTC)

So, in essence, even though the WHO is not strictly speaking a medical group, because it is influential, its words should trump that of actual medical organizations comprised of doctors exclusively, because the WHO has weight with Google? Tftobin (talk) 16:59, 29 February 2012 (UTC)

No, Google's view is largely irrelevant. We can, however, use Google as a tool with which to get a rough idea of the degree to which sources refer to the World Health Organisation. That's what matters when assessing due weight: the weight given in sources. It doesn't particularly matter whether they are comprised of doctors, epidemiologists, biostatisticians, or other related professions. What matters when assessing due weight is how much weight they're given. Jakew (talk) 17:10, 29 February 2012 (UTC)

Exactly. Google searches are a rough measure of how influential sources are. Contrary to the unsourced (and seemingly absurd) claims presented that the WHO "has very limited influence in developed countries", a basic analysis indicates that it is one of the (if not the) most influential medical source, at least in English language sources. And Gsonnenf, contrary to your claim that "The KNMG view already passed RFC because it is inclusive of majority views such as from the CDC and AMA", the RFC was actually fairly evenly split between those wishing to include it and those objecting to it. Moreover, when we examine the RFC for outside views, we find a 4 to 1 ratio against the KNMG statement. Jayjg ^(talk) 17:35, 29 February 2012 (UTC)

I have yet to see some sort of Wikipedia policy guideline that states tallying Google hits is an appropriate metric for determining the weight to allot to a source. If you can outline such relevant Wiki policy, please do so here. Therewillbefact (talk) 17:50, 29 February 2012 (UTC)

No-one has argued that "tallying Google hits is an appropriate metric for determining the weight to allot to a source". Rather, we were using the Google metric as a more objective way of refuting the handwaving argument that the WHO "has very limited influence in developed countries". Please review straw man. Jayjg ^(talk) 18:08, 29 February 2012 (UTC)

I'm sorry you feel my findings based on budget analysis, membership size and national granted authority are "hand wavy", as they are clearly not. The Google metrics shows nothing about WHO influence in developed countries compared to larger organizations like the CDC, BMA, or AMA. It does suggest they are one of many relevant sources, which we all agree on.Gsonnenf (talk) 21:28, 29 February 2012 (UTC)

Your arguments were mere assertions, and were not relevant to "influence in developed countries"; in a word, handwaving. Citations are a commonly used measure of influence; see Impact factor, Eigenfactor, and studies like this. Jayjg ^(talk) 23:36, 29 February 2012 (UTC)

I'm sorry you feel the legal authority over US health policy given to the CDC by the US government does not count as "influence in a developed country".Gsonnenf (talk) 23:56, 1 March 2012 (UTC)

Please review straw man; I haven't said anything about the CDC, and we aren't talking about "legal authority over US health policy". Jayjg ^(talk) 04:10, 2 March 2012 (UTC)

Please review WP:IDIDNTHEARTHAT. One of my main points was about government organizations, including the CDC. "legal authority over US health policy" IS "influence in a developed country".Gsonnenf (talk) 09:18, 2 March 2012 (UTC)

Having reviewed the above discussion, I can confirm that Jayjg didn't say anything about the CDC. How you were able to divine Jayjg's feelings about the CDC is, therefore, a mystery. Jakew (talk) 11:09, 2 March 2012 (UTC)

Please see the following - Jayjg: "Your arguments...were not relevant to "influence in developed countries". Two of my main arguments concerning CDC over WHO:

• "The WHO (budget: ~$842 Million - 2003) is much smaller than organizations such as the CDC (budget: $8.8 Billion - 2008), [suggesting one metric of influence for CDC] (from above)
• Government associations such as the CDC have legal authority to enforce wherein the WHO must hope even there regional offices accept there recommendation which many do not. (from above)

Jayjg calls my arguments handwaving, my arguments include the CDC as a main point and example. Therfore, he is calling my argument about the CDC handwaving or he is extremely unclear about the specific argument he doesn't like. Proof_by_assertion I am waving hands is not productive.Gsonnenf (talk) 20:22, 2 March 2012 (UTC)

This discussion is about your refuted contention that "[t]he WHO has very limited influence in developed countries". Whether or not the CDC has a larger budget, or "legal authority over US health policy", is not relevant to whether or not the WHO has "limited influence in developed countries". Please review Ignoratio elenchi. Jayjg ^(talk) 21:55, 2 March 2012 (UTC)

This discussion is about whether the WHO should be our main source for the lead on HIV. You are creating a strawman with "[t]he WHO has very limited influence in developed countries". My statement was "[the WHO has]] low influence compared to government associations and large medical associations...such as the CDC...". Please stop misrepresenting my positions, it makes it very hard to have a productive discussion. Gsonnenf (talk) 09:34, 5 March 2012 (UTC)

In that case, it's a moot point: the WHO are not our main source for HIV in the lead (it's one of 4 sources: 12, 13, 14, and 16) and nobody is proposing that it should be. Jakew (talk) 10:08, 5 March 2012 (UTC)

The problem is that it is our main statement about HIV recommendation from a medical association. I should have stated that more clearly, but these conversations get exhausting.Gsonnenf (talk) 13:12, 5 March 2012 (UTC)

"The WHO has very limited influence in developed countries." is a direct quote of a comment you made above on 21:44, 28 February 2012. I have not "misrepresented" you in any way, your clear original statement is still on this page. Jayjg ^(talk) 13:47, 5 March 2012 (UTC)

Jayjg, that is a misquoted strawman. The paragraph clearly compares its influence to organizations like the CDC. Please address the entire argument, not just pieces out of context. It is far more productive.Gsonnenf (talk) 07:15, 6 March 2012 (UTC)

On 23 July 2007 The Australian Federation of AIDS Organisations released its Briefing Paper for General Distribution, "Male circumcision has no role in the Australian HIV Epidemic." http://www.afao.org.au/__data/assets/pdf_file/0019/4528/BP0709_Circumcision.pdf It's very misleading to give one side of the issue in the lead. Robert B19 (talk) 20:25, 7 March 2012 (UTC)

I have directly quoted you, and addressed your whole argument, including your statement about the CDC, in my comment of 21:55, 2 March 2012. Please review that comment again. Jayjg ^(talk) 01:43, 11 March 2012 (UTC)

• Summary In this thread, we have debated whether the WHO statement is WP:UNDUE in the lead. Editors have made a compelling evidence based argument that it is WP:UNDUE and not majority view. The opposition has given no justification as to why the WHO position is the majority view. Many organizations, such as the CDC, AMA, KNMG or Australian Federation of AIDS Organisations, do not adopt or actively oppose this view. This discussion has shown the main WHO body recommendation on HIV based circumcision has not been adopted by the WHO regional bodies in developed countries or the governing medical associations in developed countries. Budget, membership, policy and authority comparisons with organization, such as the CDC, have shown that the WHO main body has limited influence in developed countries. Presented google search results on WHO showed no evidence of its weight compared to other views and organizations. I propose we remove the WHO HIV recommendation statement from the lead as it has been shown wp:undue for the lead.Gsonnenf (talk) 17:13, 11 March 2012 (UTC)

No persuasive argument for doing so has been presented. Jakew (talk) 17:16, 11 March 2012 (UTC)

Indeed. Gsonnenf, claiming you have made a compelling argument is quite different from actually doing so. On the contrary, your arguments have been consistently, and quite easily, refuted. Please male more accurate Talk: page statements. Jayjg ^(talk) 18:04, 11 March 2012 (UTC)

The statement that the WHO is undue would require a WP:RfC going through WP:MED. Feel free to start one however I highly doubt the majority of the medical editors here would agree that it is undue. We hold WHO statements is very high regard, up there with the Cochrane collaboration.Doc James (talk · contribs · email) 18:08, 11 March 2012 (UTC)

Of course people from the wp:med group are welcome to comment. I'm sure they also hold groups such as the AMA, BMA, CDC and other great medical institutes in high regard.Gsonnenf (talk) 20:03, 11 March 2012 (UTC)

No nation outside southern africa has implemented circumcision in their strategic plan against AIDS, nor does anyone outside africa have it under consideration. The Office of National AIDS Policy in the United States http://www.whitehouse.gov/administration/eop/onap/nhas has released its National HIV/AIDS Strategy in two .pdf documents -- they recommend condom availability, HIV testing, Abstinence from sex or drug use, access to sterile needles and syringes, HIV treatment, all as "scientifically proven biomedical and behavioral approaches that reduce the probability of HIV transmission." Wikipedia's article is making a case for circumcision that no AIDS organization or national strategy has under consideration. Robert B19 (talk) 01:32, 12 March 2012 (UTC)

Southern Africa does have 60% of the global HIV cases with rates over 30% in some countries. Many hover around the 10% rate. Tanzania is currently implementing a circumcision policy funded by USAID in an area with rates at 17%.--Doc James (talk · contribs · email) 04:58, 12 March 2012 (UTC)

I am temporarily removing the HIV paragraph while we discuss modifying it. Before anyone objects this is exactly what Jake did with the medical summary last month with the edit summary (temporarily removing sentence from lead while we discuss how to rewrite it). Garycompugeek (talk) 16:56, 14 March 2012 (UTC)

Given the fact that you edit warred over that very edit, that seems rather pointy, Gary. I trust you'll be restoring the first sentence, which is not related to HIV? Jakew (talk) 17:19, 14 March 2012 (UTC)

I have replaced the first sentence back, just thought it would be easier to work on the whole paragragh. Garycompugeek (talk) 15:36, 15 March 2012 (UTC)

My original suggestion has not been commented on just sumarily dismissed by Jake.

Circumcision is used therapeutically, as one of the treatment options for balanitis xerotica obliterans, phimosis, balanitis, posthitis, balanoposthitis and urinary tract infections.[10][11] Conflicting evidence exist that indicates circumcision reduces the risk of HIV infection in heterosexual men by 38-66% in populations that are at high risk in conjunction with consistent safe sexual practices to maintain the protective benefit.[78] Garycompugeek (talk) 17:07, 14 March 2012 (UTC)

There are several problems with it, Gary. First, it isn't "Conflicting evidence"; it's strong evidence; see the sources. Second, the sentence structure is garbled: it implies that the risk reduction only occurs in high-risk populations when used in conjunction with safe sex practices. That isn't supported by the sources. There are two statements, and they need to be made separately: 1) strong evidence indicates that circumcision reduces the risk in heterosexual men by 38-66%, and 2) because of this, the WHO recommends it in populations that are at high risk in conjunction. Jakew (talk) 17:15, 14 March 2012 (UTC)

We have plenty of sources that take issue with the findings of the RCTs done in Africa and warn of trying to extrapolate the data, hence "Conflicting evidence". I agree the second part of the message could be misconstrued. How about "The WHO recommends circumcision in populations that are high risk." Garycompugeek (talk) 16:04, 15 March 2012 (UTC)

By that logic, Gary, we'd have to include statements in this encyclopaedia such as "there is conflicting evidence that the Earth is spherical", "there is conflicting evidence that HIV causes AIDS", etc. Describing the evidence as "conflicting" gives undue weight to the views of a fringe minority. Jakew (talk) 16:09, 15 March 2012 (UTC)

your RFC asked for comments but never responded to them with particularity. this from ScienceGalKK, "...the opening paragraph's discussion of circumcision HIV is bizarrely out of place. There is already a later section discussing in detail the role that some medical professionals believe circumcision might have in disease prevention, so anything more than a brief mention of disease in the intro is overkill. Also, the use of the phrase "strong evidence" is not NPOV, since there is actually debate about the biological significance of circumcision in HIV prevention among scientists and physicians, and there is poor correlation between circumcision and HIV prevalence worldwide. Now, I don't think we need to go into that controversy until the later section of the article, either." characterizing such editors "a fringe minority" seems inappropriate. Robert B19 (talk) 17:22, 15 March 2012 (UTC)

As explained many times, the mainstream viewpoint is that the evidence is strong. Only a tiny minority of authors believe otherwise. It would violate WP:NPOV to adopt the position of a fringe minority. Jakew (talk) 17:26, 15 March 2012 (UTC)

Jake, fringe minority has become a favorite phrase around here. I find it disrespectful. I also find it more than a little contradictory, and ironic, considering that the work which has been widely accepted by the WHO has come from a 'fringe minority', half of whom are not medical doctors. Tftobin (talk) 19:34, 15 March 2012 (UTC)

Just as on Wikipedia, Tom, scientific consensus can and does change. Relativity theory, for example, initially had only one adherent. These days it enjoys consensus among physicists. If Wikipedia had been around in the early 1900s, we would have asserted Newtonian physics, avoiding giving undue weight to the upstart theory. Jakew (talk) 19:41, 15 March 2012 (UTC)

The gratuitousness is underwhelming. One wonders why Wawer's latest study was cut short. Your point only underscores the concerns of Robert B19 and Garycompugeek. If you acknowledge that what is fringe today, might be mainstream tomorrow, why label people as adopting "the position of a fringe minority."? Considering that all that authoritative HIV-circumcision knowledge rests on about three people, and their acceptance by the WHO, it seems that the mainstream isn't so solid (except by the gold standard of secondary studies). Haven't we all seen cases where it takes no medical credentials to get published in medical publications, get peer reviewed, and then become part of a secondary study? Please correct me if I am wrong. I don't see more than half a handful of medical doctors coming forward to defend the scientific techniques on which all that current belief rests. Tftobin (talk) 20:58, 15 March 2012 (UTC)

I haven't labelled people as adopting the position of a fringe minority — I haven't any interest in labelling anyone. I've pointed out that Wikipedia itself cannot adopt such a position, which we would if we described the evidence as "conflicting". The evidence at present consists of about 50 observational studies and 3 randomised controlled trials. There are also numerous meta-analyses, reviews, and commentaries, such that PubMed presently reports 928 results when searching for circumcision and HIV. The majority of publications have been positive, overwhelmingly so in the past 5 years since the RCTs were published. Jakew (talk) 21:05, 15 March 2012 (UTC)

I understand your point, and wikipedia's stance. There is no other they could adopt, under the circumstances. I also want you to note, that those randomised controlled trials were not so randomised, or controlled. If they were controlled, there would be at most one factor which was variable. Most of those studies featured the same authors, whose preferences were made plain years before those studies began. Many of the meta-analyses featured the same people. When a software engineer and a molecular biologist, to pick two occupations at random, can get a hypothetical paper past medical publishers, the peer review process, and into meta-analyses, these processes rare far from incontrovertible medical evidence, and proof of sloppy review methodology. People who question this are not from the flat Earth society, or vaccine non-believers. They can be normal, curious people, who simply don't believe the same things you do, perhaps because they need a higher standard of impartial, disinterested, medical evidence. This group includes all of European doctors, except for one exception who springs to mind. Tftobin (talk) 23:53, 15 March 2012 (UTC)

Jakew, quit calling a majority view a fringe view. Gsonnenf (talk) 22:02, 17 March 2012 (UTC)

Renaming of Page

I propose the renaming of Circumcision to Male Genital Mutilation, as a), there are no proven health benefits, and b), it causes a decrease in functionality of the male genitals. Flynn58 (talk) 06:03, 18 March 2012 (UTC)

See Talk:Circumcision/Archive 68#Proposed merger with Genital Mutilation Jakew (talk) 09:12, 18 March 2012 (UTC)

Also, renaming it might imply that it's as savage for boys as female genital mutilation is for girls. Robert B19 (talk) 17:06, 18 March 2012 (UTC)

Repeated obviously useless contentious proposals are disruptive. Carlossuarez46 (talk) 17:18, 18 March 2012 (UTC)

What might be a useful practice here would be to preface any proposal with "I have read the archives, and although this was not approved in archive ###, I think either than consensus has changed because... or this argument was never addressed: ....." And that any proposal failing such an acknowledgement that they are made in good faith with knowledge that they haven't been addressed before should be summarily treated as trolling here. The community has spent wayyyyyy tooooo much time going over the same ground with the same arguments with the same results. Carlossuarez46 (talk) 17:21, 18 March 2012 (UTC)

It might be a good idea to use the FAQ for this. If nothing else, it'd be handy to be able to direct people to it. Jakew (talk) 17:27, 18 March 2012 (UTC)

If you read the top of the page, you'll notice it already has the noticebox that states Discussions often lead to previous arguments being restated. Please read recent comments, look in the archives and review the FAQ before commenting. Perhaps there is a way of making this more prominent? Jayjg ^(talk) 20:44, 18 March 2012 (UTC)

I've made an initial attempt. This looks good in Firefox. Does it cause rendering problems for anyone? Jakew (talk) 09:59, 20 March 2012 (UTC)

I've also drafted an FAQ on the subject. Jakew (talk) 10:05, 20 March 2012 (UTC)

The FAQ premise on Page Name is absurd. I question whether most of the reliable sources refer to circumcision as "circumcision"? If we go by the WHO, wouldn't it be Voluntary Male Medical Circumcision? Tftobin (talk) 18:42, 20 March 2012 (UTC)

I can't see that the WHO constitute "most" sources, Tom, but in any case, the mistake you're making is to interpret qualifiers as though they were not present. When the WHO use the VMMC term, they are not talking about circumcision in the general sense. They're using qualifiers to explicitly exclude those performed for non-medical reasons, those performed on those who aren't volunteers, and to make it absolutely clear that they're not talking about female genital cutting (which is sometimes referred to as "female circumcision"). This article has a broader scope than that: it is about circumcisions performed for any reason and regardless of whether the patient volunteers or not. The fact remains that the WHO are using the term "circumcision" to refer to the subject. Jakew (talk) 19:45, 20 March 2012 (UTC)

Thanks for the lecture. Do we know where the majority of resources accepted here come from? If the majority come from WHO, and their titles refer to it as Voluntary Medical Male Circumcision, will we be changing the title of the page? Or is the FAQ mistaken? Tftobin (talk) 17:22, 21 March 2012 (UTC)

Should I compile a list of reputable, secondary sources that refer to circumcision as "circumcision" and cite them in support of calling circumcision "circumcision"? Furthermore, is that really necessary? It's certainly easy and possible, and represents the majority of viewpoints of medical organizations, but I didn't think that things imminently true needed to be cited. The article could say that "The NIH, New York Times, and others refer to the practice of...as circumcision". Is that what you think should be done? Do most medical organizations routinely refer to circumcision as something other than "circumcision"? Morrowulf (talk) 00:05, 22 March 2012 (UTC)

• You could start with the governments of several English-speaking countries. USA: See 22 U.S.C. Sec. 7611 (accessible here) mandating that "The President shall establish a comprehensive, integrated, 5-year strategy to expand and improve efforts to combat global HIV/AIDS." and remarkably refers to circumcision as...drumroll, please...."circumcision". Ditto the UK: see Scottish Government and UK's NHS. And Canada: Health Service Report. And Australia: Health service. Just saying... Carlossuarez46 (talk) 03:29, 22 March 2012 (UTC)

Lack of statistics

I think this article should try to someway present how many of all new born boys that gets circumcized (for non religious reasons) in different countries. I assume that in most european countries very few boys gets this operation. But rumours I've heard is that it's quite common in the USA. Is this true ? In Sweden I've never heard about this except for jews and muslims. Boeing720 (talk) 23:50, 18 March 2012 (UTC)

Please read more closely. Morrowulf (talk) 02:34, 19 March 2012 (UTC)

"Circumcision is used therapeutically, as one of the treatment options for ... ... preventing urinary tract infections"

Is this not a wee bit misleading? I appreciate that a side effect of circumcision is to lessen the rate of UTIs, but I am also reasonably sure that it is not used therapeutically for doing so. Egg Centric 14:35, 26 March 2012 (UTC)

It's used quite frequently among boys who are considered at high risk of UTI. Jakew (talk) 15:18, 26 March 2012 (UTC)

OK - have edited intro paragraph to reflect that. Thoughts? Egg Centric 15:26, 26 March 2012 (UTC)

It is certainly mislead. With the exception of balanitis xerotica obliterans, Circumcision is only recommended for discussion when all other non-surgical treatments have been exhausted. This should be reflected similarly to how Vancomycin is presented in its article.Gsonnenf (talk) 19:02, 26 March 2012 (UTC)

Neither of the cited sources support your claim that discussion of circumcision (and only discussion) is recommended only when all non-surgical treatments have failed. Jakew (talk) 19:10, 26 March 2012 (UTC)

JakeW, I recommend reading the sources. from the first source "Circumcision is only recommended for confirmed cases of phimosis caused by BXO." they also describe recurrent infections. There was another source describing them as only being used when non-surgical means failed, but apparently some one removed it. I'll have to find that. In the mean time, please read the current sources instead of just the abstract.Gsonnenf (talk) 19:20, 26 March 2012 (UTC)

I'm quite familiar with that source, Gsonnenf. The sentence you quote appears at the end of a paragraph about phimosis, and is clearly intended to mean that it is not recommended for cases of phimosis where BXO has not been confirmed. Jakew (talk) 19:25, 26 March 2012 (UTC)

Removal of HIV sentence in lead

I am at a loss as to why people are edit warring to remove the HIV sentence in the lead. This has been discussed countless times over the past few months, and the consensus has been that it belongs in the lead. If the consensus changes as to how it should be worded, let's change it then, but removing this sentence now makes no sense whatsoever. Yobol (talk) 17:45, 15 March 2012 (UTC)

Yes we would need consensus before removing very well referenced content. Maybe try a RfC --Doc James (talk · contribs · email) 17:58, 15 March 2012 (UTC)

Yes, it does seem a rather bizarre thing to do at the end of a discussion in which those proposing to remove it failed to achieve consensus for their proposal... Jakew (talk) 18:23, 15 March 2012 (UTC)

Agreed, most perplexing behavior. Jayjg ^(talk) 02:58, 18 March 2012 (UTC)

I too am at a loss to explain both of your inconsistant behaviors. When Jake removed our medical summary (still missing by the way) using the exact same edit summary that I used, Yobol was quick to support him and Doc was curiously silent. KMNG was "well reffed" too Doc and you supported it when LizardWizard added it. After Jake removed KMNG's medical summary I stated "It goes against custom to remove material already in the article just because it is being discussed on the talk page. If we did that most of the lead would be gone while we debate HIV, medical summary and controversies." but this fell on def ears. Now Doc is going even furthur and calling edits he disagrees with as vandalism. This is hardly good faith editing and seems like quite an unfair playing field. Garycompugeek (talk) 18:29, 15 March 2012 (UTC)

On the subject of consistency, Gary, is there a reason why you edit warred against removal in one instance and for it in another? Is consistency merely something you expect of others? Just curious... Jakew (talk) 19:19, 15 March 2012 (UTC)

@Garycompugeek: As far as I can tell, I did not support the removal of any text under discussion in the sequence you seem to be talking about; in fact, I restored text, rather than deleted it, which is perfectly consistent with what I am asking now. Also, that you would (erroneously) point to past behavior of others rather than to explain your own behavior, suggests a rather disruptive WP:POINTy behavior that is not appropriate for a collaborative project. Yobol (talk) 19:53, 15 March 2012 (UTC)

Really Yobol... I'm referring to this [[2]] and this [[3]] edits by you. Nothing erroneous except your last statement. Garycompugeek (talk) 20:04, 15 March 2012 (UTC)

Look, I don't much care what you or anyone else think is "inconsistent", and ask that you comment on the content, not the contributor. Either justify deletion of the material, that has already been through an RfC and discussed ad nauseum for months now on its own merits, or stop edit warring. Trying to justify your own WP:POINTy behavior with erroneous assumptions about other people's behavior is not helpful. Yobol (talk) 21:23, 15 March 2012 (UTC)

Yes I do not support the removal of KMNG's medical summary from the lead. I however was on holidays the last month which was why I did not comment. I have returned the content in question until there is clear consensus to either to change it or remove it. A RfC is probably best on a controversial topic like this.Doc James (talk · contribs · email) 21:40, 15 March 2012 (UTC)

We already have an RfC about that sentence. Yobol (talk) 21:49, 15 March 2012 (UTC)

Thanks you are correct. But we do not usually remove content while a RfC is ongoing. It looks like this one has resulted in mixed results.Doc James (talk · contribs · email) 21:53, 15 March 2012 (UTC)

Hopefully an uninvolved admin will eventually show up and put this to rest. Yobol (talk) 21:55, 15 March 2012 (UTC)

We could ask at ANI. Have shortened to "As of 2010, no professional associationof physicians recommends routine circumcision." as it is not really controversial as thus if people wish the exact source they can click the link.Doc James (talk · contribs · email) 21:57, 15 March 2012 (UTC)

I've further changed it to a compromise that includes all three summaries. Jakew (talk) 09:11, 16 March 2012 (UTC)

and I have reverted you per the RFC that clearly shows no consensus for this. Garycompugeek (talk) 12:54, 16 March 2012 (UTC)

Gary, of the 22 23 people who've responded to the RfC, just 6 (27%) (26%) indicated that the lead should include only the KNMG. It is quite clear that consensus does not favour your preferred version, and that we need to find a reasonable compromise. Please stop trying to block compromise. Jakew (talk) 13:24, 16 March 2012 (UTC)

Votes tallies

(Support One = 9

Support Two = 10

Support Both = 5

) Apparently you and I use different forms of math. I am open to compromise and have been making suggestions. Becuase you don't like them, do I accuse you of trying to block compromise? Please turn the rhetoric down. Garycompugeek (talk) 13:49, 16 March 2012 (UTC)

Apparently so, Gary. Given that you've recorded more "votes" than people who actually participated, I'm not sure that your mathematics is superior. In any case, the mistake you're making is to try to answer the question whether there is consensus to change by addressing the issue of what that change ought to be. To answer the first question properly, you need to compare those arguing for the article to stay the same (as you are) versus those who agree with a change. That's what I did above, and I think it would be difficult to argue that there is consensus to keep just the KNMG sentence. So we need to think about compromises, and those are probably going to involve either multiple summaries or none.

By the way, could you refresh my memory regarding the compromises you've suggested? Jakew (talk) 16:40, 16 March 2012 (UTC)

Sure it was a whole 2 days ago for HIV... [[4]]. As far as the Viens source goes I have many concerns that I explained in detail when you first introduced it but offered this. [[5]] Garycompugeek (talk) 18:11, 16 March 2012 (UTC)

Ah. So, only one of the two actually involved the issue we're discussing, and that was a vague, hypothetical statement that you hadn't taken the trouble to source. Given its other problems, please don't do so now, but you must admit that absence of sources is difficult for any proposal to overcome. Jakew (talk) 19:23, 16 March 2012 (UTC)

I removed the KNMG material in accordance with WP:TALK, which states: "The talk page can be used to "park" material removed from the article due to verification or other concerns, while references are sought or concerns discussed." If another policy/guideline creates an exception for when there is an active RfC, I apologise — I am not and was not aware of such an exception. Jakew (talk) 23:47, 15 March 2012 (UTC)

Nor am I. Jayjg ^(talk) 02:58, 18 March 2012 (UTC)

This topic keeps coming up because its apposed by many authors, and supported by a few very vocal authors. I agree we should take it to RfC.Gsonnenf (talk) 18:12, 25 March 2012 (UTC)

We already had an RFC on the topic last month - one which had heavy response and fairly conclusive results from both uninvolved and experienced Wikipedia editors (i.e. editors who do not regularly edit the circumcision articles, and editors with over 5,000 edits), but whose results were nevertheless ignored by inexperienced editors, the vast majority of whom were WP:SPA accounts. What would a new RFC produce that the old one didn't? Jayjg ^(talk) 19:40, 25 March 2012 (UTC)

There was almost no support for the JakeW HIV sentence in the most recent RfC. The WHO HIV sentence was also disputed by a very large number of editors. It obviously does not have consensus among the active participant on this page. You still seem to be beating the horse though. I'd advise taking a break. Gsonnenf (talk) 02:53, 26 March 2012 (UTC)

The POV tag should remain on the article until the HIV school of thought offers a justification that passes the smell test. Robert B19 (talk) 04:54, 27 March 2012 (UTC)

I agree. When authors write studies, and then international organizations hire the authors' employers to review the material there is an appearance of impartiality when none really exists. Tftobin (talk) 11:22, 27 March 2012 (UTC)

Medical article?

I feel it is wrong for this article to be considered a medical one. Circumcision is part medical procedure, but in practice mostly a cultural procedure and consequently there needs to be far more emphasis on the ethical/moral issues Egg Centric 14:35, 26 March 2012 (UTC)

Your reasoning is flawed. It's often done for non-medical reasons, but that doesn't mean it isn't a medical procedure. Jakew (talk) 15:24, 26 March 2012 (UTC)

If it's medical, why does the British Medical Association call it "non-theraputic"? Why doesn't the CDC track its outcome, like it does other medical procedures? It is surgery, done primarily for non-medical reasons. Tftobin (talk) 01:48, 27 March 2012 (UTC)

It may well be a medical procedure but that doesn't mean the article has to be a medical article. Egg Centric 15:27, 26 March 2012 (UTC)

It may not have to be in the strict sense of the word, but it should be. It is a medical procedure, we should discuss it as such. Yobol (talk) 15:28, 26 March 2012 (UTC)

By all means we should discuss the medical procedure. But we should also discuss the cultural, religious, and ethical stuff. They're far more important in all honesty. Egg Centric 15:58, 26 March 2012 (UTC)

And it is discussed. We should not discuss controversies until the actual procedure is described (it makes no sense to describe controversies in an encyclopedia article until you describe what it is), whatever your or my personal opinion of the importance of the controversy may be. Yobol (talk) 16:42, 26 March 2012 (UTC)

This is a multi-faceted article. Only the medical advice and description falls under WP:MEDRS. Ethics, society, and religious discussion fall under standard wiki rules.Gsonnenf (talk) 19:11, 26 March 2012 (UTC)

I don't really see where it is that we are disagreeing. My point is that the introductory section does not have to conform to medical article rules. Egg Centric 21:15, 26 March 2012 (UTC)

@Egg Centric: I'm saying we describe what it is (which includes what it is used for) before we describe anything about controversies. In an encyclopedia article, it makes no sense to discuss the controversies of a topic before fully describing what it is and what it used for first. Yobol (talk) 21:17, 26 March 2012 (UTC)

You can't fully describe it before the intro section. The intro section should contain an overview of the subject and that includes the controversy. Egg Centric 21:44, 26 March 2012 (UTC)

It already does. You wanted to move discussion about controversy about a medical procedure before even discussing what it used for. That doesn't make any sense to me. Yobol (talk) 21:52, 26 March 2012 (UTC)

You do not have to fully discuss it before bringing in the controversy. How about we have a new section below where we can work on the intro?Egg Centric 21:19, 27 March 2012 (UTC)

Ethics argument, irrelevant, but open to anyone who fancies saying the same thing a million times and getting nowhere

From the introduction: "Male circumcision is the surgical removal of some or all of the foreskin (prepuce) from the penis.[1] Early depictions of circumcision are found in cave paintings and Ancient Egyptian tombs, though some pictures are open to interpretation.[2][3][4] Religious male circumcision is considered a commandment from God in Judaism.[5][6] In Islam, though not mentioned in the Qur'an, male circumcision is widely practised and often considered to be sunnah.[7] It is also customary in some Christian churches in Africa.[8] ... There is controversy regarding circumcision.[19] Specific controversies have included the health benefits and risks of the procedure,[20][19] ethical and legal considerations,[19] and the application of human rights principles to the practice.[21]" To say that the introduction addresses circumcision as only a medical issue is plainly untrue. I'm not sure what you're objecting to. Should the introduction only talk about cultural and controversial aspects of circumcision, and not at all about the medical ones? There's a good balance right now, and I don't think most editors think it should be changed. Morrowulf (talk) 23:32, 26 March 2012 (UTC)

• I agree with Morrowulf, and the opening salvo in this discussion had the odd proposition that "far more emphasis on the ethical/moral issues" is needed because it is "mostly a cultural procedure". Under NPOV, it would be hard to construct any encyclopedic article that focuses on the ethical/moral issues of cultural practices without pushing a POV - and in any event, that narrow aspect is covered in Ethics of circumcision, which only focuses on medical issues because I cannot fathom cultural practices having any objective norm since ethical/moral issues are decided by cultures: it would be the height of arrogance (not that it isn't done, but the world, unlike WP, is not constrained by WP:NPOV) to point at cultural practices they don't like and say they're ethically or morally wrong. Carlossuarez46 (talk) 00:01, 27 March 2012 (UTC)

Tell it to the article on female circumcision. Nice speech, though. Tftobin (talk) 11:04, 27 March 2012 (UTC)

To compare the complications and circumstances of 'female circumcision' and circumcision is shameful. The former kills tens of thousands of woman and babies yearly, and causes enormous quality of life impacts, where the genitals can literally be ripped to the urinary tract or anus. Circumcision can rarely have minor, generally short-term complications, and does not impair sexual function, either when performed as a child or an adult. I do not appreciate your hyperbole. It is disrespectful to the incredibly serious plight of tens of millions of women. FGM is performed with dirty razors or bits of glass by non-doctors in the third world, and the rudimentary procedures employed there--for strictly and exclusively cultural reasons, not medical ones--cannot, by any reasonable person, be compared to the medicalized circumcisions, performed in hospitals and under doctors' care, that are the vast majority of those performed worldwide. Morrowulf (talk) 12:49, 27 March 2012 (UTC)

I disagree. Simply because male circumcision is less fatal than female circumcision does make it any more right from a moral stand point. Garycompugeek (talk) 13:14, 27 March 2012 (UTC)

The scope of the possible harm and benefits caused in each proportion differs conservatively by orders of magnitude. I'm not interested in the "moral stand point". I'm interested in the real, incredibly disproportionate harm, and the callous disregard that comparisons of circumcision to FGM display. Morrowulf (talk) 17:16, 27 March 2012 (UTC)

Ahh well I feel your being very hypocritical and very callous towards male circumcision, its complications and long term side effects. Ultimately it matters not a whit what you and I feel or are interested it, its all WP:OR, cant possibly go into the article and therefore shouldn't be discussed here. Garycompugeek (talk) 17:47, 27 March 2012 (UTC)

It doesn't matter what the magnitude of harms are. They are of the same nature. Egg Centric 21:19, 27 March 2012 (UTC)

Most female circumcision is not removal of the clitoris, it is removal of the clitoral hood, which is analogous to the male foreskin. It might help to read up on female circumcision, before going on a diatribe. It also might help to do a web search for "wrongful death", "meatal stenosis","hidden penis", "skin bridges", and "adhesions". It also might tone down your outrage to know that many male circumcisions are not performed under optimal medical conditions, such as "metzizah b’ peh" in places such as Brooklyn, NY, USA, which has resulted in multiple fatalities, and herpes infections for life. As far as quality of life, how would one discern? Do I know what you experience? Do you know what I experience? As a witness, medicalized circumcisions are not universally pleasant, or painless, or infection-free. Again, the CDC does not consider it medical in the US, or they would be keeping stronger records on it, as they do with procedures they consider medical. Tftobin (talk) 16:24, 27 March 2012 (UTC)

Many, certainly, but not most. I'm familiar with cases of traditional, Jewish circumcision rituals that have led to death of the infant, by a transmitted herpes infection. I'm not defending that practice. It is absurd and indefensible on the basis of its likely harms. I will not tone down my outrage. The possible harm resulting from two practices is vastly disproportionate, and presenting the practices and resultant harm as comparable is, at the least, a hideous misrepresentation of reality, and shows a callous disregard to the harm that FGM causes over the convenience of advocating some strictly theoretical and position.

By the way, you have at least one herpes infection, and likely at least two: EBV, and likely (that is to say probably in the literal sense of the world) HSV-1. They are ubiquitous, and that you point conflate the specific risks infants face from contracting herpes infections with herpes generally--"herpes infections for life"--is a show of convenient, exploitative rhetoric or of lack of understanding of herpes infections. Morrowulf (talk) 17:16, 27 March 2012 (UTC)

Are you really trying to minimize the deaths of those two boys who died from herpes infections in Brooklyn? There is saying something to make a point, and then there is saying something to make a point at all costs. Are you trying to tell me that I am using "convenient, exploitative rhetoric"? Those two boys, the one in 2005, and the one in 2011, are truly dead, and they died of herpes contracted during their circumcisions. Tftobin (talk) 21:19, 27 March 2012 (UTC)

To make an analogy to vaccination, you are shoving a needle into a child and injecting bits of pathogenic organisms into them. Vaccination is surely painful, and vaccination does kill people. That's a convenient argument to make, and on its face it may seem reasonable. When you assess the magnitude of the harms actually faced by vaccinated children--perhaps one in millions will die as a result of a vaccination--such an argument plainly fails. Yours does not terribly differ from such an argument. (As an aside--and it is an aside, as are other empirically unsubstantiated claims about the harm of a particular practice--how do you justify the practice of vaccinating children? You're doing something injurious to the child, again their informed consent. Is there no ethical case for it? If you have a response, feel free to share it on my talk page.) Morrowulf (talk) 17:22, 27 March 2012 (UTC)

Are you familiar with the glans being severed by Tara Klamps, or by Mogen clamps? Please, feel free to not tone down your outrage. Please, also feel free to do your homework, so that when you go off like a cannon, it will be for something realistic. Did I mention vaccination? I thought not. Tftobin (talk) 18:57, 27 March 2012 (UTC)

Again, it was an analogy. I was attempting to use vaccination to illustrate the strategy of attempting to say shocking, horrific things, rather than substantiating real allegations of harm with empirical evidence. 'Oh, no, Tara Klamps, or Mogen clamps! That's almost as terrifying as shoving a needle into a child!' I'm sorry if that didn't come off as clear. Again, these anecdotal attacks lack substance. Surgery itself is, by that standard, horrifying. In some surgical procedures, you cut open someone's ribcage, and can even remove their HEART! The sheet barbarity of it! Leaches are still used in modern medicine. Merely saying that a medical procedure is shocking is not evidence of harm, or that it should not ever be employed. Please post that evidence, rather than purely rhetorical attacks devoid of empiricism. Morrowulf (talk) 19:20, 27 March 2012 (UTC)

I am trying in good faith to consider that you may be unintentionally coming off as a jerk. You find the concept of female circumcision repulsive. So do I. Do I share the degree of your horror? No. Because I realize that the majority of female circumcisions are foreskin removals, which is exactly analogous to male circumcision. It's pretty much the same deal, either sex, for the majority of those who have either procedure done to them as a child. I don't think you would be mocking the clamps articles, or the wrongful death suits, if you or a loved one were subject to some of those horrors. I personally know someone who had his glans sewed back on. By the same token, I find the HIV stuff overblown, from living in a country where circumcision is the norm, and watching people die of AIDS anyway. Surgery to remove the heart is a weak strawman. Typically, when a heart is removed, it is repaired, or placed in someone else. Typically, a foreskin is not repaired, nor is it placed in someone else. Is circumcision a medical procedure? I'm not certain that society, in general, has made up its mind. It seems to be of two minds...it is and it isn't surgery. Please consider switching to decaf. Tftobin (talk) 19:53, 27 March 2012 (UTC)

Let's drop the subject. It's an emotive comparison, both for those who believe it is appropriate and those of us who believe it isn't. But more to the point, there's no need to discuss it. It doesn't advance the article in any way. Jakew (talk) 20:00, 27 March 2012 (UTC)

It does seem like sexism against men only. At http://en.wikipedia.org/wiki/Talk:Selective_Service_System someone compared it to the military draft. "As the US Government didnt arrest my parents when they had me circumcised I do not feel beholden to it. —Preceding unsigned comment added by 74.221.110.161 (talk) 13:28, 14 September 2008 (UTC)" AvocadosTheorem (talk) 17:34, 29 March 2012 (UTC)

Impartiality and NPOV

Are we certain that Jakew's web site, The Circumcision Reference Library (CIRCS), is the most impartial pro-circumcision web site which could be selected? Does it strike anyone else as uncomfortable? Is this really the best thing, for avoiding the appearance of impropriety? Another thing which seems peculiar, is that User:Jakew states, "I am neither in favour of or against neonatal circumcision, but am opposed to misleading information.", and yet someone described The Circumcision Reference Library (CIRCS), saying "CIRCS articles are chosen from a pro-circumcision point of view." What am I missing here? Tftobin (talk) 00:53, 23 March 2012 (UTC)

Occasionally, reality may appear to have a bias. This is because one's viewpoint may not be based solely in reality and may arise in part from information beyond that from, for instance, peer-reviewed literature. For example, all evidence indicates that global warming is real; you may say that this indicates that the evidence regarding global warming has a "pro-global warming" point of view, or something similar, but this is simply invalid framing. I viewed the site critically considering that it as possible the site does have a pro-circumcision bias, but I notice that the site has a section featuring articles discussing the risks of complications from circumcision. I'm not sure how articles discussing direct, negative health impacts of circumcision indicate a pro-circumcision point of view. Perhaps you could elucidate. Morrowulf (talk) 03:03, 23 March 2012 (UTC)

"reality may appear to have a bias." Do you "know a reality"? Without a lens of bias? Is it possible to separate the two, without the scientific method? It's almost impossible with the scientific method. This is not at all what I was discussing. I was discussing that the work of an editor appears as a reference in the article. This is not about "my reality" or "my bias". It is that someone chose to spotlight a source created by an editor, and cite it as a reference. Whoever posted it, may be using it as a source in ways unintended by the creator, if his words on his user page are true. Speaking of bias, exactly how many of the anti-circumcision articles have been lent credence? Or framed in a neutral point of view? How many well known articles have not been posted at all? But that is not my point. Whether the author of the website intended it to be biased, or unbiased, or failed or succeeded at either, is neither here nor there. The fact that a website with which an editor here is associated, is being referenced as a source of information, is at best highly questionable. Tftobin (talk) 10:59, 23 March 2012 (UTC)

There's nothing inherently inappropriate about citing a Wikipedia editor's work; see WP:COS. However, CIRCS is a self-published source, and hence would not be suitable for use as a reference, regardless of authorship. As our ref 138, we cite an article in JAMA (Laumann et al), and we also we provide a convenience link to a reprint of that article at CIRCS. I've no objection to removing that link (while, obviously, retaining the source); in fact I've been considering removing it and the 6 or so links to CIRP reprints anyway, on grounds that it's probably better not to link to unofficial reprints of unknown accuracy. We could remove the notice at the head of the references section at the same time. Jakew (talk) 11:22, 23 March 2012 (UTC)

How does anyone else feel? Perhaps use www.circinfo.net instead of CIRCS, as the pro-circumcision web site?

How does one maintain NPOV as an editor, the position that "I am neither in favour of or against neonatal circumcision, but am opposed to misleading information.", and a pro-circumcision web site, at the same time? Does this seem logically inconsistent to anyone else? Tftobin (talk) 14:57, 23 March 2012 (UTC)

Does circinfo.net provide reprints of the same reliable sources, Tom? If it doesn't, then how, exactly, could we use it? Remember that it is a WP:SPS, and cannot be cited as a reference itself.

As for your question, I believe it is answered here. Jakew (talk) 16:21, 23 March 2012 (UTC)

Seem odd that the circumcision page, with all of its stringent rules about verifiable sources and secondary studies, would have a WP:SPS for all this time? I don't know how others feel, but I would be fine with both CIRCS and CIRP and the references to them disappearing. Tftobin (talk) 17:23, 23 March 2012 (UTC)

Sorry--when was it decided that the site is pro-circumcision? I believe that I said the site has multiple anti-circumcision articles. Is it just not anti-circumcision enough for it to be valid? And all of the articles are framed neutrally. Their information is presented without criticism.

And are the articles referenced in the manner they are merely for the convenience of people who may seek to look at them? Would replacing them with just the article title and other publication information so that people can find and verify the articles on their own be a superior solution? Morrowulf (talk) 23:09, 23 March 2012 (UTC)

I think there are about 7 references in total, and we could and should provide the PubMed abstract for those papers. But we have to weigh the convenience for the reader of being given a link to the full text with the possibility that we might be linking to a version that is not a true copy of the original, and/or might have annotations or highlighting added by the website (see reprint of our ref 127 at CIRP, for example). I'm not absolutely certain of the right approach, but I'm leaning in the direction of removing those convenience links. What are your thoughts? Jakew (talk) 09:53, 24 March 2012 (UTC)

Back before time, when CIRCS was included, it had this statement. "CIRCS articles are chosen from a pro-circumcision point of view." If you care to go back far enough, you can find it. I find it comical that you can talk to me about bias, but since it fits your particular bias, you see nothing pro-circumcision about it, when even the author refers to it as pro-circumcision. This speaks volumes. Show me the reference to "Fine-touch pressure thresholds in the adult penis", or read Waskett's analysis of the Joy of Uncircumcising, which does not account for sensation from the foreskin, for instance. Jakew's point is that people can't find the articles on their own, in either CIRCS or CIRP, because information is not static. It goes in and out of publication. CIRCS and CIRP have preserved information which was once published, but now no longer is in print, or on the net anywhere else. There is some risk involved. What were once verifiable sources, no longer are, so you have to trust these organizations. If someone is of the opposite bias, they point and say, "It came from that web site. Those people can't be trusted. Of course, with their bias, that's what they are going to say.". Its value as evidence is diminished because of that. Then again, there is a historical record of previous value. That is why Jakew and I ask others, what do you think? It's a double edged sword Tftobin (talk) 12:33, 24 March 2012 (UTC)

I think you've misunderstood, Tom. These articles are perfectly verifiable. Wikipedia's verifiability requirement does not require that sources are freely accessible; see WP:SOURCEACCESS. To access the full text of Laumann et al., for example, all one has to do is visit a medical library, hold a subscription to JAMA, or purchase a PDF (for about $30[6]).

Incidentally, I don't believe I've ever stated that CIRCS is pro-circumcision. Jakew (talk) 12:53, 24 March 2012 (UTC)

I haven't stated on my own that CIRCS is pro-circumcision. The statement that "CIRCS articles are chosen from a pro-circumcision point of view." was taken, verbatim, as a quote of what was already there. It happened long before I was editing here. Please feel free to go after whomever it was who stated it. Tftobin (talk) 21:34, 26 March 2012 (UTC)

I think confusion may have resulted from your statement that "when even the author refers to it as pro-circumcision", which I took to mean "the author of the site", ie., myself. Perhaps you meant "the author of the words in the disclaimer"? Jakew (talk) 11:43, 27 March 2012 (UTC)

Precisely, Jakew. Thanks for helping to clear up the lack of clarity. Tftobin (talk) 16:03, 27 March 2012 (UTC)

Tftobin, Your comment included a statement or statements about editors, not article content. Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor." Jayjg ^(talk) 01:26, 25 March 2012 (UTC)

Please delete this erroneous statement, Jayjg. When I quote from the circumcision page, I am not making it up. Nor does that imply that it represents my sentiments, merely that that is how it is stated on the circumcision page. When I quote User:Jakew verbatim, I am not making that up, nor does it express my sentiments. I was merely pointing out that there was a logical inconsistency with the labeling of the web site, which, since Jakew questioned it himself, he seems to agree, that there is a logical inconsistency in calling CIRCS a pro-circumcision site. Tftobin (talk) 21:34, 26 March 2012 (UTC)

The statement "since it fits your particular bias, you see nothing pro-circumcision about it", made on 12:33, 24 March 2012, and to which my comment was a response, was a statement about contributors, not content. Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor", and per WP:CIVIL, please make accurate Talk: page statements. Jayjg ^(talk) 02:58, 1 April 2012 (UTC)

There are editors who adopt a truly snotty tone. It is not an aid to discussion. It feels more like a power trip to read. Just saying, this could be a better place. Tftobin (talk) 12:19, 1 April 2012 (UTC)

I'm glad you've identified one of the problems with your posts. That's the first step. I'm looking forward to improvements in them that will lead to this talk page becoming "a better place". Jayjg ^(talk) 19:07, 1 April 2012 (UTC)

Yes, it definitely feels like a power trip. Tftobin (talk) 23:59, 1 April 2012 (UTC)

If that's the case, then why don't you stop doing it? And what does any of this have to do with article content? Jayjg ^(talk) 00:15, 2 April 2012 (UTC)

In my visit to the site, I did not note any explicit or implicit indication that it was biased. Also speaking of biased sources, I just googled "The Joy of Uncircumcision" and found some shocking things on the site:

"Emotional pain. When feeling hopeless over their unchosen circumcised state, men can be helped to manage anger by doing something about a condition which they had always believed was irreversible.

Resentment. A 1991 survey of 301 males seeking restoration information showed that almost 70% of those circumcised as infants or children resent their parents for their circumcision. Regaining power over their bodies reduces resentment.

Empowerment. Victims of rape, crime and child or spousal abuse typically report a deep sense of helplessness and vulnerability. Who is more helpless and vulnerable than a restrained newborn having part of his penis amputated? Men restore to take back control of their bodies from the damage done by parents, their physicians and our culture."

What was that about biased sources? I don't see peer-reviewed articles in support of these statements; I see statements that occasionally cite studies, even though these studies do not offer useful information and largely fail to support the claims made on this site; is it really shocking that people upset they're circumcised are upset at their parents for circumcising them? And where is the evidence that foreskin restoration reduces parental resentment? And surveys of men in the general population, not in men already seeking to restore their foreskin and upset at their parents, should be offered. And really? Comparing rape to circumcision? This is absurd. I'm a new arrival to this article, and I'm only looking for factual information that is not biased, and I am not advocating any viewpoint that is not suggested by these facts or by medical organizations. However, the information that you referenced that is missing is not in any way acceptable for inclusion in this article. Morrowulf (talk) 23:16, 24 March 2012 (UTC)

I think it's of considerable value to the reader to provide links to online copies of reliable sources. However, I don't think we should state that a website is a "pro-circumcision" or "anti-circumcision" website unless there is a reliable source stating this or the website itself states it. Opinions may differ as to whether a website is or is not "pro-circumcision" or "anti-circumcision". ☺Coppertwig (talk) 18:52, 25 March 2012 (UTC)

I agree in theory, but in practice these websites are pretty obviously either pro or anti circumcision. In fact, there are very large numbers of anti-circumcision websites out there, along with a small number of pro-circumcision sites. The duck test is relevant. Jayjg ^(talk) 19:43, 25 March 2012 (UTC)

And what does this have to do with the matter at hand? Please stick to the topic. Tftobin (talk) 21:34, 26 March 2012 (UTC)

The "matter at hand" was whether we should state websites are "pro-circumcision" or "anti-circumcision"; please review the comment to which I was responding, and, in general, please follow the discussion more closely. Thanks! Jayjg ^(talk) 02:21, 1 April 2012 (UTC)

Got anything to back up the assertion that "In fact, there are very large numbers of anti-circumcision websites out there, along with a small number of pro-circumcision sites."? If you do, I would love to see it. Tftobin (talk) 12:19, 1 April 2012 (UTC)

You'll find it in the source that you used to back up your assertion that circumcision "is easily the second most controversial operation in the world". Jayjg ^(talk) 00:16, 2 April 2012 (UTC)

I disagree. I think opinions differ and that what looks pro- or anti- to one person may look neutral to another. ☺Coppertwig (talk) 00:00, 26 March 2012 (UTC)

It's very telling that jake's website only has two papers about the ethics of circumcision. As a contributor above notes, reality can be biased towards one or the other viewpoint and the facts are that circumcision is not provably harmful over all (especially when done by a doctor and not some guy sucking the blood from a baby's dick), and may even have some benefits. But most anti-circumcision arguments focus on the ethics of mutilating children, and this is something that the pro-circumcision advocates have very few answers to - apart from in many cases "god told us to". Egg Centric 12:26, 26 March 2012 (UTC)

I'm not sure there's much to be gained by labelling sites as "pro-circumcision" or "anti-circumcision". Even if we assume for the sake of argument that a site's bias is blatantly obvious to all, there's no pressing need to say so. We do, however, need to advise readers that these are reprints (as opposed to pages provided by the original publisher), and that they may be altered in the form of annotations or highlighting. Would it be worth rephrasing the notice in terms of these issues? Jakew (talk) 15:39, 26 March 2012 (UTC)

We shouldn't be linking to content that has been altered with annotations or highlights. We should be linking to the original content or an exact copy. I'm also concerned about the copyright of these copies. If the publisher does not make them available to the public, is posting these on your own public site a violation of the publishers copyright? This should certainly be looked into. We don't want wikipedia contributing to piracy. Gsonnenf (talk) 19:26, 26 March 2012 (UTC)

Most of the articles seem to be only abstracts, though there are a few full-text versions. I suspect that Jakew posts the full text of whatever sources he has license to, for whatever reason that may be. It may be true that all of these sources are available in whole or part on other places online. If you don't believe that there is value in providing users with compilations of relevant sources, and without changing the sources in any way, then links to content can, I suppose, be replaced with mere citations of the articles so users can locate and verify the sources themselves. I don't think that's a very defensible solution in terms of either its motivation or in terms of its effect on readers of the article who may be interested in viewing the referenced material. Morrowulf (talk) 23:37, 26 March 2012 (UTC)

These sites are like things you keep in your closet, because you can't bear to throw them away, though they have outlived their usefulness. How much is an article from 1998 really worth these days? As Jakew stated correctly, there are 6 articles which would be lost by getting rid of CIRP, and none which would be lost by getting rid of CIRCS. If you can't cite them in discussion, and not have them be considered legit, they are just taking up space. If somebody really, really wants them, speak now, otherwise I think they are just there for partisans to point to stuff that supports their viewpoint, and say, "See." They really appear to provide more support to both sides of the argument, than they actually supply. Tftobin (talk) 11:13, 27 March 2012 (UTC)

Straw poll

This straw poll is to determine whether there is consensus to remove convenience links to reprints of a small number of articles at CIRP.org and CIRCS.org, on grounds that we know that annotations and highlighting have been added in some cases, and we cannot be certain of the reliability. It is not a proposal to remove the references altogether; they would still be cited, and PubMed abstracts would still cited where appropriate.

What does 'where appropriate' mean? Tftobin (talk) 16:05, 27 March 2012 (UTC)

Well, some articles aren't listed in PubMed, so we can't link to a PubMed abstract for those articles. Perhaps I should have said 'where possible'. Jakew (talk) 16:09, 27 March 2012 (UTC)

• Support as proposer. Jakew (talk) 11:38, 27 March 2012 (UTC)
• Support Tftobin (talk) 18:50, 27 March 2012 (UTC)
• Oppose - Verifiability is one of the core wikipedia principles. Being able to easily access a reliable source directly, even if it's hosted at a biased site, is very valuable. These two sites should be a last resort though, only used if the source cannot be found elsewhere. Also, removing these links will needlessly inconvenience users, who will search for the document via google or google scholar, then end up viewing the document through cirp or circs anyways. kyledueck (talk) 00:38, 29 March 2012 (UTC)
• Question - why? Jake I must admit that I found your obsession with this article very peculiar and being of a very pro-choice and consquently anti-infant circumcision frame of mind myself did some research and came across that article on "another wiki" about you... yet it was perfectly clear to me that that was slanderous crap; you don't have to be ashamed of being interested in a subject (I find the sexual fetish slurs on you at said site a disgraceful and irrelevant smear tactic) and if your site hosts the paper fer gawds sake feel free to link to it. I appreciate that there is a thing about wikipedia being seen to be neutral - but this talk page and its archives see to that. Surely it's actually better for wikipedia that we have someone who is prepared to both edit the article and keep the sources hosted! Egg Centric 00:46, 29 March 2012 (UTC)
  • I thought I explained why in the paragraph describing the poll. Per WP:CITE#Convenience links: "When offering convenience links, it is important to be reasonably certain that the convenience copy is a true copy of the original, without any changes or inappropriate commentary, and that it does not infringe the original publisher's copyright." We know that several of these pages include highlighting and/or annotations (eg., here), and we can't be reasonably certain that no other changes have been made. Removing the links seems to be the obvious course of action. Jakew (talk) 07:53, 29 March 2012 (UTC)

Perhaps we should move these links to a sticky thread in the talk page. That way we can still track these resources, for our own use, without polluting the main article with biased annotations or highlighting.Gsonnenf (talk) 00:15, 30 March 2012 (UTC)

That doesn't strike me as an acceptable solution. I think readers would assume that we're reading the cited sources, and not acting based on some other copies of them. So long as merely mentioning the proper title of the article is more important than giving access to what is largely an agreeable compilation of information from them, I'm not sure anything besides merely citing the articles by title is an acceptable solution. Morrowulf (talk) 02:17, 3 April 2012 (UTC)

My proposal

I'm adding to the top again even though I know that new content should be added to the bottom on purpose. This article has been diseased for a while and we need to call attention to it.

First of all, we need to add back the neutrality flag. This article is not neutral at all. Secondly, Jakew and all the other pro-circ editors should be removed. Is it possible for us mere mortals to add this neutrality flag? Or do we have to be one of the "editors"?

When I read the FGM article on Wikipedia, it sounds like a "bad thing", which it is. When I read this article, it sounds like a "good thing". This is bias. Why are there different standards for boys & girls? Don't boys deserve a right to their own genitals?

Medical benefits to circumcision are irrelevant since there are lots of surgeries that could have "benefit" that we don't do since they violate human rights. We don't do infant mastectomies even though they would save the lives of millions. Think about it.

But let's say we do talk about "benefits". Ethical studies done in the US by the US Navy and others have shown no benefits for HIV or STD prevention. Yet the unethical African studies are featured prominently in this article; those studies paid participants, didn't tell partners if a participant had HIV, and are funded by pro-circ organizations. This isn't science: it's a sham. And let's not forget that MGM does nothing to prevent HIV -- a condom is still required. So why, again, are we destroying men's genitals when they still have to wear a condom? I've never heard of anything so silly. Would you have sex with an HIV+ man just because he was cut? Would you have sex with an HIV+ woman if you were cut? Preposterous. Erikvcl (talk) 14:00, 3 April 2012 (UTC)

This page is a joke

This page is full of unscientific and discredited research quoted as fact. I've never seen so much bias on any other subject on Wikipedia. The editors for this page should be removed immediately and replaced with individuals who can properly interpret research to achieve as neutral a viewpoint as possible. Erikvcl (talk) 20:11, 29 March 2012 (UTC)

While I might tend to feel as you do, the editors are between a rock and a hard place. Some research producers are working double overtime to push out studies. No one is rising to the challenge, to prove them wrong. One viewpoint has nearly endless cash. No one is contributing vast sums of money, to prove that a normal body part works normally. Consequently, there are many well-funded studies, which tend to give the result the person who wrote, or funded them, wanted. There are many meta-studies. As a consequence of the meta-studies, there exists a body of secondary sources. For the other viewpoint, they are not producing many studies, and almost no meta-studies. Even if an editor wanted to represent that viewpoint, they have nothing to work with, which rises to the stringent standards of editing this particular wikipedia page. The fault, as I see it, shouldn't be laid at the feet of the editors. It should be with the people who peer review junk science, so that it goes on to be published, and so that meta-studies are done on it. As they say in the computer business, garbage in, garbage out. Wikipedia has some high standards. The medical publishing business has lowered theirs, as to appear to be competing with the investment banks, and the ratings bureaus, circa 2008. Just because something violates your experience, and your common sense, doesn't mean that there isn't peer-reviewed, meta-studied secondary sources which will affirm it. Where is the same data which validates your (and my) experience. It really is not so simple. Tftobin (talk) 21:20, 29 March 2012 (UTC)

You do bring up some good points and I understand that an encyclopedia has limitations as it is a secondary source that draws from primary sources. I saw some research that showed no difference in sensitivity between cut and uncut men. How was the study done? By comparing the same parts on the penis even though one penis has far more parts. It doesn't take a rocket scientist to realize that this study is bogus. Is this study appropriate for use on Wikipedia? Of course not. I am not aware of a single peer-reviewed scientific study that confirms that circumcision is beneficial preventing STDs, HIV, or prostate cancer -- yet these benefits are a prominent part of the Wikipedia article. What I've seen is a lot of poorly-done unscientific research that hasn't received the proper peer review. The ethical considerations are given very little weight in the Wikipedia article. This is one of the most important aspects -- we consider it unethical to give minors tattoos and to cut the genitals of girls. But for boys its OK. Why isn't this inconsistency not featured here? Erikvcl (talk) 14:37, 2 April 2012 (UTC)

I absolutely, totally understand your point, about the measurement of sensitivity. As Jakew has explained, correctness and incorrectness have no real bearing on what goes into wikipedia. It is the ability to cite verifiable sources, verifiable in the sense of, "yes, they said that". "yes, it was peer-reviewed." "yes, it was subject to a meta-study, and can be cited as a secondary resource". I am aware of multiple studies which show that circumcision status has no bearing on disease prevention of HIV, HPV, and the common STDs, from the US and UK, but no meta-studies, and no secondary resources. It costs approximately $1945 to get published in what is known as a peer-reviewed site, which is commonly cited. You pay your money, and you appear to get peer-reviewed. Tftobin (talk) 17:02, 3 April 2012 (UTC)

I think the US Navy study has some validity. And the ethical concerns. And the comparison with FGM. If Wikipedia doesn't strive for correctness, it's worthless. Erikvcl (talk) 17:06, 3 April 2012 (UTC)

The Navy study is valid. The University of Washington study regarding HPV is valid. There are two in the UK which agree, and are valid. There are no meta-studies. That's the problem. I totally agree, If Wikipedia doesn't strive for correctness, it's less than worthless. It has become what it strove to replace. People will read it, and go to a more reliable source, like online Britannica. Tftobin (talk) 11:06, 5 April 2012 (UTC)

Let's play with the intro

Here it is. Please copy and paste it and make your wanted modifications to it in a new subsection of this. Egg Centric 21:22, 27 March 2012 (UTC)

Male circumcision is the surgical removal of some or all of the foreskin (prepuce) from the penis. Early depictions of circumcision are found in cave paintings and Ancient Egyptian tombs, though some pictures are open to interpretation. Religious male circumcision is considered a commandment from God in Judaism. In Islam, though not mentioned in the Qur'an, male circumcision is widely practised and often considered to be sunnah. It is also customary in some Christian churches in Africa.

Estimates by the World Health Organization (WHO) suggest that 30 percent of males worldwide are circumcised, of whom 68 percent are Muslim. The prevalence of circumcision varies mostly with religious affiliation, and sometimes culture. The timing of circumcision similarly varies, though it is commonly practised between birth and the early twenties.

Circumcision is used therapeutically, as one of the treatment options for balanitis xerotica obliterans, phimosis, balanitis, posthitis, balanoposthitis and for preventing urinary tract infections in high risk boys. Summaries of the views of professional associations of physicians include that none currently recommend routine circumcision,and most recommend neither universal circumcision nor its prohibition.

Strong evidence from Africa indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66%, and studies have concluded it is cost effective in sub-Saharan Africa. The WHO currently recommends circumcision be recognised as an intervention as part of a comprehensive program for prevention of HIV transmission in areas with high endemic rates of HIV. Some bodies have discussed under what circumstances circumcision is ethical.

There is controversy regarding circumcision. Specific controversies have included the health benefits and risks of the procedure, ethical and legal considerations, and the application of human rights principles to the practice.

Sure I'll play but you started this thread Egg, what are you trying to change or modify and why? I feel the HIV paragraph is misleading. I have argued that it is not lead worthy and/or does not reflect the criticism attributed to it. I don't care much for the new medical summary either, it seems to wordy and contradictory of itself. If we keep HIV in the lead my compromise would be,

"Studies in Africa have indicated that circumcision reduces the risk of HIV infection in heterosexual men by 38-66%, however these findings conflict with data in modern countries like the United States. The WHO currently recommends circumcision be recognized as an intervention as part of a comprehensive program for prevention of HIV transmission in areas with high endemic rates of HIV. Some bodies have discussed under what circumstances circumcision is ethical." Garycompugeek (talk) 16:08, 28 March 2012 (UTC)

The results if the studies in African have been inconsistent. There are six African countries where men are more likely to be HIV+ if they’ve been circumcised: Rwanda, Cameroon, Ghana, Lesotho, Malawi, and Swaziland. In Malawi, the HIV rate is 13.2% among circumcised men, but only 9.5% among intact men. In Cameroon, the HIV rate is 4.1% among circumcised men, but only 1.1% among intact men. Tftobin (talk) 20:11, 28 March 2012 (UTC)

Sorry--are you suggesting there's experimental evidence indicating that circumcision leads to higher rates of HIV? Or are you merely citing an observational survey, even in the presence of better types of evidence on the issue? To expound upon this a little more, there're other explanations, if you're not using experimental evidence. Perhaps Malawian men are likely to be more educated and wealthier, if they're uncircumcised. Perhaps circumcised men just have sex with more women. What's the experimental study you're referencing? Morrowulf (talk) 02:20, 3 April 2012 (UTC)

Ah, that's an important points. I've seen papers suggesting that circumcision may cause circumcised African men to engage in more unprotected sex because they believe circumcision protects them. Its important we factor these correlations in. Gsonnenf (talk) 06:30, 3 April 2012 (UTC)

It makes no difference. It's a Malawian study, which states that freshly circumcised boys are encouraged to engage in intercourse before their wound is completely healed. It is a primary source, so it can't be cited, in this page, in wikipedia. Tftobin (talk) 20:33, 4 April 2012 (UTC)

References

Egg's proposed version #1

(For my own simplcity of editing I've ignore citing)

Male circumcision is the controversial surgical procedure entailing removal of some or all of the foreskin (prepuce) from the penis.

Circumcision is used for both theraputic and religious or cultural reasons.

Theraputic uses of circumcision include using it as a treatment option for balanitis xerotica obliterans, phimosis, balanitis, posthitis, balanoposthitis and for preventing urinary tract infections in high risk boys. Professional associations of physicians endorse its use for one or more of these conditions; furthermore, none currently recommend routine circumcision, nor do many endorse its prohibition.

This isn't telling the whole story. Though indeed, circumcision is used to treat balanitis xerotica obliterans, phimosis, balanitis, posthitis, and balanoposthitis, in countries where circumcision is common, more conservative treatments for these conditions exist. Circumcision is almost never the cure for these conditions in countries where routine circumcision is not practiced. Balanitis xerotica obliterans is also called lichen sclerosus. It often responds to topical steroid cream, such as Temovate 0.05%. Women get lichen sclerosus, and rarely have surgery. Phimosis often responds well to daily stretching with the fingers. Those few cases which do not respond well, often respond well to betamethasone cream applied externally, in addition to stretching with the fingers. If that fails, there is always the dorsal or ventral slit operation, which removes no tissue, but frees the glans. Balanitis, posthitis, and balanoposthitis are typically treated in non-circumcising countries with diaper cream containing zinc oxide, or an anti-fungal. They sound a lot more dangerous, when called by these names. Tftobin (talk) 16:59, 29 March 2012 (UTC)

Nevertheless, the majority of circumcisions are for cultural reasons.Early depictions of circumcision are found in cave paintings and Ancient Egyptian tombs (although some pictures are open to interpretation.) Religious male circumcision is considered a commandment from God in Judaism. In Islam, though not mentioned in the Qur'an, male circumcision is widely practised and often considered to be sunnah. It is also customary in some Christian churches in Africa.

Estimates by the World Health Organization (WHO) suggest that 30 percent of males worldwide are circumcised, of whom 68 percent are Muslim. The prevalence of circumcision varies mostly with religious affiliation, and sometimes culture. The timing of circumcision similarly varies, though it is commonly practised between birth and the early twenties.

There is a great deal of controversy regarding circumcision. Specific controversies have included the health benefits and risks of the procedure, ethical and legal considerations, and the application of human rights principles to the practice.

So what do we think about that ladies and gents? Egg Centric 00:00, 29 March 2012 (UTC)

hmmm... I think you should leave out controversial in the first sentence. you mention controversy soon enough. --VikÞor | Talk 03:23, 29 March 2012 (UTC)

Agree. Jakew (talk) 07:48, 29 March 2012 (UTC)

Disagree. It is easily the second most controversial operation in the world, second only to female circumcision. Tftobin (talk) 17:07, 29 March 2012 (UTC)

Some quick comments:

• The most glaring problem is the omission of the HIV material.
• The second paragraph is unnecessary.
• Awkward phrasing in "Theraputic uses of circumcision include using it as a treatment" (bad spelling, too).
• In the next sentence, a dubious assertion: "Professional associations of physicians endorse its use for one or more of these conditions". Do they? What constitutes an "endorsement" of its use?
• The meaning is scrambled in "furthermore, none currently recommend routine circumcision, nor do many endorse its prohibition", as a result of performing WP:SYNTH on two sources.
• "Nevertheless, the majority of circumcisions are for cultural reasons" needs the inclusion of the word "performed" to be grammatically correct, but I'd question whether the sentence is needed.
• "There is a great deal of controversy regarding circumcision." -- "Great deal of" is hyperbole. What constitutes a "great deal"? Just say "there is controversy".

In summary, this doesn't seem to offer anything over the present version of the lead, and in fact introduces a number of problems, some serious and some less serious. Jakew (talk) 09:17, 29 March 2012 (UTC)

The outcomes of the HIV studies contradict those of multiple studies in the US and the UK. Tftobin (talk) 21:24, 29 March 2012 (UTC)

When multiple countries are trying to enact legislation to ban it outright, or have recently attempted to do so regionally, I think it is safe to say there is a great deal of controversy. Finland, Sweden, San Francisco spring to mind. I think there is legal action in the Netherlands as well. I know the controversy in the US never seems to cease. Hyperbole suggests exaggeration. I don't think this is a case of hyperbole at all. Tftobin (talk) 21:24, 29 March 2012 (UTC)

Circumcision is considered controversial when applied for cultural/religious or medical prevention reasons. Targeted treatment, such as a treatment for BXO, is not considered as controversial. The controversy needs to be mentioned in this context. There is an enormous amount of sourced material that this controversy exists and groups are taking legal action to have it banned. This is not given proper weight in the lead. Gsonnenf (talk) 00:24, 30 March 2012 (UTC)

From wikipedia, Ethics of circumcision: "The Royal Australasian College of Physicians (RACP) and the British Medical Association (BMA) observe that controversy exists on this issue,[9][10] the BMA insisting that a non-therapeutic circumcision must not go ahead without the consent of both parents and, if competent, the child himself.[10]". If it's documented that controversy exists in one section of wikipedia, it would seem that it would be able to document that controversy exists in another section of wikipedia. In my opinion, that, coupled with the KNMG statement, would rise to the level of a great deal of controversy. Couple that with the Medicaid defunding in the US, and the defunding, and possible re-funding, in Colorado, USA, and the outlawing, and de-outlawing in Sweden, well, that would all seem to be the very definition of a great deal of controversy. We haven't even touched upon the medical controversies raging. What is more controversial? The Iranian nuclear program. Female circumcision. What else? Tftobin (talk) 18:41, 31 March 2012 (UTC)

Nobody is suggesting that we should omit mention of the existence of controversy. But that doesn't mean that we should employ unencyclopaedic hyperbole such as "a great deal of controversy". Saying that there is controversy, as we currently do, is fine. Jakew (talk) 18:45, 31 March 2012 (UTC)

I was suggesting that we be truthful about the level of controversy. Just saying it is controversial is not being totally honest. It is one of the most controversial things on the planet. You saying "Saying that there is controversy, as we currently do, is fine." does not make it fine for everybody. I think it is rather dismissive, and don't think the understatement does the subject's impact any justice. I would think that how explosive the atmosphere in this forum can get, gives an indication of what deep differences of feeling are generated by it. Consider how hard it is to reach any kind of consensus. That is a measure of how controversial it is. As encyclopedic content, there is no shortage of sources which say it is controversial. I am open to other opinions on the subject. Tftobin (talk) 02:09, 1 April 2012 (UTC)

The lede quite clearly indicates the nature of the controversy around circumcision. "It is one of the most controversial things on the planet" is a hard claim to support, and seems at best non-factual. Do you have any sources for this statement? Jayjg ^(talk) 02:27, 1 April 2012 (UTC)

When hundreds of articles regarding the subject open with a statement that it is controversial, might that make it a candidate for highly controversial? Perhaps this is one of the differences between our two nations? Tftobin (talk) 12:25, 1 April 2012 (UTC)

Faulty reasoning. You can't infer a stronger statement than sources make simply because lots of them make it. By analogy, the fact that lots of sources say that athlete's foot is a disease doesn't imply that it is a major, life-threatening disease. Jakew (talk) 13:23, 1 April 2012 (UTC)

Is it very controversial, when two thirds of the doctors of a major Western country refuse to do it? Tftobin (talk) 00:10, 2 April 2012 (UTC)

By that standard assisting childbirth is even more controversial. Jayjg ^(talk) 00:14, 2 April 2012 (UTC)

Two thirds of doctors would refuse to assist with childbirth, would they? On what planet? Not specialising in something is a different thing, as thee are well aware Egg Centric 01:23, 2 April 2012 (UTC)

Planet: Earth. Continent: Europe. Country: Sweden. http://www.thelocal.se/20900/20090725/ Tftobin (talk) 10:37, 2 April 2012 (UTC)

Can you read? Egg Centric 00:17, 3 April 2012 (UTC)

Why yes, thank you. I've been reading proficiently since age 5. I can read this: "A survey done by the association reported that two of three pediatric surgeons do not want to perform circumcision. Göthberg regards the operation as an assault since the procedure is done without the child's consent." Tftobin (talk) 21:05, 4 April 2012 (UTC)

Then you would surely understand the difference between circumcision and childbirth. Read what I bloody said. Thanks in advance for your apology. Egg Centric 03:14, 6 April 2012 (UTC)

My mistake. We were talking about circumcision, and whether it is controversial, or extremely controversial. You and Jayjg changed the conversation to childbirth. I owe you no apology. Look up Wikipedia:Etiquette, especially before you start attacking people. Tftobin (talk) 10:47, 6 April 2012 (UTC)

No, Jayjg changed the subject, and I called him on it. Then you displayed a persecution mindset. Egg Centric 14:00, 6 April 2012 (UTC)

You saying statements such as "Can you read?" and "Read what I bloody said. Thanks in advance for your apology." do not constitute me having a "persecution mindset". They demonstrate you you having bad manners, and a total disregard for Wikipedia:Etiquette. But while you and I squabble, others are laughing, because two people who share the same general views are distracted. Tftobin (talk) 16:23, 6 April 2012 (UTC)

(ec) Tom is correct. Egg, it'd be a good idea to review WP:CIVIL. Jakew (talk) 16:24, 6 April 2012 (UTC)

I am actually coming to realize that you are a gracious guy, and twice the gentleman I am, Jakew. I am realizing I need to be more like you, in order to be a better person. Scary, but it's true. I honestly hope I will remember this kindness, and your example, when I am tempted to be uncivil. Tftobin (talk) 00:29, 7 April 2012 (UTC)

I think the problem is that there isn't a universally agreed-upon standard. There is no test by which we measure how controversial something is, and no means of sorting topics in order of quantity of controversy. Consequently, quantifiers can only be subjective: one person might describe something as "very" controversial, while another might describe the same thing as "mildly" controversial, and neither person is wrong. Those quantifiers can never be fact; they can only ever be opinion, and shouldn't really be asserted by Wikipedia. Jakew (talk) 08:11, 2 April 2012 (UTC)

Jakew, Your logic is impeccable here. You are correct. Tftobin (talk) 10:37, 2 April 2012 (UTC)

We have sources describing Circumcision as the most controversial surgery of all time. In terms of the talk page, assuming its extremely controversial topic is absolutely appropriate.Gsonnenf (talk) 06:24, 3 April 2012 (UTC)

Could you share which source? We could put this to bed more quickly. It would seem that "Circumcision as the most controversial surgery of all time.", if it is indeed stated that way in something accepted as a source in here, would be quite deterministic. Tftobin (talk) 17:06, 3 April 2012 (UTC)

Not necessarily, no. Given a statement such as "X is the hottest object in the kuiper belt", could one say "X is extremely hot"? Since X probably has a temperature of 50 or so Kelvins, that would seem absurd. The problem is that one cannot extrapolate from a statement describing circumcision as most controversial among a limited subset unless we know how controversial that subset is in relation to all subjects. Jakew (talk) 08:56, 3 April 2012 (UTC)

Comparing the emotive content of this subject to "athletes foot" and the "Kuiper belt" is a visit through the looking glass to an imaginary world where the meaning of words is whatever you want them to mean. Robert B19 (talk) 19:09, 3 April 2012 (UTC)

I want to hear the story explaining the impact of female circumcision by comparing it to "athletes' foot" and the "Kuiper belt" Tftobin (talk) 10:51, 5 April 2012 (UTC)

http://www.ncbi.nlm.nih.gov/pubmed/15097799 . Jakew, you don't seem to understand that we are looking at its controversy compared to its own category for deciding how much to weight controversy in its own article. We undoubtedly accept reliable sources believe its extremely controversial judged as such. Other sources, such as the legislation, bans from certain countries, suggest it is also controversial on a grander scale. Gsonnenf (talk) 04:35, 4 April 2012 (UTC)

That article pretty much locks it in for me. It's calling a spade a spade. It is doctors calling it the "world's oldest and most controversial operation". I see no reason not to proceed with 'extremely controversial', even though I think that is being euphemistic. Tftobin (talk) 11:01, 5 April 2012 (UTC)

No, Gsonnenf, I don't think I do understand that "we are looking at its controversy compared to its own category for deciding how much to weight controversy in its own article". I'm not even sure what "we are looking at its controversy compared to its own category" even means. What is "its category"? I can think of half a dozen candidates. Second, "we've been discussing this article, and rather than weight issues, we've been discussing whether it is appropriate to include language such as "There is a great deal of controversy regarding circumcision". Jakew (talk) 08:34, 4 April 2012 (UTC)

Egg's proposed version #2

...to follow shortly...

RfC on the position of medical associations closed

This is to notify interested editors that based on a WP:AN request I have closed the discussion that is now at Talk:Circumcision/Archive 70#RfC: how should the lead summarise positions of medical associations? as follows: I find that there is no consensus about how the lead should summarise the position of medical associations about this topic. Further discussion appears to be necessary.  Sandstein  16:05, 5 April 2012 (UTC)

Does this mean that, for right now, the KNMG position is no longer under discussion, and must be restored until further discussion takes place? Tftobin (talk) 00:25, 6 April 2012 (UTC)

No, we've got a compromise in place. Jakew (talk) 09:00, 6 April 2012 (UTC)

There was never a compromise. There's an on-going majority consensus that the article's POV is out of balance with pov advocacy of HIV/AIDS studies. Robert B19 (talk) 18:40, 6 April 2012 (UTC)

Please review WP:MEDRS, WP:SYNTH and WP:TERTIARY before making edits like this, and please make more accurate talk page comments. Jayjg ^(talk) 18:45, 6 April 2012 (UTC)

I actually agree with the compromise. Pass a Method talk 19:23, 6 April 2012 (UTC)

Me too. Currently it says "Summaries of the views of professional associations of physicians include that none currently recommend routine circumcision, and most recommend neither universal circumcision nor its prohibition.". This looks fine to me. I think it's fine to use a summary of medical positions stated by one (Dutch) association: I don't think it's putting too much weight on the Dutch POV, because it's essentially conveying the positions of medical associations worldwide. ☺Coppertwig (talk) 13:57, 7 April 2012 (UTC)

References

Video

If people can post still photos of penises in various states of circumcision, would it be remiss to put in a video of circumcision? I hid in mind something neutral. If not, why allow photos, and not video? Tftobin (talk) 18:30, 11 April 2012 (UTC)

Since Wikipedia has just started incorporating videos into article's I think it's an excellent idea Tom. Garycompugeek (talk) 19:04, 11 April 2012 (UTC)

Problematic changes

I recently reverted a large series of problematic changes that had not been discussed. The changes were obviously too numerous to list the reasons in the edit summary, so I'd like to explain some of the problems here.

• First, the addition to the beginning of the "Medical aspects" section of: "According to Finnish Medical Association, the medical benefits of a routine circumcision diminish against the harms and risks". This is poor English, and consequently difficult to understand, but the effect appears to advance this viewpoint (and only this viewpoint) in that section. Obviously this has associated NPOV problems.
• Second, the addition of two paragraphs to the "Sexual effects" section, citing a news site and a primary source. Neither are appropriate per WP:MEDRS.
• Third, the addition to the "History" section of "According to Moses Maimonides, perhaps the greatest Jewish philosopher ever, the strongest reason for circumcision is to repair the defective human moral by diminishing lust and ability to sexual excitement". It's difficult to know where to begin. "Perhaps the greatest Jewish philosopher ever" is a fairly obvious violation of WP:PEACOCK. It has no particular importance or notability (Maimonides was merely stating his opinion; it wasn't based on research of any kind). It's not even a statement about history, so it doesn't belong in the section.
• The addition of some material to the "Finland" subsection of "Legal issues" is less problematic, but it needs trimming down considerably.
• The creation of the "Finland" subsection of the "Positions of medical associations" section is an interesting addition. It certainly needs editing, but I see no reason why this source should not be cited. Google Translate converts it to broken, but just about understandable, English.
• The addition of a "Sweden" subsection of the "Positions of medical associations" section, citing a news report. This is inappropriate per WP:MEDRS. Jakew (talk) 19:27, 15 April 2012 (UTC)

Sentence in intro about not recommending routine circumcision and not recommending universal circumcision etc.

The following sentence, currently in the intro, is very awkward: "Summaries of the views of professional associations of physicians include that none currently recommend routine circumcision,[13] and most recommend neither universal circumcision nor its prohibition.[14]" I tried to edit it, but my edit was reverted. The edit summary for the revert stated that the "contrast with universal circumcision helps clarify the positions." I think I understand the point to be that there's a difference between universal and routine circumcision. Is that right? That's fine, but the sentence is still awkward and unclear. The words "Summaries of the views of professional associations of physicians include that..." contribute nothing useful and, I think, actually make the sentence harder to follow. Surely all we need to say is "No professional associations of physicians currently recommend routine circumcision." The next part of the sentence ("most recommend neither universal circumcision nor its prohibition") is less bad, but still rather inelegant and hard to understand on first reading. Part of the problem is that it sounds as if it means, "most do not recommend universal circumcision and most do not recommend prohibiting universal circumcision". But I think it's intended to mean, "most do not recommend universal circumcision and most do not recommend prohibiting routine circumcision." Right? Finally, if I understand the source right, it's not "most", but all.

So I'd suggest changing it to the following: "No professional associations of physicians currently recommend routine or universal circumcision;[13][14] however, none [or: most do not] recommend prohibiting the practice.[14]"

Sound ok? I'd just go ahead and change it myself, but I realise that this article is, understandably, a bit of a battlefield at times, so I don't want to tread on any toes! garik (talk) 21:58, 8 April 2012 (UTC)

I would leave out "or universal" because it is superfluous. Failure to recommend routine circumcision would mean that obviously universal circumcision isn't recommended either. kyledueck (talk) 22:09, 8 April 2012 (UTC)

That's my view too, but my edit was reverted apparently because I left "universal" out (unless I misunderstood the reason for reverting), so maybe we're missing something. garik (talk) 22:28, 8 April 2012 (UTC)

"Routine circumcision" actually means the same thing as "universal circumcision" (see footnote 2 to ref 14), but the meaning is less intuitively obvious and is prone to misinterpretation (unfortunately people often incorrectly use the term "routine circumcision" to mean "elective circumcision"). Using the "universal" term helps to reduce the risk of misunderstanding. We certainly shouldn't remove the clearer term and effectively replace it with a less clear term. That's why I reverted your edit.

The problem with your proposal above is that "currently recommend routine or universal circumcision" seems to suggest that the two terms have different meanings. The situation could be improved by rephrasing as "currently recommend routine (ie., universal) circumcision".

I should point out that this sentence was the subject of an RfC at Talk:Circumcision/Archive 70#RfC: how should the lead summarise positions of medical associations?; the present sentence is a compromise between the two positions. It isn't ideal. I must also apologise for my rather confusing edit summaries — not sure what happened! Jakew (talk) 08:51, 9 April 2012 (UTC)

I still think that the word "universal" isn't needed at all, but Garik's edit, along with your rewording: "currently recommend routine (ie., universal) circumcision" is a definite improvement over what's currently there. I think we should add it in (and by we I mean... someone other than me!), even if we continue to discuss other options. kyledueck (talk) 13:54, 9 April 2012 (UTC)

I agree with Garik and already stated this medical summary is awkward and contradictory of itself. I also agree with Jake that using both terms in the same sentence lends itself to more confusion. How bout.. "No professional associations of physicians currently recommend routine circumcision;[13][14] however very few recommend prohibiting the practice." Garycompugeek (talk) 13:24, 9 April 2012 (UTC)

That looks good to me. If everyone agrees that there's no difference between routine and universal circumcision, then we certainly don't need both terms in the sentence (and "routine" is the better term, I feel). One thing though: Am I right in understanding that in fact no professional associations recommend prohibiting the practice? If so, then we should say that. garik (talk) 14:07, 9 April 2012 (UTC)

"Am I right in understanding that in fact no professional associations recommend prohibiting the practice?" - You are correct, that's what the source says: "no medical body has advocated a policy that calls for the prohibition of circumcision"[7] kyledueck (talk) 14:22, 9 April 2012 (UTC)

The source may say it, but there are medical bodies who are advocating for a policy which calls for the prohibition of circumcision. The Swedish Paediatric society is one. Norway was arguing over a minimum age of 15 a few months ago. Tftobin (talk) 00:03, 11 April 2012 (UTC)

I disagree with your assertion that "routine" is a better term. As I explained above, it's often misunderstood, and for that reason "universal" should be preferred. I would rather include both terms than to remove "universal". Jakew (talk) 14:56, 9 April 2012 (UTC)

OK, well let's go with "universal" then. garik (talk) 15:12, 9 April 2012 (UTC)

Huh. Obviously some people still disagree with this. Apparently "we are summarizing viewpoints and should state them as such". I disagree. The current wording is inelegant, unclear, and unnecessarily cumbersome. Assuming it is accurate that no professional associations recommend universal circumcision or recommend prohibiting it, then we really don't need to say "Summaries of the views of professional associations of physicians include that...". But I'm loth to rerevert and get into an edit war. Comments? garik (talk) 15:53, 9 April 2012 (UTC)

And if it's not accurate that no professional associations recommend universal circumcision or recommend prohibiting it, then we still need to reword it, because that's what it currently implies. And the words "Summaries of the views of professional associations of physicians include that..." do nothing to dispel that implication. garik (talk) 15:57, 9 April 2012 (UTC)

It just states that they're summaries, not that they're correct. There's some reason to doubt the accuracy of the assertion that none recommend universal circumcision, as mentioned in the RfC. In the last few years, many African countries have introduced large-scale circumcision programmes as part of HIV prevention campaigns. If these programmes are supported by those countries medical associations, as seems likely, then it seems entirely plausible that they might recommend universal circumcision. I'm inclined to agree that we should avoid asserting this as a fact, and should remain neutral regarding its accuracy. Jakew (talk) 16:15, 9 April 2012 (UTC)

As I understand it, you're saying that you want to stress that some sources claim that no professional associations recommend universal circumcision (or prohibiting it), while not asserting that this is fact. Fine, but the current wording simply fails at the task. garik (talk) 16:31, 9 April 2012 (UTC)

In other words, if it is an accurate summary to say that no one does x, then it is equally accurate to say simply that no one does x. If it's not true that no one does x, then it is equally untrue to say that in summary no one does x. garik (talk) 16:33, 9 April 2012 (UTC)

So you're saying that by describing something as a summary, we're implying that it is a true and accurate summary? Jakew (talk) 17:13, 9 April 2012 (UTC)

Universal is not the correct term. A google scholar search for "routine circumcision" yields 1460 results, while "universal circumcision" yields only 171. Similarly, "routine infant circumcision" has 168 results, while "universal infant circumcision" returns only 8 results. Since routine is clearly the more commonly used term, WP:COMMONNAME necessitates that we use that term, if we are going to use just one. Also, "Routine" circumcision is the wording used in the source cited. kyledueck (talk) 16:44, 9 April 2012 (UTC)

COMMONNAME is part of the article titling policy. If someone suggested that we create a new article or retitle an existing one, I'm afraid I did not see that part of the discussion. Otherwise, it's irrelevant. Jakew (talk) 17:13, 9 April 2012 (UTC)

"So you're saying that by describing something as a summary, we're implying that it is a true and accurate summary?" Yes. The words "Summaries of the views of professional associations of physicians include that none currently recommend routine circumcision" implies it to be true and accurate that no professional associations of physicians currently recommend routine circumcision. Or, rather, it implies it to be as true and accurate as (e.g.) the claim that circumcision "is also customary in some Christian churches in Africa" (or any other citation-supported claim on Wikipedia). If you want to imply that this claim may well be less true and accurate than other claims in the Circumcision article, then you need to reword the sentence. The word "summaries" alone does nothing to that end. garik (talk) 17:24, 9 April 2012 (UTC)

It occurs to me that you may be interpreting the word "summaries" to mean only "published articles summarising the views of professional associations". If that's what you understand the word to mean, then the current wording is awkward and inelegant, but doesn't carry the same implication of accuracy. But, unfortunately, that's not the only meaning of "summary" and it's not how many people will read the sentence. We could fix it by saying something like, "Published summaries of the views of professional associations of physicians state that ..." garik (talk) 17:45, 9 April 2012 (UTC)

That sounds reasonable to me. Let's try it on for size. FactoidDroid (talk) 17:42, 10 April 2012 (UTC)

The word "published" isn't crucial. Changing "include that" to "state that" is more important. Apart from anything else, it just sounds more idiomatically English. I've made a further edit so that it says "routine (i.e. universal) circumcision". As it stood, it strongly implied that routine circumcision and universal circumcision were different things. garik (talk) 20:20, 10 April 2012 (UTC)

Note ref 2 from the cited source, "I believe that the term “routine infant circumcision” is a misnomer. It denotes a position that nobody really holds, namely that as a matter of routine, all healthy boys should be circumcised. Opposition to a policy of “routine infant circumcision” does not have to indicate opposition to a parent’s right to choose for their son to undergo the procedure, nor the provision of the procedure in general". The author says he is not talking about "routine", let alone "universal" infant circumcision. So why are we? And citing him? Surely there's something wrong with that. --Nigelj (talk) 21:13, 10 April 2012 (UTC)

He explicitly discusses universal infant circumcision: "Most medical associations [...] maintain that although there are potential medical benefits associated with the procedure, on balance these benefits do not overwhelmingly support a policy of universal recommendation. [...] Although they recognise that existing medical evidence does not support that the procedure that can be universally recommended, they do not believe the medical evidence shows that the procedure is so detrimental that it should be prohibited or outlawed." Jakew (talk) 21:21, 10 April 2012 (UTC)

Actually, I think there is a difference between a "universal recommendation of circumcision" and "universal circumcision", which should probably be reflected in the article. Based on that, how about we change the sentence to read:

Summaries of the views of professional associations of physicians state that none currently support universally recommending circumcision,[13] but that none recommend prohibiting the practice.[14]

Whatever we do, leaving the sentence as it currently is should not be an option. It's unidiomatic, confusing, and potentially misleading. garik (talk) 21:39, 10 April 2012 (UTC)

I'm not sure that there's a meaningful difference between the two, given that we're discussing recommendations in the first place. I think the "summaries ... state" construction is a little awkward; I tend to think that summaries are just sequences of words, and (unlike their authors) can't themselves state anything. I also think that the current phrasing is fine, and I actually prefer it. Nevertheless, I don't strongly oppose the phrasing you mention. However, I'm a bit puzzled by the refs you propose to cite. Given that ref 14 includes the "universally recommended" language, why are you proposing to cite ref 13 for that part of the sentence? Jakew (talk) 09:34, 11 April 2012 (UTC)

You're right about the refs; I hadn't paid attention to them when I suggested the above sentence. I'm inclined to agree that "Summaries ... state" is probably not the best phrasing we can come up with (you may recall I supported a much more radical change originally—and still do), but "Summaries ... include that" really is several times more awkward. Using "state" with an inanimate subject is perfectly standard and idiomatic English, and very normal in scholarly writing. The use of "include" with a subordinate that-clause is much less so. It makes it sound as if the sentence was constructed by a committee of non-native speakers (which, I guess, may be the case). The other problem, as noted above, is that "Summaries ... include that ..." doesn't make clear that we're talking about published summaries. When I first read it, I took it to be an awkward way of saying, "To summarise views held by professional associations of physicians on circumcision: None currently recommend..." Instead, it's an awkward way of saying something else. If we use the word "state", we avoid the mistaken interpretation.

I also still think it's a big problem to mention universal and routine circumcision separately if they're supposed to be the same thing. Now, obviously there's some dispute over whether they are quite the same thing (and I can imagine ways in which they're not), but if we decide that they're not and still want to mention both of them, then we need to be explicit about what the difference is. I'm with you on this, Jakew (if I understand you right): I don't think any difference there is between them is worth distinguishing in this sentence. Either way though, we need to change it. I still think there is a difference between universally recommending circumcision and recommending universal circumcision, but it is a very slight difference, so I don't care especially about maintaining that distinction. As noted above, there are more important things wrong with this sentence. garik (talk) 13:24, 11 April 2012 (UTC)

So, given what I've said above, would anyone object to me changing the sentence in question to the following?:

Summaries of the views of professional associations of physicians state that none currently recommend routine (i.e. universal) circumcision,[13][14] but that none recommend prohibiting the practice.[14] garik (talk) 21:48, 15 April 2012 (UTC)

No objections from me. Jakew (talk) 08:31, 17 April 2012 (UTC)

WHO-related changes

Based on Wikipedia:Identifying_reliable_sources, I removed text and supporting reference to http://www.who.int/hiv/mediacentre/news68/en/index.html because it is not a reliable source. One of the experts in the study founded a company that invented, sells, and markets a circumcision device (http://www.accucirc.com/contact.php). See http://todayshospitalist.com/index.php?b=articles_read&cnt=647 for additional proof of this association. This conflict of interest violates Wikipedia's policy and renders the WHO as an unreliable source with regards to studies it endorses on HIV and circumcision. Erikvcl (talk) 04:53, 10 April 2012 (UTC)

Please see WP:MEDRS#Medical and scientific organizations, which specifically identifies the WHO as a reliable source. I'd also be interested to know which part of WP:RS indicates that medical organisations should be regarded as unreliable because of potential financial interests of a single consultant used by that organisation. Finally, you did not remove references to http://www.who.int/hiv/pub/malecircumcision/neonatal_child_MC_UNAIDS.pdf but, rather, http://www.who.int/hiv/mediacentre/news68/en/index.html. Jakew (talk) 08:32, 10 April 2012 (UTC)

It is incorrect to believe that any organization is infallible. Each research study, paper, or recommendation must be evaluated since financial motivations and greed will induce bias reducing the value of that organization's claims. Just because the Wikipedia page mentions the WHO doesn't mean that they are an ethical organization that isn't unduly influenced by money or greed. The WHO is against female genital mutilation but supports male genital mutilation. This represents sexism and a failure to recognize gender equality.

To address your point directly, if you read WP:QS#Questionable_sources it clearly states that sources "...with an apparent conflict of interest" are not acceptable. A WHO consultant who would financially benefit from the conclusions he advocates is a clear conflict of interest. In addition, WP:QS#Questionable_sources also states "...other sources to be extremist or promotional...". In this case, the WHO's recommendation is promotional in that it benefits Tomlinson's Accucirc business. The WHO's views are also extreme in that the fly in the face of modern medical ethics, the Hippocratic_oath#Modern_version, and existing peer-reviewed research.

Furthermore, the source reference represents the conclusions of analysis commissioned by the WHO that did not receive proper peer review from non-WHO scientists, researchers, or ethics professionals: it appears to be a primary source. According to WP:PRIMARY, primary sources must be used with great care only. This source, with its conflict-of-interest and other ethical considerations does not meet this criteria. Erikvcl (talk) 14:26, 10 April 2012 (UTC)

That's a creative interpretation of policy, Erik, but ultimately incorrect. Nothing in policy requires sources to be "ethical" or to "recognise gender equality" in the judgement of editors; these are merely your own original criticisms of their position. You're free to disagree with them, but not to remove information on that basis.

Next, you claim that Tomlinson has a "clear conflict of interest". I'd question that assertion on several grounds. First, we have no way of knowing whether Tomlinson benefits financially from the Accucirc device (it's plausible that he doesn't profit from it). Second, while we know that he was involved in WHO's expert consultation[8] which resulted in their recommendations, we don't know what he said at that meeting. Third, we don't know whether he stood to gain anything at the time of that meeting (if he invented the Accucirc afterwards, it can't retroactively create a conflict of interest). Fourth, we have no way of knowing what interests he may have declared during the meeting. In any case, all this is a moot point, because we don't cite Tomlinson. We cite the WHO. So it's irrelevant whether Tomlinson has a conflict of interest, since Tomlinson is not the source.

Next, you omitted the context when you quoted part of WP:QS. Here's a fuller quotation, with added emphasis: "expressing views that are widely considered by other sources to be extremist or promotional". Clearly, the fact that you consider the WHO's recommendation to be promotional is irrelevant, because you're not a source.

Finally, like all conclusions of medical associations, it's both a secondary source and a primary source. It's secondary in the sense that it's the result of analysis of primary source data (in this case, the RCTs). It's primary in the sense that it's the viewpoint of that organisation. In any case, since we simply report what they say, there isn't a problem. Incidentally, you seem to have misunderstood WP:PRIMARY: "only with care" is not intended to be used as an excuse to exclude material with which editors disagree. It indicates that primary sources should only be used in certain ways ("A primary source may only be used on Wikipedia to make straightforward, descriptive statements of facts that any educated person, with access to the source but without specialist knowledge, will be able to verify are supported by the source."). Jakew (talk) 16:00, 10 April 2012 (UTC)

Jakew, since you consider that Erikvc is not a source, what would be a source which would be acceptable to the circumcision page of wikipedia, which would be respected in pointing out the difficulty in the WHO being both a primary source, a meta-data source, and a secondary source? Tftobin (talk) 18:34, 11 April 2012 (UTC)

Tom, my remark that Erik is not a source was made in response to Erik's claim that the WHO are "promotional". As I pointed out, he had taken that word out of context, overlooking the fact that the policy he cited explicitly required that the assessment as "promotional" must be that of other sources (ie., not WP editors). Jakew (talk) 18:46, 11 April 2012 (UTC)

Agreed with Jakew; such poor interpretation of policy to justify removal of reliable sources seems borderline disruptive. Yobol (talk) 16:48, 10 April 2012 (UTC)

I find it extremely plausible that Dr. David Tomlinson is profiting from patenting four circumcision clamps. I have never known anyone who held four patents on similar devices, and appeared in their advertising, to not make a profit on those patents. Disruptive, perhaps. Truthful? Absolutely. Want me to drive down and ask him? He's less than 100 miles from me. Tftobin (talk) 00:27, 11 April 2012 (UTC)

It's plausible, but if you're going to accuse a person of acting with a conflict of interest, it's a good idea to have facts rather than thinking that something is plausible. I would've thought that basic human decency should have made that obvious; if not, WP:BLP spells it out. Jakew (talk) 08:32, 11 April 2012 (UTC)

I don't recall using the verb 'accuse'. That was presumptive. Asking a person if they make a profit from something, is not the same as accusing them of anything. Besides, there are other methods, which might be construed as less offensive, such as asking the compan(y|ies) involved if they pay out royalties to anyone on the patent(s). I don't always take the low road. It would be nice to be given the benefit of the doubt occasionally. Tftobin (talk) 18:38, 11 April 2012 (UTC)

It is a fact that Tomlinson is the owner/founder of Accucirc and I posted a link to this effect. To think that he would not profit from a pro-MGM policy is naive. It is also surprising to me that Wikipedia would want to be associated with organizations who perform unethical research. What I'm struggling with is that many editors have told me that the ethical behavior of a source has no bearing on that source's reliability or validity. This is a strange position to hold. Would you hold as valid & reliable a study commissioned by BP showing no harm to the Gulf of Mexico after the recent spill? I get the feeling that the editors' interpretation of Wikipedia policy is inconsistent. The poor interpretation of policy does not reside with me. Multiple editors have rebuked the neutrality of this article, yet it does not carry the POV marker. Multiple editors have disputed the credibility of this article yet it does not carry the disputed marker. Erikvcl (talk) 18:24, 12 April 2012 (UTC)

Both Erik and Jake make some interesting points. I am loath to use WHO because of its government bureaucracy and political agenda however I suggest you take this to the reliable sources talk page if you wish to pursue it Erik. Just because you disagree with Erik is no reason to call him disruptive Yobol. He is using the talk page and clear edit summaries so please let us all play nice. Garycompugeek (talk) 17:02, 10 April 2012 (UTC)

Erikvc, I hope you get further with this than I did, in the reliable sources page. You bring some fresh points. Please read up on my attempt, so you can avoid some of the newbie pitfalls. I find some of the WHO's behaviors to be a study in mismanagement of conflicts of interest. They've been getting a free pass in here as an unimpeachable source for years, while their data conflicts with that of other countries, including the US and UK. Groups throw money at the WHO, and they make their own primary, meta, and secondary studies, much like the financial system of the US self-certified in 2008-2009. The rules of this page make it absolutely vulnerable to the excesses of the WHO's methods, for just these reasons. Tftobin (talk) 00:24, 11 April 2012 (UTC)

I did not call this "new" user disruptive, I called their behavior of so badly misapplying policies and guidelines "borderline disruptive". If you have any further suggestions for me, take it to my talk page. Yobol (talk) 17:11, 10 April 2012 (UTC)

I called into question the ethical behavior of a source. I was right to call that source into question and I interpreted the policies accurately. This is not disruptive behavior, but rather the behavior of someone who is trying to eliminate the clear bias and inaccuracies in the article. Erikvcl (talk) 18:24, 12 April 2012 (UTC)

Using an article Talk: page to call into question the "ethical behavior" of an individual actually falls under WP:BLP, a policy well worth reviewing. Jayjg ^(talk) 01:23, 16 April 2012 (UTC)

If you are honestly defending the WHO, the standards here at Wikipedia are very low. This is regarding an organization, public facts, and tainted research. Your reference to WP:BLP is laughable and irrelevant. Erikvcl (talk) 04:27, 16 April 2012 (UTC)

WP:BLP applies both to Tomlinson and the publicly identifiable editors of this page. I strongly advise you not to laugh it off again. Jayjg ^(talk) 00:47, 17 April 2012 (UTC)

Ericvcl, please see WP:WOODSHED. Tftobin (talk) 23:12, 17 April 2012 (UTC)

Drive-by reference

I'm dropping this here, but I'm sure it'll get rejected out of hand despite the fact that it's heavily cited with reliable sources. Please read the following:

http://www.cirp.org/library/disease/HIV/

Not one single study besides the African study confirms that MGM prevents HIV. This either means only one of two things: African men are physiologically different or the studies are bogus. Jakew: I challenge you to prove me wrong here. The studies are bogus. African men are not physiologically different. In addition to being an idiotic idea, MGM doesn't prevent HIV. WHO is unethical. This is all very simple. Also, please read:

http://www.reuters.com/article/2007/12/04/us-aids-circumcision-idUSN0345545120071204 http://www.thewholenetwork.org/14/post/2011/10/new-study-australia-rejects-circumcision-as-a-preventative-for-hiv.html http://www.thewholenetwork.org/14/post/2011/10/us-navy-finds-that-circumcision-does-not-prevent-hiv-or-stis.html

Of course, you won't like The Whole Network, but please look at the SOURCE, not the page itself. This all made me think of something: how much money did the WHO donate to Wikipedia last year? Food for thought. Erikvcl (talk) 02:45, 16 April 2012 (UTC)

The Whole Network is not a reliable source. Neither is CIRP. Reuters, as a news source, is reliable in some contexts but not others. In medical contexts, such as this, it isn't (see WP:MEDRS#Popular press. The study it references is a primary source, as is the US Navy study referenced by the second Whole Network link. The first Whole Network link, misleadingly titled "Australia Rejects Circumcision as a Preventative for HIV", is actually about an opinion piece published by Robert Darby and Robert Van Howe (only one of whom is even Australian, let alone representatives of that nation), both of whom are well-known for their anti-circumcision views.

Your statement that "Not one single study besides the African study confirms that MGM prevents HIV" is incorrect. As I've explained previously, there isn't a single "African study", but, rather, three randomised controlled trials that are commonly cited, plus dozens of multiple observational studies (I cited a meta-analysis in which 21 of 27 studies found a protective effect previously). And, contrary to your claim, there are other studies elsewhere: the CDC cite several US studies in their Factsheet; another that springs to mind is from India. But we don't cite primary sources, and we certainly don't try to use them to "prove" our own original analyses. We cite secondary sources. Jakew (talk) 08:51, 16 April 2012 (UTC)

Interesting how it is mentioned that Robert Darby and Robert Van Howe are well-known for their anti-circumcision views, and yet it is never mentioned that Professor Brian Morris is well known for his pro-circumcision views. How much of of Morris fails to make an entry here? Why is something written by an American doctor an opinion piece? Why is "Morris regards circumcision as "mandated", citing reduced risk of balanitis among other benefits" not considered an opinion piece? Tftobin (talk) 11:45, 16 April 2012 (UTC)

I don't think people ever present Morris' opinions as those of Australia, Tom. Jakew (talk) 11:54, 16 April 2012 (UTC)

No, but up until very recently, his 'Morris regards circumcision as "mandated", citing reduced risk of balanitis among other benefits' was posted here, unchallenged. If it were me writing, I would be cautious about whom I dismissed as an opinion piece, since every piece is an opinion piece, and since some very extreme viewpoints have been posted here. Tftobin (talk) 16:21, 16 April 2012 (UTC)

As an aside, it's worth remembering why circumcision studies in, say, America will not show a benefit against HIV acquisition. If you have a 50% reduction in chance of getting HIV, which seems likely in circumcising heterosexual men, and you have two trial arms with 10,000 members in each, you might see 2 in the experimental group. There is a 50% reduction in risk. However, because of statistical significance and the very small number of infections in western populations, it's hard for trials here to show statistical significance. That shouldn't be taken to mean that circumcision isn't working in western men. While that's certainly a possibility, it is not one that follows logically, or empirically, from the African clinical trials and what is known about incidence in western populations. Morrowulf (talk) 16:54, 16 April 2012 (UTC)

How does this explain the .003% infection rate in Finland, 0.10% rate in Japan, and 0.10% rate in New Zealand, where circumcision is rare, and the 3.33% rate in Israel, and the 2.10% in Ethiopia, where 93% of the males are circumcised? Tftobin (talk) 19:20, 16 April 2012 (UTC)

To explain the HIV prevalence in various countries, you have to understand how differences in multiple behaviours and practices affect that country, and how long HIV has had to spread in that population. That's true regardless of whether you accept or reject that circumcision is protective; the only difference is whether you include circumcision or not in your model. But this is getting off-topic; remember that talk pages are not for debating the subject. Jakew (talk) 19:38, 16 April 2012 (UTC)

Was Dr. Morris' opinion piece quoted in 'Morris regards circumcision as "mandated", citing reduced risk of balanitis among other benefits' primary research, or secondary research? I am honestly curious. If it was primary, what was it doing here? If it was secondary, what group of doctors agreed? Tftobin (talk) 00:32, 17 April 2012 (UTC)

It was - and is - a conclusion based on review of primary sources, making it a secondary source ("[Secondary sources] rely on primary sources for their material, making analytic or evaluative claims about them." — WP:PSTS). Like all secondary sources, of course, it's also a primary source for itself. Jakew (talk) 09:02, 17 April 2012 (UTC)

POV tag for HIV scare-mongering intro

At least five current eds have contributed their judgment to the inappropriate inclusion of HIV warning in the intro. This is the on-going disucssion about its violation of neutrality. Why haven't any of the eds on the opposingside suggested the lead is NPOV? Becausefromtheirpoint of view its making the case for circumcision, exclusingthe HIV scare-mongering would make it truly npov, not the current sham objectivity,some eds even denying they havve no pro-or-con opinion. Robert B19 (talk) 19:02, 27 March 2012 (UTC)

another ed will have to restore the tag... the article went haywire when I put it there just now... Robert B19 (talk) 19:16, 27 March 2012 (UTC)

I'm sorry: perhaps you could clarify how the article is scare-mongering? Talking about the WHO's recommendations and research findings that circumcision is a cost-effective (and otherwise effective) way to combat HIV in areas where it is endemic is scare-mongering? Empirical, objective evidence does not itself have a point of view, regardless if it supports opinions that may not be your own, my own, or others'. Morrowulf (talk) 19:28, 27 March 2012 (UTC)

If you understood how the WHO works, you would see how specious that argument is. The WHO and UNAIDS created a panel to review research, and policies. The group they put in charge of review (The Clearinghouse on Male Circumcision for HIV Prevention), perhaps coincidentally, perhaps not, include the employers of at least three of the authors of the three '60% effective' African studies. http://www.malecircumcision.org/about/male_circumcision_about_us.html The other two groups contain people who have co-authored with either a creator of the study, or with each other. As such, the appearance, but not necessarily the actuality, of checks and balances exist. The grant money continues to pour in. No one implies that circumcision without condoms is safe sex. There, however, appears to be a heavy emphasis on the circumcision side of the house, and less so on the condom and safe sex side. Please, stop calling it 'empirical, objective evidence'. Considering the precariousness of its checks and balances, it sounds like "the great and powerful Oz has spoken". There is room for doubt. Those three studies were stopped, without the HIV status of all the participants being accounted for. You don't see the majority of European doctors falling over themselves to embrace the results. They've been practicing medicine for a long time now. The 60% results don't do much to explain the high rate of American HIV infection, nor the high rate of Ethiopian infection...nor the low rate of Finnish, Danish, French, and New Zealander infection. It is not as cut and dry as some may wish it to be. Tftobin (talk) 20:15, 27 March 2012 (UTC)

Tom, the Clearinghouse on Male Circumcision for HIV Prevention was created some time after the WHO and UNAIDS conducted their expert review, and is separate from that (it was created on 29 Nov 2007, while the expert review took place in the week beginning 7 Mar 2007). In any case, believing the WHO to be biased is not an argument that the article is biased: editor's personal assessment of sources is original research by definition. Jakew (talk) 20:31, 27 March 2012 (UTC)

I don't really care when the Clearinghouse was created. I am suspect of expert reviews, which come to conclusions, which are strikingly contrary to the results witnessed in AIDS infected countries. My issue was with the WHO's recommendations being called "Empirical, objective evidence", to 'prove' that there was no scare mongering. Tftobin (talk) 17:07, 28 March 2012 (UTC)

And what are the "specific issues that are actionable within Wikipedia's content policies"? Jakew (talk) 19:37, 27 March 2012 (UTC)

undue weight for the introduction requires a pov tag; the specific issues on-going talk page under Sections--Removal of HIV sentence in lead; Impartiality and NPOV;POV tag for HIV scare-mongering intro;Let's play with the intro;Egg's proposed version #1--the "faux consensus" about HIV scaremongering in the introduction is bogus, basically just ignoring the pov issues so many of us raising here... if you want to talkjabout AIDS and HIV, save it for the appropriat scetion in the article. Robert B19 (talk) 16:28, 31 March 2012 (UTC)

Emotive and non-specific claims like "scare-mongering" and "faux consensus" aren't helpful to discussion. The issue of the weight of the HIV material has been discussed at length, and the discussion can be found in the archives. Jayjg ^(talk) 02:24, 1 April 2012 (UTC)

All those in favor of the current HIV lead, please review the archives. You will see there is a strong case against it, in that it violates wp:undue coming from many different authors.Gsonnenf (talk) 06:25, 3 April 2012 (UTC)

On the contrary, the arguments against it generally seem to involve a misunderstanding of WP policy and/or the subject matter. It seems rather a stretch to call that a "strong case". Jakew (talk) 08:46, 3 April 2012 (UTC)

At least be as honest as Encyclopedia Britannica Online/Circumcision, which prefaces the HIV prevention sentence with the straightforward phrase "Advocates of circumcision cite studies indicating that circumcised men have a lower incidence of AIDS, syphilis, and other sexually transmitted diseases than uncircumcised men." www.britannica.com/EBchecked/topic/118439/​circumcision Robert B19 (talk) 18:55, 3 April 2012 (UTC)

It is neither more nor less honest. The sentence you quote is about the actions of those who advocate circumcision. We don't specifically document the actions of such people. Jakew (talk) 10:19, 4 April 2012 (UTC)

We simply accept their peer-reviewed studies, meta-studies, and secondary sources. Tftobin (talk) 20:29, 4 April 2012 (UTC)

Im sorry you feel the disagreement is based on a misunderstanding of WP policy. Please consider that you maybe the one misunderstanding the policy as many well spoken people disagree with you.Gsonnenf (talk) 06:37, 7 April 2012 (UTC)

I haven't seen any experienced or non-WP:SPA editors disagree with Jakew on this matter (or, actually, pretty much anything else). Please consider that inexperienced editors, or editors who primarily edit on one topic, may not have a complete, comprehensive, or accurate grasp of policy. Jayjg ^(talk) 02:22, 9 April 2012 (UTC)

Encyclopedia Britannica gets it that policy must be authentically neutral, not a fig-leaf for pov pushing. Robert B19 (talk) 17:57, 12 April 2012 (UTC)

Encyclopaedia Britannica's policies are not Wikipedia's; please make more relevant statements. Jayjg ^(talk) 01:09, 16 April 2012 (UTC)

Experienced editors and non-WP:SPA disagree with Jakew all the time. Please try to be more accurate in your statements, Jayjg. Tftobin (talk) 01:07, 13 April 2012 (UTC)

Which ones have done so recently, particularly on this topic? Please try to back up this implausible statement, Tftobin. Jayjg ^(talk) 01:09, 16 April 2012 (UTC)

Tftobin springs to mind. Still find it implausible? Tftobin (talk) 11:15, 16 April 2012 (UTC)

...who has made a total of 306 edits, and hence does not qualify as experienced, and (with the exception of 8 edits to 5 other articles) has exclusively edited circumcision, and hence meets the definition of an WP:SPA. Jakew (talk) 11:40, 16 April 2012 (UTC)

Where does it state that 5 other articles is not enough? WP:BITE Tftobin (talk) 16:10, 16 April 2012 (UTC)

Nowhere, Tom. There's no obligation to edit any other articles. There is nothing inherently wrong with being an SPA: it isn't against policy. But if you describe yourself as a non-SPA you're likely to be corrected, as I did above, and that's solely because you brought it up. Jakew (talk) 16:16, 16 April 2012 (UTC)

So, where is the invisible dividing line which isn't documented anywhere, where someone transitions from an SPA to a non-SPA? Five articles apparently is not enough. What is? Tftobin (talk) 19:11, 16 April 2012 (UTC)

When almost all of an editor's edits are related to a single topic, WP:SPA applies. Please stop wasting time here with pointless wikilawyering. Jayjg ^(talk) 00:50, 17 April 2012 (UTC)

It is not pointless to ask a question, when you are being judged by rules which are not written down anywhere, including WP:SPA. Please comment on the subject, not on the editor in the future. Tftobin (talk) 10:33, 17 April 2012 (UTC)

Tom, you raised the issue of whether you were an SPA by citing yourself as an example of a non-SPA (see your post dated 11:15, 16 April 2012). It's not reasonable to complain when somebody responds to that. If you don't want to be discussed, don't introduce yourself as a subject. Jakew (talk) 11:15, 17 April 2012 (UTC)

I am asking a question. If editors want to keep this a closed boys club with a bunch of invisible rules, which you pull out to admonish the newer editors, fine. I'm just not that thin skinned. If you want to give answer to the question I asked, that would be fine, too. You two could use a little discussion of the subject, and not the editor, yourselves. Tftobin (talk) 23:07, 17 April 2012 (UTC)

Jayjg please stop belittling other editors of being inexperienced. Suggesting your opinion matters more because of this violates WP:OWN. Most of us have productive jobs where we interpret and makes choices based on policy, coming from academic journals to SBIRs, much stricter than those of Wikipedia. You show a great deal of disrespect by implying others are inexperienced and your interpretation must be the correct one when you have a long history of breaking policy yourself. Your implications that people who disagree with you are "inexperienced" is not clearly not a valid argument. I suggest you take a break from Wikipedia if you don't understand this. Gsonnenf (talk) 21:06, 18 April 2012 (UTC)

I don't think Jayjg intended to imply that other editors are inexperienced at what they do for a living, Gsonnenf. However, that is not the same as experience with Wikipedia or its policies. Let's not mistake one for the other. Jakew (talk) 21:17, 18 April 2012 (UTC)

I constantly feel belittled by being told I'm inexperienced, and being pointed to wp: abbreviations. Then, if I ask for clarification, I get told to stop wikilawyering. Make no mistake, there is a lot of hostility in this environment. Not everyone is as coolheaded as the big kahuna. Tftobin (talk) 22:36, 18 April 2012 (UTC)

Gsonnenf Your comment included a statement or statements about editors, not article content. Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor." Jayjg ^(talk) 00:43, 19 April 2012 (UTC)

Additional information regarding HIV-MGM fallacy

Please read the following link which cites a reputable journal article: http://jamespatemd.com/blog/?p=2153#.T4hrZ7MaAqo

This actual source (the journal article) confirms everything that I've been saying here. Can we please now take some action regarding removing the WHO as a reliable source? Also, I'm putting the POV flag back since it's clearly warranted by the discussions here. I see three editors who don't see bias and a great many more editors who do see a bias. Erikvcl (talk) 18:13, 13 April 2012 (UTC)

It's a blog post citing a fringe publication criticising the RCTs. It doesn't in any way justify removal of the WHO. Jakew (talk) 18:28, 13 April 2012 (UTC)

As I mentioned, the source is a journal article (not the blog) which is a reliable secondary source per Wikipedia guidelines. Please justify your claim that this is a "finge publication". There is a clear conflict of interest that exists at the WHO that renders the WHO source unreliable. Please justify how this conflict of interest wouldn't taint the research. Erikvcl (talk) 18:42, 13 April 2012 (UTC)

It is a secondary source, but we don't include every secondary source. WP:UNDUE requires that we avoid giving undue weight to minority viewpoints, especially those of extreme minorities. Prior to around 2007 there were indeed mixed views about whether circumcision protects against HIV, but since the publication of the RCTs there has been a clear scientific consensus that it does (if you doubt this I invite you to read through the abstracts at PubMed. A handful dispute the association, but the overwhelming majority acknowledge it. I've already addressed your claims re conflict of interest in #WHO-related changes (see my comment dated 16:00, 10 April 2012 (UTC)), so I won't waste further time on it. Jakew (talk) 18:50, 13 April 2012 (UTC)

This has gone a bit far, in my opinion. If someone posts primary research, they get told it has to be secondary research. There is no wikipedia general rule forbidding high quality primary research, except in circumcision. Now, someone posts some secondary research, and is being told, "we don't include every secondary source". It's OK to cite Professor Morris, saying 'Morris regards circumcision as "mandated", citing reduced risk of balanitis among other benefits'. This is not WP:UNDUE, giving undue weight to minority viewpoints, especially those of extreme minorities? In what universe? Tftobin (talk) 20:21, 13 April 2012 (UTC)

Do you honestly and truly believe that the WHO conducted that study ethically? Do you honestly believe that it is ethical for Tomlinson to be an advisor to the WHO and that he would not taint the research? Erikvcl (talk) 18:56, 13 April 2012 (UTC)

Incidentally, you appear to misunderstand the purpose of a POV tag. It is not intended to be used as a warning or a badge of shame, hence the fact that a number of editors may perceive bias is not a justification for it. It's intended to attract new editors to the article, to rectify specific issues that have been identified on the talk page. For that reason, the person adding the tag is expected to provide an explanation of those issues on the talk page: "explain on the article's talk page why you are adding this tag, identifying specific issues that are actionable within Wikipedia's content policies". Nobody has yet provided such a detailed description of the issues, which is why the tags have been removed. Jakew (talk) 18:38, 13 April 2012 (UTC)

I have described my issues with the article at length. The article is too complex to fix its problems all at once and so it will need to be fixed over time. It is frustrating that the editors are interpreting Wikipedia policy to maintain a status quo rather than to genuinely improve the article towards NPOV. This smacks of cronyism. Erikvcl (talk) 18:47, 13 April 2012 (UTC)

Okay, if you won't comply with the instructions for the tag, I'll remove it. I'll give you a few hours to change your mind. Jakew (talk) 18:50, 13 April 2012 (UTC)

Just out of interest, how on earth do you reconcile your statement that "it must contain the POV flag as a warning to potential readers that there is a bias in the article" with the instructions at {{POV}} that clearly state: "This template should not be used as a badge of shame. Do not use this template to "warn" readers about the article"? Jakew (talk) 18:52, 13 April 2012 (UTC)

It is very annoying that all these Wikipedia policies are very hard to find; I wonder if that is on purpose. The POV policy states: "Do not use this template unless there is an ongoing dispute in an article". There is an ongoing dispute in this article. For years now, folks have been trying to fix the article and you revert all but the most trivial changes. The policy also states when to remove:

1. No discussion about neutrality issues was started on this article's talk page.
2. Discussion about neutrality issues is dormant.
3. There is consensus in the discussion that the problems have been resolved.

All of those statements are false as every single editor except for Jayg, Yobol, and yourself have disputed the neutrality, so we should not remove this flag. Erikvcl (talk) 19:02, 13 April 2012 (UTC)

The instructions clearly explain that, when an editor adds the tag, "The editor placing this template in an article should promptly begin a discussion on the article's talk page. [...] Please also explain on the article's talk page why you are adding this tag, identifying specific issues that are actionable within Wikipedia's content policies." That is the "discussion about neutrality issues" that the instructions refer to. Jakew (talk) 19:07, 13 April 2012 (UTC)

I did exactly that! That's why I added a new section to discuss the neutrality. I followed the instructions exactly. Erikvcl (talk) 19:11, 13 April 2012 (UTC)

You added the tag at 19:15, April 13, 2012. You haven't created any new discussions since that time. If we look at your actions beforehand, you created this section (which doesn't raise any NPOV issues), and this section at 19:59, April 12, 2012‎, which vaguely claims that "this article is anything but neutral", but which fails to identify any specific actionable issues. Jakew (talk) 19:18, 13 April 2012 (UTC)

So what if I created this section moments before or moments after the POV tag? I obviously can't create both simultaneously. The actionable issue is my claim about the WHO and I provided a source to back up my claim that complies with Wikipedia's content guidelines. I understand that you don't accept my claim as valid. I was reading the policy guidelines earlier today and they clearly stated that an article should not be dominated by only one editor. Erikvcl (talk) 19:43, 13 April 2012 (UTC)

First, your claim about the WHO wasn't an NPOV issue. It was an RS issue. Second, you offered no substantive response to my critique of your claim. Third, while Boyle and Hill express their disagreement with the WHO's recommendations, their article does not in any way support your claim (it doesn't even mention Tomlinson). Finally, you began that discussion on 04:53, 10 April 2012 (UTC), three days before placing the tag. The requirement is that you "promptly begin a discussion"; nobody will be unreasonable and disregard a section placed, say, a few minutes beforehand, but it's hardly sufficient to wave vaguely in the direction of a discussion opened several days ago, in which you didn't raise any NPOV issues. Jakew (talk) 19:55, 13 April 2012 (UTC)

I raised at least four actionable issues. Tftobin (talk) 20:25, 13 April 2012 (UTC)

You complained about four issues, but you didn't explain how those issues violated the applicable content policies (and it's hard to see how your arguments could apply to the content policies anyway). In any case, it's a moot point, since you didn't place the tag. You need to look at this from the viewpoint of a new editor who sees the tag on the article (which reads: "The neutrality of this article is disputed. Please see the discussion on the talk page."), and so (s)he opens the talk page. (S)he might be thinking "hmm, can I remove this tag? Let me check the talk page to see if the issues have been resolved". Or (S)he might be thinking, "what are the issues, then?" (S)he can and should expect to see a section with an obvious title (eg., "POV tag") that enumerates the issues with the article and clearly explains how each violates the content policies. It's not reasonable to expect him/her to sift through the talk page, looking for something that someone, somewhere might conceivably regard as an issue justifying the tag. Jakew (talk) 20:44, 13 April 2012 (UTC)

I've put the POV tag several times myself because we should be as objective as Encyclopedia Britannica regarding the HIV scaremongering about circumcision. Currently the wording reads as though the HIV prevention theory is acceped as established fact by the medical community. also, there is an analogous theory about female circumcision conferring a similar HIV prevention benefit. Robert B19 (talk) 01:26, 14 April 2012 (UTC)

Well, since it is an established fact, it's difficult to see how presenting it as such is a problem. And since female genital cutting is not the subject of this article, I'm struggling to see why you refer to it. Jakew (talk) 07:47, 14 April 2012 (UTC)

you don't understand, really, the analogy to female circumcision? Robert B19 (talk) 21:58, 14 April 2012 (UTC)

The HIV prevention theory is far from accepted as established fact by the medical community. There is contrary evidence in both the US and the UK. If it was accepted, why is the Swedish Paediatric Society working to ban routine infant circumcision? None of this is news to you, Jakew, so why the statement that it is an established fact? Who outside the WHO and Professor Morris considers it an established fact? Tftobin (talk) 23:20, 14 April 2012 (UTC)

Tom, the existence of contrary evidence is all but inevitable given the fact that observational studies in particular are imperfect and, consequently, prone to reporting incorrect results. Even if one makes the assumption that observational studies will find the correct result, say, 75% of the time, one would expect a full quarter of studies to be "contrary evidence". Scientists recognise the need to keep a sense of perspective, and have devised rigorous methods of analysing evidence, including recognising differences in quality (such as between observational studies and RCTs), and in taking stock of large numbers of studies (such as through statistical meta-analyses).

According to news sources, the Swedish Society make their argument "on the grounds that the children are unable to form a decision in the matter." Quite evidently, that argument has nothing to do with HIV, so I am mystified as to why you raise that point.

To answer your question, UNAIDS, Family Health International, the Bill & Melinda Gates Foundation, USAID, and AIDS Vaccine Advocacy Coalition are all in agreement. So, too, are the Cochrane Collaboration, the authors of every published meta-analysis since the publication of the RCTs, and the authors of more than 90% of recent reviews. It is, quite clearly, an established fact. Jakew (talk) 08:12, 15 April 2012 (UTC)

Quite right. Bill and Melinda Gates Foundation financed the research. UNAIDS is a WHO-related agency. Europe doesn't buy it. South America doesn't buy it. Nor does Australia, New Zealand, Canada, etc. The medical organizations of no developed country have changed their policy, to recommend circumcision for HIV prevention. This isn't quite the established fact it is being portrayed as, it it? Tftobin (talk) 19:44, 15 April 2012 (UTC)

What on earth do you mean when you say "Europe doesn't buy it"? Do you mean that the continent of Europe has collectively issued a press release or policy announcing our rejection of the idea that circumcision protects against female to male transmission of HIV? If so, where is this document? If not, what do you mean?

As for recommending circumcision for HIV prevention, that's not the question we were discussing. "Does circumcision protect against female to male circumcision" is not the same question as "should circumcision be performed in order to reduce HIV". The first is (conceptually) a simple scientific question. The second is a complicated issue with many facets, including weighing of risks against benefits (is the net reduction worth the risk), as well as less scientific considerations such as financial (will it cost more or less than the HIV cases averted) and ethical aspects. Jakew (talk) 19:52, 15 April 2012 (UTC)

I wasn't aware we were discussing, "Does circumcision protect against female to male circumcision". I can assure you I never thought that was the same question as "should circumcision be performed in order to reduce HIV". Tftobin (talk) 00:21, 16 April 2012 (UTC)

No European country has embraced the "circumcision reduces HIV infection by 60%" studies, and has changed their health policy to recommend circumcision for the prevention of HIV on the grounds that it reduces HIV infection by 60%. The same statement is true for South America, North America, Australia, and Asia. Is that clearer? Tftobin (talk) 00:21, 16 April 2012 (UTC)

Robert, given that talk pages are not to be used for arguing one's own views about the subject, I don't see why you're making the analogy. Jakew (talk) 08:12, 15 April 2012 (UTC)

Precisely. So why are you denying all edits that don't meet your point of view? Erikvcl (talk) 04:21, 16 April 2012 (UTC)

Your question is an example of the fallacy known as a loaded question. Jakew (talk) 08:21, 16 April 2012 (UTC)

I wonder if it is a fallacy. I am getting ever more curious as to what a full audit would turn up. Tftobin (talk) 11:35, 16 April 2012 (UTC)

Wonder as much as you wish, but remember to comment on content, not the contributor. Jakew (talk) 12:10, 16 April 2012 (UTC)

We are commenting on the content. The content discussion is regarding bias and the WHO as a reliable source. All of this discussion goes to those two points. Erikvcl (talk) 02:58, 17 April 2012 (UTC)

Erik, you might be interested in looking in the archives, there was a long well supported dispute about the weight given to the WHO main body about the comments in the lead. I've been too busy with RL to begin on RFC based on this, but rest assured many authors agree that the WHO is given to much weight compared to larger more authoritative medical organizations, especial given that the regional bodies of the WHO don't accept its recommendations.Gsonnenf (talk) 21:19, 18 April 2012 (UTC)

Addition to 'Cancers' section

I've again reverted an addition to the "cancers" section, which had the following problems:

• "In contrast, a later study by Van Howe (2009)" (addition italicised) is both unnecessary and non-neutral. It is unnecessary because the reader should be entirely capable of working out that 2009 is after 2002; saying so adds no information. It is non-neutral because it subtly promotes one study, and, since this is unnecessary, it's better not to do so.
• The addition of "Furthermore, a newly available vaccine against human papillomavirus (HPV) could prevent most cases of cervical cancer, without surgery" is problematic for several reasons. First, as I've previously noted, the assertion of the source that "Furthermore, a newly available vaccine against human papillomavirus (HPV) could prevent most cases of cervical cancer" is an "off-topic sentence as it is not directly related to the subject of the article". This article isn't about methods of preventing cervical cancer. It's about circumcision. Secondly, the apparent attempt to establish relevance by inserting the words "without surgery" is original research, as this is not an statement made by the source itself. Finally, we cannot use exactly the same words as a source unless we're quoting that source; to do otherwise violates WP:PLAGIARISM. Jakew (talk) 21:13, 19 April 2012 (UTC)

I see a bias, and non-neutral presentation, in the words surrounding the presentation of the Rivet/Bosch part. I played by the rules. Even though there was nothing wrong with the first entry, it was edited, over and over. Touch it again, and we go into dispute mediation. Tftobin (talk) 00:57, 20 April 2012 (UTC)

Your comment included a statement or statements about editors, not article content. Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor.". Jayjg ^(talk) 00:45, 20 April 2012 (UTC)

Better? Tftobin (talk) 00:56, 20 April 2012 (UTC)

Yes, thank you for removing the comments about editors. Jayjg ^(talk) 01:16, 20 April 2012 (UTC)

Tom, you can request mediation if you like, but the request is likely to be declined unless you've already made a reasonable effort to use a talk page to resolve the issue. That means addressing the issues raised by others, and explaining the problems that you perceive. Simply claiming that something is biased (without saying why) and claiming that there was nothing wrong with the text (without addressing the issues raised) is insufficient. Jakew (talk) 07:10, 20 April 2012 (UTC)

I'm also reverting the latest addition, which inserts "a later study by Van Howe showed no statistically significant decrease". This is seriously misleading, especially when presented immediately after a meta-analysis of studies, because it implies that Van Howe also conducted a meta-analysis and found no statistically significant decrease. In fact, he didn't (or if he did, he didn't report on it). He gives no indication of having produced summary statistics and having tested a pooled result for statistical significance; he doesn't claim that there is no significant difference across studies, as that sentence implies. He merely asserted a summary of what other authors had found. (And his summary doesn't imply a non-significant pooled result: "Avoid "vote counting" or the tallying of positive versus negative studies. Vote counts ignore the possibility that some studies are negative solely because of their sample size. [In an example] Although each of the seven randomized control trials in the meta-analysis failed to achieve statistical significance, the pooled results were highly significant."[9]) And since that summary is stated in the following sentence, it is utterly pointless to repeat it, so I can't see any way in which the sentence could be repaired. The addition also suffers from the "later study" problem outlined above. Jakew (talk) 07:29, 20 April 2012 (UTC)

Is it to your satisfaction now, sir? Tftobin (talk) 20:12, 20 April 2012 (UTC)

Ordering of non-therapeutic and therapeutic uses of circumcision in the lead

Jakew, in the edit summary of this revert you mention that 'it doesn't make sense to discuss "non-therapeutic" usage until therapeutic usages have been described.' I'm afraid that I don't understand your reasoning, could you elaborate please?

I'm of the opinion that non-therapeutic uses of circumcision should go first in the lead. Mentioning therapeutic uses of circumcision first is misleading because it gives the impression that most circumcisions are performed for therapeutic reasons, but that is not the case. The paragraph is mainly about non-therapeutic circumcision (2 sentences devoted to it, vs. 1 sentence devoted to therapeutic uses), so to me it would make more sense to begin with that since it constitutes the bulk of the paragraph.

Sorry to quibble about such a small point, but it was important enough for the two of us to change the ordering three times, so it looks like some discussion is warranted. kyledueck (talk) 15:28, 5 April 2012 (UTC)

Certainly, Kyle. The problem is that the term "non-therapeutic" is defined as the inverse of "therapeutic"; that is, non-therapeutic circumcisions are, by definition, all circumcisions other than those performed for therapeutic reasons. It is essentially what's left after considering circumcisions performed for the treatment of disease. So it makes sense to explain therapeutic circumcisions first, then discuss the remainder. That way, by the time the reader arrives at "non-therapeutic" circumcisions, (s)he is already familiar with the "therapeutic" circumcisions that the term "non-therapeutic" inverts. By analogy, if we were to divide living things into "bacteria" and "non-bacteria", it would make sense to present bacteria first. Jakew (talk) 15:47, 5 April 2012 (UTC)

No I don't see the logic there. Or would you prefer that we split things into "mutilation" and "non-mutilation" instead? Fact is the non-therapeutic uses are by far the most common uses of circumcision... therefore we ought to dicuss them first. Egg Centric 03:16, 6 April 2012 (UTC)

How about we discuss cultural uses and theraputic uses, with cultural first? Egg Centric 03:18, 6 April 2012 (UTC)

The problem is use of the term "non-therapeutic" before therapeutic usages have been defined. But I've no objection to presenting therapeutic usages second, as long as we avoid using those terms: "Circumcisions are commonly performed for social, cultural, religious, or prophylactic reasons.[12] Circumcision is also used as one of the treatment options for balanitis xerotica obliterans, phimosis, balanitis, posthitis, balanoposthitis and recurring urinary tract infections.[10][11]" Jakew (talk) 09:06, 6 April 2012 (UTC)

I am simply curious. Why would you want to avoid using those terms? Tftobin (talk) 16:27, 6 April 2012 (UTC)

I'm happy to use the terms, as long as they're presented in a logical order. But — as pointed out above — it doesn't make sense to refer to non-therapeutic usage before therapeutic usage has been defined. Jakew (talk) 17:07, 6 April 2012 (UTC)

Re style, I agree with Jakew that it's more readable if the word "non-therapeutic", if used at all, occurs after the idea of "therapeutic" has been discussed. Re balance, I oppose removing mention of therapeutic circ from the first sentence of the 3rd paragraph unless some mention of therapeutic circ is added to at least one of the first two paragraphs. ☺Coppertwig (talk) 14:06, 7 April 2012 (UTC)

Fair enough. I guess there are pros and cons to either way that the two sentences are ordered... and I did notice that the source I used described the therapeutic uses first, so I'd be fine with leaving the ordering as it is. Thanks for the comments everyone. kyledueck (talk) 14:52, 7 April 2012 (UTC)

Presenting them in the order of theraputic, then non-therautic, while it may be most logical, is not the way circumcision is done in real life. The vast majority is non-theraputic, and a tiny fraction is theraputic, if you want use that word. I think that since the vast majority is non-theraputic, perhaps we should define the terms, then present non-theraputic, then theraputic. In this, I agree with Egg Centric. Why put the most uncommon use first? That makes no sense. Tftobin (talk) 18:21, 8 April 2012 (UTC)

Is there a rule saying that one should always present a more common entity first? If we were discussing living creatures, for example, would it be necessary to discuss bacteria before humans, because there are more of them? Jakew (talk) 18:39, 8 April 2012 (UTC)

We're not talking about bacteria. We're talking about a human activity. Let me ask the inverse. Should we put the more arcane human activity first? If so, why? Tftobin (talk) 23:49, 10 April 2012 (UTC)

In this case neither of these activities is "arcane". Jayjg ^(talk) 01:12, 11 April 2012 (UTC)

Arcane is a matter of opinion. You, Jayjg, are entitled to yours. I am entitled to mine. When 70% of the male population is neither theraputically circumcised, nor non-theraputically circumcised, both might appear arcane to someone looking from a different perspective. Tftobin (talk) 12:19, 11 April 2012 (UTC)

arcane (ɑːˈkeɪn) — adj. known or understood by very few; mysterious; secret; obscure; esoteric. (Dictionary.com). Circumcision is none of those things, and that's not "a matter of opinion". Jayjg ^(talk) 01:06, 12 April 2012 (UTC)

arcane "mysterious and difficult to understand". http://www.macmillandictionary.com/dictionary/british/arcane

I find theraputic "mysterious and difficult to understand", especially when there are so many alternatives which do not involve surgery. Tftobin (talk) 01:01, 13 April 2012 (UTC)

The fact that you describe circumcision as "mysterious and difficult to understand" does not make the act itself "mysterious". There is no mystery about the act itself, which has been performed on over 1 billion men. There are pictures, videos, descriptions, medical papers etc. of it all over the internet. No "mystery" there. Jayjg ^(talk) 01:08, 20 April 2012 (UTC)

Please review Wikipedia:The Truth Tftobin (talk) 20:02, 20 April 2012 (UTC)

Seriously? 1 billion men were "mysteriously" circumcised? It's impossible to find anything about this "circumcision" procedure on the internet? LOL! Jayjg ^(talk) 22:01, 20 April 2012 (UTC)

Is that what I said? That's news to me. In the future, please make accurate and relevant Talk: page comments. Tftobin (talk) 00:47, 22 April 2012 (UTC)

Can we call a truce? This discussion stopped being about article content about 11 days ago. kyledueck (talk) 01:03, 22 April 2012 (UTC)

So are you saying that one rule should be applied when talking about "human activities" and another for other subjects? Why? Jakew (talk) 08:25, 11 April 2012 (UTC)

Let me ask you this. Why are you so hell-bent on having the order be theraputic first, and non-theraputic second? Tftobin (talk) 12:15, 11 April 2012 (UTC)

For one thing, that's the order that is, even according to you, "most logical". Jayjg ^(talk) 01:06, 12 April 2012 (UTC)

Acccording to the page under discussion, "Estimates by the World Health Organization (WHO) suggest that 30 percent of males worldwide are circumcised, of whom 68 percent are Muslim". The vast majority of circumcisions are religious in nature, i.e., non-theraputic. Putting theraputic circumcision first, places an artificial medical emphasis, when most are non-medical. Jayjg, I am quite aware of what I wrote, without you repeating it to me. Tftobin (talk) 00:48, 13 April 2012 (UTC)

So, to return to my earlier question, "If we were discussing living creatures, for example, would it be necessary to discuss bacteria before humans, because there are more of them?" Jakew (talk) 08:24, 13 April 2012 (UTC)

If we were discussing bacteria, perhaps that would be appropriate. When a tool is used one way 80% of the time, and another way 20% of the time, does it make sense to put the 20% use first? I am starting to sense an awful lot of resistance, and not a lot of solid reasoning behind it, like there is a definite agenda no one wants to state. Tftobin (talk) 11:41, 13 April 2012 (UTC)

Since you've already admitted that placing therapeutic first is "most logical", you appear to be contradicting yourself. Jakew (talk) 11:53, 13 April 2012 (UTC)

Am I? Go back and read the sentence. I'm not up for game playing. If you want it in a particular order, why? When theraputic use is a tiny fraction of non-theraputic, why must theraputic come first? Tftobin (talk) 17:27, 13 April 2012 (UTC)

Please see my comment dated 15:47, 5 April 2012 (UTC). Jakew (talk) 17:29, 13 April 2012 (UTC)

Let's put it to a vote, as to whether theraputic or non-theraputic should go first. Tftobin (talk) 18:50, 13 April 2012 (UTC)

Nope. See WP:NOTDEMOCRACY and WP:PNDS. Jakew (talk) 18:54, 13 April 2012 (UTC)

Repeating the same thing is not the same as a discussion. So, who determines order, when there is a dispute? Tftobin (talk) 20:09, 13 April 2012 (UTC)

If you ask a question that's already been answered, you shouldn't be surprised if you're directed to the previous answer. Regarding content disputes, nobody arbitrates. We can look for a compromise or a way around the problem. For example, we could revert Kyle's addition of the "non-therapeutic" sentence, which triggered the dispute. Or, as I suggested above (09:06, 6 April 2012 (UTC)), we could remove the terms "non-therapeutic" and "therapeutic", and present the content in the order you prefer. Jakew (talk) 20:20, 13 April 2012 (UTC)

I would like to see it presented, before agreeing. I am leaning towards the removal of the terms "non-therapeutic" and "therapeutic", and presenting the content in the order in which they most commonly occur. It just seems more honest. Tftobin (talk) 15:51, 14 April 2012 (UTC)

New Sources are generally Reliable

Jake:

http://en.wikipedia.org/wiki/Wikipedia:NEWSORG It says: "News reporting" from well established news outlets is generally considered to be reliable for statements of fact (though even the most reputable reporting sometimes contains errors). Therefore, a news outlet report on the Swedish Paediatric position on circumcision should be acceptable. Sugarcube73 (talk) 18:26, 21 April 2012 (UTC)

Sources can be reliable in some contexts but not in others, Sugarcube. Please see WP:MEDRS#Popular press, which states "The popular press is generally not a reliable source for scientific and medical information in articles." Jakew (talk) 18:35, 21 April 2012 (UTC)

Sugarcube has restored the material, arguing that "This is ethical material not scientific or medical." That is an inventive argument, but ultimately flawed. First, since Wikipedia:Manual of Style/Medicine-related articles, the companion guideline to MEDRS, includes "Ethical and medicolegal issues any ethical issues that are specific to this field" within its scope, ethical issues relating to medical procedures are clearly medicine-related issues for the purpose of applying WP:MEDRS. Second, the section is entitled "Positions of medical associations" and, consequently, the reason for including any material is because of the relevant body's presumed authority in matters of medicine. If one takes the position that it is wholly unrelated to medicine, then one is effectively making a case that it doesn't belong in the section. Jakew (talk) 19:02, 21 April 2012 (UTC)

Dubious changes

I've recently reverted a series of dubious changes. Specific problems were:

• Removal of the word "surgical" from the definition, in spite of the fact that this is extremely well sourced.
• Undue weight given to Hitchens in the addition of "or as author and journalist Christopher Hitchens points out, Male Genital Mutilation, on a par with female genital mutilation"
• Illogical re-ordering of some material regarding types of local anaesthesia, which moved the sentence "neither method eliminates pain completely" to after discussion of the ring block, implying that the sentence applied to the ring block. The cited source does not support that statement.
• Illogical re-ordering of UTI material. First, we need to state whether circumcision affects UTI, citing the highest-quality evidence. Then, we quantify. To do otherwise makes no sense. Jakew (talk) 18:56, 22 April 2012 (UTC)

Definition in the lead

I object to this being removed: "*"Male circumcision is an elective surgery to remove the foreskin. . ." Circumcision, British Columbia Health Guide, June 2, 2006. Retrieved July 18, 2007." The new description seems to have omitted the elective portion. It's important. Tftobin (talk) 20:51, 23 April 2012 (UTC)

You seem to be quoting from an out-of-date link, Tom. The current definition reads: "Male circumcision is a surgery to remove the foreskin, a fold of skin that covers and protects the rounded tip of the penis". Jakew (talk) 21:03, 23 April 2012 (UTC)

It was there a few days ago. Of course, it is not there currently. An editor removed it. Does its removal mean that the surgery should no longer be considered elective? Tftobin (talk) 15:36, 24 April 2012 (UTC)

I think you misunderstand, Tom. You're quoting above from bchealthguide.org, and the citation above says that it was retrieved from that website in July 2007. Since that time, bchealthguide.org have revised their page, such that it no longer defines circumcision as elective surgery. That's probably because there are situations (such as emergencies, albeit rare) in which it's not elective surgery. I provided a link above to their current page. Jakew (talk) 15:49, 24 April 2012 (UTC)

Similarly, the beginning lead references situations in which circumcision is not a surgical but a cultural or religion removal. Pyrlights (talk) 18:43, 24 April 2012 (UTC)

I think Pyrlights means therapeutic (medically necessary) instead of surgical for all circumcisions require the surgical removal of some foreskin from the penis. Garycompugeek (talk) 19:27, 24 April 2012 (UTC)

I can think of very few cases where surgery is elective. In the case of circumcision, it is either a method of last resort, or forced upon the individual. Very few people "elect" to get circumcised. Rip-Saw (talk) 20:51, 24 April 2012 (UTC)

Sorry, what is the point of all these comments? The source in question doesn't use the word "elective", there's nothing we can do about that. Jayjg ^(talk) 23:47, 24 April 2012 (UTC)

POV

I would suggest reading the Female_genital_mutilation article. From reading that article, it is quite clear that this article is anything but neutral. Please stop removing the POV tag without proper discussion.

I have been accused of "having a disruptive interpretation of policy". What is more disruptive is when a single editor controls an entire article completely ignoring Wikipedia's goal of being a community-developed (and accurate) encyclopedia based on meritocracy. I would argue that the inability to see this article as biased precludes someone from having the authority to edit it.

There is no credible scientific evidence that says MGM prevents HIV, yet this is featured prominently. Even so, would you have sex with an HIV+ women just because you were cut? This is not prevention at all. We don't do infant mastectomies just because it would save millions of women's lives. The hippocratic oath says you do no harm: you don't cut healthy tissue in medicine as it is not ethical. We have let ethically-challenged sources and junk science contaminate this article. Yet, we discard valid, ethical, scientific research like the US Navy study for no other reason than it is a "primary source". The US has the highest rate of MGM and it has higher rates of STDs, HIV, and other cancers than countries where the citizens are intact. Furthermore, more children DIE from MGM than from penile cancer, SIDS, drop-side cribs, etc. The "cure" is worse than the disease.

I can provide valid, credible, reliable references to everything I just stated in the last paragraph. I will provide this information through edits in the coming months. However, I have started by vetting the sources in the article as it stands before I provide new information. I have been met by unjustified resistance based on a predisposed bias of editors. I find this disappointing and unfortunate. Erikvcl (talk) 18:59, 12 April 2012 (UTC)

You are not the first new editor to be attacked. It was implied that I was a plant from an anti-circumcision organization, sent to infiltrate. I had comments from outside of wikipedia posted on the talk page. We file complaints, (several long-time editors in here have had a long series), and the attackers still attack. I share your sentiments, Erikvcl. Everything put together, sooner or later falls apart. Truth will remain. Tftobin (talk) 01:25, 13 April 2012 (UTC)

Speaking of POV, there is no medical association of any country which has endorsed Dr. Morris' view that "in contrast, Morris regards circumcision as "mandated", citing reduced risk of balanitis among other benefits.". Since it is not supported by medical evidence, it needs to be removed. Tftobin (talk) 01:25, 13 April 2012 (UTC)

Are you seriously suggesting that Wikipedia should only include statements that have been endorsed by medical associations? Don't you think that would make it a little difficult to express the full range of viewpoints? That and the sentence immediately before it, and which it balances, aren't wonderful sentences, but that has to be one of the strangest arguments I've seen. Jakew (talk) 08:21, 13 April 2012 (UTC)

Really? Every time I try and post, I get told it is not a secondary resource. Dr. Morris comes out with the most fringe of fringe views, which contradicts the advice of every medical society of every country, and it is cited here as if it is real. If we are going to be that off balance with what we post here, take out the Morris sentence, and the sentence which is being counterbalanced by it. Circumcision for balanitis, mandated, and I am being asked if I am serious? Tftobin (talk) 11:47, 13 April 2012 (UTC)

I've removed it and the preceding sentence. They were both rather tangential to the article. Jakew (talk) 20:36, 13 April 2012 (UTC)

You removed a valid cited piece of information that is completely relevant. You tell people to get sources and they do, but you reject their input anyway. You removed this information without any kind of consensus. You are not the dictator of this article. You remove all information that could be perceived as anti-MGM and your include pro-MGM sources even when they are not reliable. You have moved into the realm of irrationality. Can we please get some fresh editorial blood here? Are there any other senior Wikipedia editors who can properly moderate this article without bias? I am beyond frustration here. You may have won lots of medals, but, as I've said before, I detect cronyism. Erikvcl (talk) 20:42, 13 April 2012 (UTC)

As I indicated, an argument could be made for removing both sentences, and Tom agreed, saying "take out the Morris sentence, and the sentence which is being counterbalanced by it". Conventionally when one person suggests something, another agrees, and nobody objects, we'll tentatively call it a consensus so I went ahead and made the change. It seems rather tangential, when discussing an association between circumcision and a disease, to consider views regarding whether it should be applied to all boys as a result. By analogy, common cold notes that "Regular hand washing appears to be effective at reducing the transmission of cold viruses especially among children", but unless the idea had entered mainstream thinking, it would seem a little obscure, to say the least, to discuss whether mandatory handwashing should be introduced as a result. It's fairly obvious from your uncivil response and personal attacks that you disagree, but you haven't stated any concrete objections. Do you have any? Jakew (talk) 21:26, 13 April 2012 (UTC)

Re-reading your exchange, I don't see any clear indication that you had an agreement with Tftobin. Morris's statement is bogus; the other statement should stay in. You are violating the Wikipedia policy of Wikipedia:Conflict_of_interest by having a pro-MGM website. You also violate the policy of Wikipedia:Consensus with the way you control this article with an iron fist and browbeat everyone. Yet you continue to criticize everyone else for the policies that they are violating! I'm not making personal attacks --- I am calling to attention the inappropriateness of your actions and the actions of other editors. The editors have attacked me and not one has apologized. People make a point and your response is "you didn't make a point" --- I've seen this half a dozen times or more on this page. It gets old. Every single change people want to make here is a fight. I know I am being disruptive, but "playing by the rules" hasn't worked. Lots of folks are frustrated. I may come back to this at some point, but I'm giving up for now. There's way too much irrationality, game-playing, bias, and cronyism. Erikvcl (talk) 02:02, 14 April 2012 (UTC)

You may feel you are the first person to voice these things. When I brought them up as WP:COIN (conflict of interest), I was told that there was no conflict of interest, because the editor never hid the fact that he or she operates a web site which was described in the circumcision article as pro-circumcision (not by the editor him or herself), and that he or she was not excessively citing the six or so articles they had written. I think you will find that wikipedia is extremely light on enforcement, far more light and lenient than any other organization I have encountered. The suggestion was made to me that if I felt strongly enough, I could go back, and determine (as you have already intuitively sensed) statistically, and prove bias, and then they may or may not do something about it. I have seen editors do things that might land them in court in the outside world. When people have been editing for 5 or more years, they know every device to obfuscate, manoeuver, and wiggle, as you have correctly observed. There is an old and comfortable relationship between some of the more long term editors, and wikipedia central, which in my observation, allows rules to be bent into pretzel shapes. I can tell that when you detect intellectual dishonesty, you voice it. I encourage you to continue to participate. I don't say that because you and I share the same viewpoint, or see the same injustices, or have tried the same paths. I encourage you because you speak the truth as you see it. There is a growing sense of frustration among all the editors. In my experience, when people wield dictatorial powers, it does not last forever. Berlin walls come down, and 30 year African leaders get deposed. Artificial things do not last. Tftobin (talk) 16:20, 14 April 2012 (UTC)

You'll both find editing Wikipedia a much less frustrating experience if you stop personalising issues. Wikipedia is governed by its policies and guidelines; getting angry at those who enforce those rules achieves nothing. Focus instead on understanding the rules — and the subject — better; you'll find that there will be far less resistance to your proposals as a result because they will be better proposals. Jakew (talk) 17:26, 14 April 2012 (UTC)

Please take your own advice. Tftobin (talk) 23:04, 14 April 2012 (UTC)

his sentence is really weak. It states more or less that there may or may not be some evidence that there is a connection between circumcision and prostate cancer, but is far from definitive. "Morris et al. reported that there is some evidence, albeit mixed, that circumcision may protect against prostate cancer; they called for more extensive research into the matter." Why are we including conjecture? This needs to be removed. Tftobin (talk) 01:25, 13 April 2012 (UTC)

You participated in the discussion that led to its inclusion, Tom, in which you said "I can live with it" regarding the present text. Morris et al are used as a secondary source which "summarizes one or more primary or secondary sources, usually to provide an overview of the current understanding of a medical topic, to make recommendations, or to combine the results of several studies" (to quote from the relevant guideline. Jakew (talk) 08:21, 13 April 2012 (UTC)

Maybe in the light of the well publicised, but science-poor study done by the Fred Hutchinson Cancer Center, I am growing less enamoured of the aspersions without proof. The sentence itself is conjecture. If this is the state of secondary research, perhaps we should rethink. I am not trying to be difficult here. I was just reading the article, and it's a junk sentence, based on evidence which may or may not point to something. Is this really wikipedia quality material? Tftobin (talk) 12:00, 13 April 2012 (UTC)

I'm afraid I don't see the problem, Tom. You seem to be arguing that we should delete any sentence reflecting evidence which is less than certain. Human knowledge is imperfect; most of cosmology, for example, is based on educated guesswork. But we don't delete all articles on cosmology. What we should do is to be careful when wording sentences, such that we accurately reflect the confidence that scientists have in their assertions. If something is known, we say so. If it's suspected, we say that too. If there's evidence, but not proof, as in this case, we say that. Jakew (talk) 12:20, 13 April 2012 (UTC)

Except that in this case, it is more like an aspersion. Cosmology is not asserting that something may be more disease prone, without actual evidence. Little cosmology gets published, with says, "It may be so, but then again, it may not be." Tftobin (talk)

Morris et al aren't making an assertion without evidence, either. They cite their evidence. But they acknowledge that this evidence doesn't constitute absolute proof. And you might find Wikipedia's article on the Oort cloud interesting. "The Oort cloud [...] is a hypothesized spherical cloud of comets which may lie roughly 50,000 AU, or nearly a light-year, from the Sun. [...] Although no confirmed direct observations of the Oort cloud have been made, astronomers believe that it is the source of all long-period and Halley-type comets entering the inner Solar System and many of the centaurs and Jupiter-family comets as well." Jakew (talk) 17:55, 13 April 2012 (UTC)

As best I can see, the article on the Oort cloud is not implying or inferring that it causes or aids in contracting a potentially fatal human disease. The same cannot be said of the Morris and company article. Tftobin (talk) 18:54, 13 April 2012 (UTC)

So are you suggesting that it needs unusual treatment? Jakew (talk) 21:30, 13 April 2012 (UTC)

Jakew, the article says nothing. That you would post something like the entry above is beneath your typical level of dignity. The article adds nothing to the discussion of circumcision, because it says nothing deterministic, or definitive. Do you want wikipedia to be an encylopedia, or do you want it to support research which meets the criteria, but does not provide information? Tftobin (talk) 16:20, 14 April 2012 (UTC)

By the same argument, mentioning the Oort cloud adds nothing to discussion of the solar system. I don't find that to be a persuasive argument, and I think removing it would be harmful to the encyclopaedia: information doesn't always have to have firm proof to be of value. Sometimes it's useful to the reader to have the best available information. But what's vital is that the reader isn't misled to believe that the data is better (or worse) than it is. Jakew (talk) 17:26, 14 April 2012 (UTC)

I don't find your argument persuasive. I find it disingenuous, that you co-authored the vacuous article, and then insist that it be included here, when it contributes nothing. It does not insure the reader is not mislead. It plants seeds of doubt, without any evidence. Tftobin (talk) 23:10, 14 April 2012 (UTC)

I suggest you check your facts, Tom. The article cites [www.scirp.org/journal/PaperInformation.aspx?paperID=17415 ref 124], and as you'll see from the link I provided, I'm not a coauthor of that article. I believe you owe me an apology. Jakew (talk) 07:49, 15 April 2012 (UTC)

You are correct, Jakew. I was mistaken. You are not a co-author with Dr. Morris of that particular vacuous article. You are the co-author of a different article on circumcision and prostate cancer with Dr. Morris, entitled "CASE NUMBER AND THE FINANCIAL IMPACT OF CIRCUMCISION IN REDUCING PROSTATE CANCER". I apologize for the error, Jakew. Now, can the vacuous article [www.scirp.org/journal/PaperInformation.aspx?paperID=17415 ref 124], which adds nothing to wikipedia's knowledge be removed? Tftobin (talk) 19:26, 15 April 2012 (UTC)

If it were removed, the reader would not be informed of the evidence suggesting an association with prostate cancer. I can't see why providing less information is in the interests of the reader, I'm afraid. Jakew (talk) 19:37, 15 April 2012 (UTC)

It's an aspersion. It's not proof. It's like saying, "Perhaps she's homosexual, but maybe not". Something that non-deterministic really has no place in an encyclopedia. It has a negative connotation for 3+ billion people, that they may (but it is unproven) (and it needs more research), possibly, be at risk for a disease of old men. It proves nothing. It does a disservice by its presence. It needs to go. Tftobin (talk) 00:03, 16 April 2012 (UTC)

It's not an aspersion, it's a summary of the evidence. That's exactly what we rely upon secondary sources to do. Jakew (talk) 06:55, 16 April 2012 (UTC)

There is no other summary of evidence in any encyclopedia I have seen, which says that this may be so, or it might not be. We just don't know, but it appears that way, so more study might be in order. If you can find one on a medical topic, outside of wikipedia, please point me to it. Otherwise, please be reasonable, and remove the article. Tftobin (talk) 11:20, 16 April 2012 (UTC)

We don't base our content on that of other encyclopaedias, Tom. And I'm afraid I've yet to see a persuasive argument for removing the article. Jakew (talk) 11:47, 16 April 2012 (UTC)

What could possibly pass as a persuasive argument? After all, reasonable or not, accurate or not, a senior editor has the upper hand, and truth is sacrificed to verifiability. What more could anyone want, I mean, besides real medical accuracy, or scientific truth? What is it they say about absolute power? Don't worry. It's rhetorical. This, too, shall pass. Tftobin (talk) 00:23, 17 April 2012 (UTC)

Please review Wikipedia:The Truth. Jayjg ^(talk) 00:59, 17 April 2012 (UTC)

It cuts both ways. Tftobin (talk) 10:38, 17 April 2012 (UTC)

It does? I don't claim to know what is "truth" or "scientific truth", and I certainly never comment about them. In fact, I rarely even comment about circumcision on these pages. My focus is on ensuring the article and its editors adhere to policy. Jayjg ^(talk) 00:47, 19 April 2012 (UTC)

That comes as a surprise. Thanks for clarifying. Tftobin (talk) 19:19, 19 April 2012 (UTC)

No surprise if you read my comments for what they actually say. I seriously recommend you re-read them in that light. Jayjg ^(talk) 01:11, 20 April 2012 (UTC)

I will do that. I had been leaning in agreement with another editor, whose name I can't mention, because we can't mention editors, the one who had been chastised for mentioning editors, but whose comments I thought at the time were right on the money. I will go back, and try and read with an open mind. Tftobin (talk) 19:58, 20 April 2012 (UTC)

The view that The sentence, "The moist, warm space underneath the foreskin is thought to facilitate the growth of pathogens, particularly when hygiene is poor." appears to cite no source. "thought to" means it is unsupported by medical evidence. I can cite several studies which show that the glans of circumcised men are more likely to have staph and strep, than the glans of uncircumcised men. This line needs to be removed. Tftobin (talk) 01:25, 13 April 2012 (UTC)

It's sourced to the citation that follows (ref 111), which states: "The area under the foreskin is a warm, moist environment that may enable some pathogens to persist and replicate, especially when penile hygiene is poor". (And there's no shortage of studies showing larger quantities of pathogens in uncircumcised men; see here for a brief list. But most of those are primary sources, of course.) Jakew (talk) 08:21, 13 April 2012 (UTC)

If they are primary sources, why are they being allowed? Can I include my primary sources, which prove that there is more incidence of staph and strep on the glans of circumcised boys, than on the glans of boys with foreskins? Or does it go? Tftobin (talk) 23:10, 14 April 2012 (UTC)

If you mean my parenthetical comment, which referred to the primary studies of pathogens by circumcision status, they aren't included, and that's because they're primary sources. We do, however, include a secondary source, ref 111. Jakew (talk) 07:49, 15 April 2012 (UTC)

Despite the fact that the article is a secondary source, there is no evidence that there are more pathogens lurking under the human foreskin, than there are under any other mucous membranes, namely the [mouth|foreskin|vagina|vulva|armpit|anus]. Just because someone said it, and someone else rubber stamped it, does not make it so. Any reasonable person would not believe that more than 3 billion men are walking around with pathogens under their foreskins. If so, how does this world function? Are you interested in truth? Or are you simply interested in your point of view winning? The whole world is watching, and waiting for your answer. Tftobin (talk) 19:37, 15 April 2012 (UTC)

The source doesn't claim that there are more pathogens under the foreskin than the other locations you mention, Tom, so I can't see why your statement has any relevance. Please address what the source (and the article) actually says, rather than attacking a strawman. Moving on, it is essentially certain that all men, circumcised or otherwise, have pathogens on the surface of their penises, and indeed elsewhere on their bodies. That is an essentially normal condition, as microorganisms, some capable of causing harm, are everywhere. Normally they don't cause harm, though it can be more likely if their numbers are high or if the body is weak. Jakew (talk) 19:46, 15 April 2012 (UTC)

Except that the statement does not make it clear that there are pathogens everywhere on the body, it specifically calls out the male foreskin as "The moist, warm space underneath the foreskin is thought to facilitate the growth of pathogens, particularly when hygiene is poor." Is it strawman for me to call out that the sentence is associating the foreskin and the growth of pathogens? Or are you obfuscating? "Is thought to", once again, is not deterministic. Either do the science and determine it to be true, do the science and determine it to be false, but don't put something half baked in an encyclopedia entry. If I were to find a secondary resource which said, "Keratinization of the glans is thought to lessen sexual sensation greatly for the circumcised man.", would this be proper, ethically, for me to cite, and use as a reference? Tftobin (talk) 00:14, 16 April 2012 (UTC)

Given the subject of this article (and hence our sources), it should not be surprising that there is a certain focus on the foreskin, as opposed to other body parts. The source is certainly saying that the presence of the foreskin facilitates the growth of pathogens, though the implicit comparison is with a circumcised penis rather than with other body parts. This is based on research finding greater numbers of pathogens in samples taken from the uncircumcised penis, and in that sense is diametrically opposed to the hypothetical sentence you mention (since evidence shows equal glans sensitivity and keratinisation). Jakew (talk) 06:55, 16 April 2012 (UTC)

Perhaps the source is saying "saying that the presence of the foreskin facilitates the growth of pathogens", but the wikipedia article is saying, "The moist, warm space underneath the foreskin is thought to facilitate the growth of pathogens, particularly when hygiene is poor." As medical evidence goes, this is shoddy. Especially since actual research can be cited which comes to the exact opposite conclusion. Once again, an aspersion containing is thought to does not belong in an encyclopedia. I was not arguing whether or not keratinization exists. I was saying that if I were to find an article which said "Keratinization of the glans is thought to lessen sexual sensation greatly for the circumcised man.", would this be proper, ethically, for me to cite, and use as a reference? I, personally would not use it. It casts an aspersion, and plants seeds of doubt, without evidence...while saying is thought to. The original statement in question, while it might come from secondary research, is an example of truly obvious poor research, and as such, it is unethical to put in an encyclopedia. Rationalize as you will, there is no getting around that it is poor science. Tftobin (talk) 11:31, 16 April 2012 (UTC)

The phrase "is thought to" is fairly standard language for describing current scientific understanding; according to a brief Google search, it appears in 63,100 Wikipedia articles. We can rephrase, if you like, but I see no reason to remove the information. Indeed, since it provides background information that helps to explain how circumcision reduces the risk of balanitis, it actually furthers the readers' understanding. Jakew (talk) 11:47, 16 April 2012 (UTC)

I am certain circumcision reduces the risk of balanitis. I am also certain that it can be treated with nappy (diaper) cream containing zinc oxide. Amputation of the arm can significantly reduce the risk of a hangnail. I'm certain that advocating it would further the readers' understanding. Tftobin (talk) 16:15, 16 April 2012 (UTC)

Proof? Pathogens? Really? The [mouth|foreskin|vagina|vulva|armpit|anus] is a warm, moist environment that may enable some pathogens to persist and replicate. That is simply part of being alive. Are we trying to be factual here? Or are we trying to prove that someone can write something, and get it approved? Tftobin (talk) 12:00, 13 April 2012 (UTC)

I'm afraid your point is unclear. Jakew (talk) 12:20, 13 April 2012 (UTC)

I agree with Erikvcl. The point is that someone took the characteristics of mucous membranes all over the human body, singled one out, and made it sound insidious. Why? It's unclear. Should we remove the tongue from the mouth, in order to make the environment less susceptible to germs and potential pathogens? Of course not. Why would the same logic not apply?

His point is crystal clear: Would you add to the Vulva article or the FGM article a statement about the large presence of pathogens in the vulva and the reduction in pathogens if the labia were removed? I suspect not. Erikvcl (talk) 13:54, 13 April 2012 (UTC)

If that was the conclusion of a substantial body of research, and if it were included in a reliable secondary source, then yes, of course. Jakew (talk) 14:07, 13 April 2012 (UTC)

I'll give you credit for consistency, though I'd like to see you try to add this information. I'd bet money that the editors of those two articles wouldn't let you add it. You mentioned "substantial body of research": there is no substantial body of research that MGM prevents HIV yet this conclusion is featured prominently in this article. To my knowledge there has been one study commissioned by the WHO that came to this conclusion. The WHO study has been widely discredited, is riddled with ethical issues, and its advisors/researchers had a conflict of interest with the outcome. Meanwhile, even though the Wikipedia content guidelines clearly state that primary sources may be used with care, a US Navy study that contradicts the WHO study is not allowed here. The US Navy has a vested interest in lowering health care costs, so there is no conflict of interest; furthermore, the US Navy study used proper scientific and research techniques (e.g. it did not pay participants, etc.). Erikvcl (talk) 14:31, 13 April 2012 (UTC)

I'm afraid your knowledge needs updating, Erik. There is indeed a substantial body of work. It is unclear which study you mean by "one study commissioned by the WHO". The three most commonly cited are the randomised controlled trials that were conducted in South Africa, Uganda, and Kenya. These were the studies that led the WHO to recommend circumcision programmes, though the WHO did not commission any of the studies. In addition to the RCTs, there have been at least 50 observational studies, including the US Navy study that you mention. Most, but not all, of these observational studies (21 of 27 studies in a meta-analysis dating from 2000) found reduced risk in circumcised men. At the present time, PubMed lists 936 results when searching for "circumcision HIV", which is roughly a fifth of the 5,254 results for "circumcision" alone. Jakew (talk) 14:50, 13 April 2012 (UTC)

The idea that genital cutting is beneficial for HIV prevention is absurd at face value. It doesn't obviate the need for a condom, so what's the point? You don't need research to know that. You may have looked into the studies in more depth than I have, I'll give you that. However, doesn't mean that you conclusions are correct. The African studies have NOT been duplicated elsewhere and the WHO is an ethically challenged source. My original edits here ONLY pertained to the reliability of the WHO as a source. Wikipedia policy guidelines clearly state that "conflict of interest" is a factor in determining the reliability of a source. But it appears as the editors are interpreting Wikipedia's own policies in creative ways in order to keep a certain viewpoint. Erikvcl (talk) 14:59, 13 April 2012 (UTC)

Erik, I'm very happy to debate the merits of circumcision as HIV prevention with you, but not here. WP:TALK makes it clear that article talk pages are not for general discussion about the subject. My opinion about whether circumcision is beneficial for HIV prevention is completely irrelevant. So is yours. What we need to concern ourselves with is how best to represent what reliable sources (particularly, since this is a medical subject, review articles) say about the subject of the article. As individual editors, we'll probably find that we disagree with what some of those sources say (I know I do in a number of cases); I'm afraid we just have to tolerate that. Jakew (talk) 15:39, 13 April 2012 (UTC)

Allow me to clarify: my main point has always been that the WHO is not a reliable source on the subject of MGM as HIV prevention due to conflict of interest within the organization. This discussion is appropriate to have and it is one of the reasons why I am claiming the article has bias. I am quite clear that my own personal bias has nothing to do with the article and I have not made sweeping changes to the article to try to steer it toward my personal point of view. Erikvcl (talk) 15:48, 13 April 2012 (UTC)

Jakew, do you not understand that whatever your motives may be, the manner of your editing here at least gives you the appearance of OWNing the article and biasing it to a pro-circumcision viewpoint? Do you think you should be doing something to correct that impression? Egg Centric 14:13, 13 April 2012 (UTC)

Especially when other potential editors are told that part of the article is going to go in a certain order, without giving a reasonable explanation as to why the less common practice must go first. Tftobin (talk) 18:57, 13 April 2012 (UTC)

I think it might be a good idea to comment on content, not the contributor, Egg. Jakew (talk) 14:22, 13 April 2012 (UTC)

It seems as though the editors themselves should follow this advice. Yobol commented on me, a contributor, rather than the content of my comments by calling my interpretation "disruptive". If the editors aren't holding up the high standards of the Wikipedia policies, how can the rest of us be expected to? Erikvcl (talk) 14:36, 13 April 2012 (UTC)

I think you'll find that it was Yobol, not Jayjg, who made that comment (here), and he described the "poor interpretation of policy" as disruptive, not you. In other words, it was directed at an argument, rather than a contributor. Jakew (talk) 14:53, 13 April 2012 (UTC)

I corrected my comment above; I shouldn't have relied on my memory for that. Erikvcl (talk) 19:03, 13 April 2012 (UTC)

NPA has nothing to do with this. Wikipedia needs to be seen as acting through consensus and adhering to neutrality. When it doesn't seem to be, it is not a personal attack to point that out. Do you think there is an issue here or not? Egg Centric 14:35, 13 April 2012 (UTC)

It's wise to keep the pov tag on the article until we get a meeting of the minds on these issues under dispute. Robert B19 (talk) 21:55, 14 April 2012 (UTC)

We keep POV tags where the person adding the tag has created a discussion in which they identify specific actionable issues that violate NPOV policy, and even then we only retain the tag while discussion is active in that section. Please stop re-adding the tag without following its instructions. It is disruptive. Jakew (talk) 07:49, 15 April 2012 (UTC)

Robert, as Jake notes, constantly adding the NPOV tag without stating any specific policy issues is highly disruptive. Please stop. Jayjg ^(talk) 01:03, 16 April 2012 (UTC)

Agreed, I do not see significant POV issues being detailed here to justify the NPOV tag. Yobol (talk) 01:04, 17 April 2012 (UTC)

I see a plethora of POV dispute. Particularly the weight given to the HIV section in the lead which has garnered double digit number of authors involved in the dispute. I encourage authors to consolidate the POV disputes from the past couple months and start a discussion on the POV message board for tag inclusion.Gsonnenf (talk) 21:15, 18 April 2012 (UTC)

Manufacturing a dispute in order to justify adding a POV tag will not result in a POV tag being added. Jayjg ^(talk) 00:39, 19 April 2012 (UTC)

Just because you do not agree with other editors reasoning's Jayjg, does not justify calling their efforts fabrications. I think Gsonnenf idea is an excellent one, policy talk pages are an good source of clarification. Garycompugeek (talk) 13:30, 19 April 2012 (UTC)

My comment neither "disagrees with other editors reasoning's" nor "calls their efforts fabrications". In the future, please make accurate and relevant Talk: page comments. Jayjg ^(talk) 01:14, 20 April 2012 (UTC)

No, the comment calls another editor's actions "Manufacturing a dispute in order to justify adding a POV tag", which in itself is disrespectful. Then, some editor hides behind their mama's skirts with "Comment on content, not on the contributor." What was "Manufacturing a dispute in order to justify adding a POV tag", if not commenting on an editor? I guess you can't have it both ways, if you're a regular editor, but you can if you are an experienced editor, as some are so fond of pointing out. It seems to be a two tier system. Tftobin (talk) 20:09, 20 April 2012 (UTC)

Your comment included a statement or statements about editors, not article content. Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor.". Jayjg ^(talk) 21:58, 20 April 2012 (UTC)

So, it's OK for one editor to call out another editor's actions as 'manufacturing a dispute', but that it not commenting on the other editor? What's that smell? Hypocrisy? Tftobin (talk) 00:53, 22 April 2012 (UTC)

Your comment included a statement or statements about editors, not article content. Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor.". Jayjg ^(talk) 02:39, 22 April 2012 (UTC)

Implying our disputes, where many authors presented a great deal of POV evidence you disagree with, are "fabrications" is dishonest and hostile. Stop this behavior.Gsonnenf (talk) 02:04, 20 April 2012 (UTC)

Your comment included a statement or statements about editors, not article content. Per WP:NPA and WP:TPYES, "Comment on content, not on the contributor.". Jayjg ^(talk) 02:13, 20 April 2012 (UTC)

The POV tag belongs on this article. Robert B19 (talk) 23:06, 23 April 2012 (UTC)

It's not enough to just keep claiming this; one must actually provide evidence of real NPOV violations as well. Jayjg ^(talk) 23:51, 24 April 2012 (UTC)

I just read the article and I fail to see where NPOV is violated. Negative and positive medical effects are listed. Ethical questions are introduced and there are many Wiki articles on the controversy behind circumcision. This is not a comment on whether or not the tag belongs in the article, but merely a comment that the article is not POV. Rip-Saw (talk) 07:24, 24 April 2012 (UTC)

Many of us have been proving for a long time thatthe Intro promotes scaremongering by pushing the HIV prevention theory. Robert B19 (talk) 21:39, 24 April 2012 (UTC)

"Proving" involves more than simply continually asserting something is true - see also proof by assertion and ad nauseam. Jayjg ^(talk) 23:51, 24 April 2012 (UTC)

There is nothing wrong with mentioning the main reason circumcision should be ethically performed in the lead, but the phrasing needs to be reworded. Studies of African men cannot be generalized to the world population, for various reasons. Rip-Saw (talk) 00:26, 25 April 2012 (UTC)

The POV tag belongs here for so many reasons. Encyclopedia Britannica sets an objective standard. Here's an encyclopedic article that should be the basis for the controversy Bioethics of neonatal circumcision - Encyclopedia http://www.experiencefestival.com/a/Bioethics_of_neonatal_circumcision/id/1932700 Robert B19 (talk) 23:49, 26 April 2012 (UTC)

"so many reasons" isn't good enough - you must explicitly which part(s) of the article violate the NPOV policy, citing both the material in the article, and the specific parts of the NPOV policy it violates. A personal disagreement with the results of peer-reviewed studies and review articles does not constitute a POV violation. Jayjg ^(talk) 00:07, 27 April 2012 (UTC)

reverted "If too much skin is removed, the penis may not be able to grow to its full length."

I removed this sentence and its reference for the following reasons:

1. It is misplaced under "Complications". The possible side-effect of circumcision on erect penis size is not a "complication" that needs further medical treatment.
2. Its cited source "Understanding Circumcision: A Multi-Disciplinary Approach ..." is not a WP:MEDRS, as noted here on this Talk page. Even though its publisher does publish some materials that are WP:MEDRS, that in and of itself it not sufficient to declare everything it publishes to be WP:MEDRS. See the separate discussion here on this Talk page.
3. The sentence itself misrepresents the source, which does not say anything about "if too much skin is removed."

The original study that the "Understanding Circumcision: A Multi-Disciplinary Approach ..." proceedings of the anti-circumcision conference mentions in passing can be viewed here.

It is a 1995 study from Australia that was published in the journal Venereology. The study is called "Are condoms the right size(s)? A method for self-measurement of the erect penis." It was not a study of penis size directly, but rather a study that examined the results of a set of penis self-meaurement instructions, and how it corresponded to self-reported condom size satisfaction. Penis size was not directly studied by the researchers, and the self-reported circumcision status and penis measurements were not directly confirmed by the researchers.

I do not feel that this study is strong enough or was conducted directly relevant enough to circumcision to include in this article. Zad68 (talk) 15:42, 25 April 2012 (UTC)

Zad68 I respect your opinion here and thanks for commenting. I noticed your recent association with Jake and have never seen you edit here so I must ask you what brought you to this page? Garycompugeek (talk) 17:50, 25 April 2012 (UTC)

Thanks Gary. I'm trying to remember exactly why I'm here... Honestly it was probably Joe Circus. For my own education and "Wikipedia career," I've been trying to learn how to deal with contentious editors. At some point in the past few months, I don't remember exactly why, I became aware of Joe Circus and started following his posts and sockpuppets and seeing how the Admins dealt with it. This led me to Circumcision, which has been an excellent education for me in learning how to do the difficult stuff on Wikipedia (formatting and reverting obvious vandalism are "easy stuff"). While here, I've started paying attention to Jakew's edits to learn how to handle medical topics and sources. When the anti-circumcision proceedings were cited, I thought "We can do better than that," so I decided to do a little digging to find the original study, and when I found it, wanted to contribute. So, that's the story... Zad68 (talk) 18:02, 25 April 2012 (UTC)

Appreciate your candor. I initially learned a lot of Wikipedia policy from Jake also... Garycompugeek (talk) 18:10, 25 April 2012 (UTC)

If anyone else's interested, I charge very reasonable tuition fees... ;-) Jakew (talk) 18:18, 25 April 2012 (UTC)

I want triple my money back!! :) Zad68 (talk) 19:33, 25 April 2012 (UTC)

Nobody's interested in paying you, but I'll admit, I have learned a lot from your mostly very positive comments and approaches, and sometimes admirable restraint and manners. I may get a blast from someone else about commenting on editors, but I also feel a complement is in order. Tftobin (talk) 16:50, 26 April 2012 (UTC)

Thank you for the explanation Zad68. I looked for the article that was referenced in that book but could not find full text anywhere. It would seem that the original research was not what I thought it was, and using it would be a mistake. Rip-Saw (talk) 21:19, 25 April 2012 (UTC)

Glad to hear. The lesson I got out of this was the confirmation that the WP:MEDRS requirements set a high standard, but they're right. Zad68 (talk) 03:09, 26 April 2012 (UTC)

I don't know that the standards are that high, but I understand why they are needed to avert even more contention in here. Tftobin (talk) 16:54, 26 April 2012 (UTC)

Dispute resolution for Circumcision

For all WP: Civil parties interested, dispute resolution is going on at Wikipedia:Dispute_resolution_noticeboard#Circumcision_discussion. Please leave any issues you have with other users where they are and bring WP: Policy and solid arguments about the sources used in Circumcision with you. Rip-Saw (talk) 18:27, 27 April 2012 (UTC)

Questionable revert

I have to question a recent revert here: [[10]] for the reason "rv, does not appear to be a medical association". Previously, the following statement was made: "Are you seriously suggesting that Wikipedia should only include statements that have been endorsed by medical associations? Don't you think that would make it a little difficult to express the full range of viewpoints?". This is clearly inconsistent. On one hand, we are clearly stating that we can't express a full range of viewpoints if we limit ourselves to sourced material by medical associations, but on the other hand, we are doing reverts on properly-cited material that is the conclusion of a sovereign government. Erikvcl (talk) 04:52, 27 April 2012 (UTC)

The material in question was added to a section entitled "Positions of medical associations". Hence it is reasonable to expect that the positions included are those of medical associations.

As a less important point, the nature of the "Council for Medical Ethics" is unclear. They may be a government body as you assert; on the other hand they might be a private organisation (like the UK's Council of Elders). Jakew (talk) 07:04, 27 April 2012 (UTC)

Again we see the straw man. You clearly stated that Wikipedia should consider non-medical organizations to show a full range of viewpoints. Now you're speculating on whether or not the Council for Medical ethics is a private organization or not. Why does this matter? You stated that we should show a full range of viewpoints -- even non-medical ones. This is a valid non-medical one. Case closed -- please revert your revert. Erikvcl (talk) 06:10, 28 April 2012 (UTC)

Since you agree that it's not a medical association, why on earth do you think it belongs in a section listing views of medical associations? Jakew (talk) 07:40, 28 April 2012 (UTC)

I never claimed the organization to be one way or the other. I was following your lead. I did some basic reasearch. See http://www.smer.se/bazment/2.aspx . I'd call it a national medical organization. I'm OK with changing the heading and still including the statement & source. Erikvcl (talk) 01:56, 29 April 2012 (UTC)

The link you've posted above is about the "Swedish National Council on Medical Ethics". The addition that I reverted, however, involved the "Norwegian Council for Medical Ethics". Much as I appreciate you doing basic research, might I request that you research the organisation that we're actually discussing? Jakew (talk) 07:39, 29 April 2012 (UTC)

Sorry, you're right. I didn't mean to be sloppy. My point still stands as it is a national medical org. Erikvcl (talk) 13:25, 29 April 2012 (UTC)

I wouldn't say that the Swedish body is a national medical organisation. Rather, they appear to be an government advisory body. However, since we don't know their views on circumcision, that's not really relevant. The "Norwegian Council for Medical Ethics" is a different group in a different country, and although they have a vaguely similar name, that seems a poor basis for making guesses about one on the basis of the other. As I pointed out above, it might be a government organisation, or it could be a private group with a grand-sounding name. We don't know.

Regarding whether the scope of the section should be broadened, I think there are pros and cons to doing so. On one hand, it would potentially allow more information to be included, such as the Norwegian body (if that turns out to be governmental), as well as policies of Swaziland, Botswana, Uganda, and Kenya. On the other hand, it raises questions such as: how broad should the scope actually be, and where do we draw the line? (We can't include everyone's viewpoint, but there's a reasonable argument that, in a medical article, medical associations have the most noteworthy views.) Also, how do we keep the section to a manageable size? (This is, after all, supposed to be an encyclopaedia article, not a giant compilation of policy statements.) Jakew (talk) 14:08, 29 April 2012 (UTC)

Synthesis in the lead's HIV paragraph

This topic was split off from #Summarizing opposing views in the lead's controversy paragraph, above. — Preceding unsigned comment added by Kyledueck (talk • contribs) 12:22, 30 April 2012 (UTC)

The lead currently has WP:SYNTH in it with the statement "Strong evidence from Africa indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66%," this statement is generalizing the findings of the cited study to apply to all men everywhere when the study specifically mentions African men and only African men throughout the entire thing. One cannot cherry pick a information taken out of context from a large study the way the lead does. Unless anyone can show where the study specifically generalizes their results to the entire world, that text will be rewritten to be less ambiguous. Rip-Saw (talk) 14:33, 25 April 2012 (UTC)

From the conclusion of the cited source (a Cochrane review): "There is strong evidence that medical male circumcision reduces the acquisition of HIV by heterosexual men by between 38% and 66% over 24 months." Would you care to explain how the sentence you quote is WP:SYNTH? Jakew (talk) 14:38, 25 April 2012 (UTC)

Because you need to read the entire article to put that summary in context. The entire article is about African populations of males. The authors never mention generalizing their results to the entire population, and that summary is poorly interpreted when taken out of context. The lead currently makes no distinction between African populations and the rest of the population, merely saying "heterosexual men." This is taking the summery out of context. The discussion reads: "Three large African RCTs assessing the effectiveness of male circumcision in preventing HIV acquisition in sexually active men in the general population were conducted between 2002 and 2006." Here the "general population" they are referring to is quite obviously, and can only be, the African general population. My adding the word "African" in the lead was merely clearing up ambiguity. I did not add a qualifier not present in the source, as you claim. The word Africa or African is mentioned a dozen times over a dozen pages. You could argue my edit is overly wordy, but misleading and inaccurate it is not. Rip-Saw (talk) 21:42, 25 April 2012 (UTC)

That still doesn't make it WP:SYNTH. Also, please review Wikipedia:Neutral point of view/FAQ#Anglo-American focus. Jayjg ^(talk) 00:18, 26 April 2012 (UTC)

I don't care which policy it violates, it's poorly worded, misleading, and has to change. As it is right now, someone could read that and think the statement applies to all men everywhere, while the article makes no such generalization to all men. Do you honestly fail to see that?Rip-Saw (talk) 03:18, 26 April 2012 (UTC)

Rip-Saw, I don't have access to the full text of the study but I read the abstract here. Here is the plain-language abstract: "Results from three large randomised controlled trials conducted in Africa have shown strong evidence that male circumcision prevents men in the general population from acquiring HIV from heterosexual sex. At a local level, further research will be needed to assess whether implementing the intervention is feasible, appropriate, and cost-effective in different settings." The abstract says "men in the general population" and not "African men." Can you please answer these questions:

1. Where in the article does it say "These results are applicable to African men only" or anything along those lines?
2. In general, are studies that are conducted in a particular locale considered to produce results only relevant to that locale? If so, can you give examples?
3. If you feel it is "common sense" that these results are applicable only to Africa, what would possibly be the difference between African men and men in the rest of the world that would prevent the results from being applicable to men elsewhere? Elsewhere you said the results cannot be generalized "for various reasons," what are those reasons?

Thanks... Zad68 (talk) 03:32, 26 April 2012 (UTC)

The article should be free to the public at WHO

1. The article never explicitly states that the results can be applied to the world population. To hint otherwise in this article is WP: SYNTH.
2. As a matter of good practice in science, we do not generalize findings across cultures if culture in any way impacts the findings. Since sexual practices are very much culture-based, these findings can only be applied to people with sexual attitudes similar to those in Africa.
3. For instance, condom use in the study was low(40%); condom use will likely have more of a protective effect for circumcised men, and affluent industrialized nations use condoms more. So in affluent countries, the effects of circumcision may only be a 20% reduction in HIV. The problem is that the lead text states 38-66%, and it makes no distinction as to what populations it is referring to. Also, AIDS rates are higher in Africa, and the socioeconomic status (SES) is lower. Since more people have an advanced form of the disease, the risk of transmission may be higher. These are just two reasons that the results may not apply in other regions of the world. I do not make any claim to knowledge that the effects are any different; they may be the same. We don't know.

Now that I think about it, this stuff probably is not common sense, and it is wrong of me to assume others would easily see the problems with the generalizations (I just got done writing a 12-page review of medical literature, my mind is still in science mode so I apologize if I've come across as overly harsh).

The article states: "Prior to 2003, six reviews ... and one meta-analysis (Weiss 2000) had been published which reached different conclusions on the association between male circumcision and HIV infection. In 2003 we published a Cochrane review of 35 observational studies and concluded that insufficient evidence existed to support an interventional effect of male circumcision on HIV acquisition in heterosexual men (Siegfried 2003). The review supported previous review findings that the results from existing observational studies showed a strong epidemiological association between male circumcision and prevention of HIV, especially among high-risk groups." The review acknowledges that the effects are greater for high-risk groups of people. It also questions the effect of circumcision in studies before the African studies (which were probably not as high-risk, Africa is about as high-risk as it gets for HIV). While I am sure there is an effect in all populations, I fully support the authors in stating the effect is larger in high-risk groups. I would not object to the lead stating this, but that would be WP:SYNTH since the authors never said these results apply to all high-risk groups. I really dislike the way the authors phrased their conclusions, and if there is another paper that draws conclusions from this study that would be nice. I will try to locate one.Rip-Saw (talk) 05:26, 26 April 2012 (UTC)

Here is a paper abstract summing up what I just said: http://www.ncbi.nlm.nih.gov/pubmed/19430583: "This article discusses major contextual differences between the United States and the three African countries where the clinical trials [in Africa] were conducted, and cautions that the applicability of the scientific data from Africa to this country must be carefully considered before rational policy recommendations regarding routine neonatal circumcision can be made as a strategy to prevent the spread of HIV in the United States."

Another study on the topic has the authors concluding: "Male circumcision provides a degree of protection against acquiring HIV infection, equivalent to what a vaccine of high efficacy would have achieved. Male circumcision may provide an important way of reducing the spread of HIV infection in sub-Saharan Africa." Randomized, Controlled Intervention Trial of Male Circumcision for Reduction of HIV Infection Risk: The ANRS 1265 Trial. Rip-Saw (talk) 05:53, 26 April 2012 (UTC)

It's still unclear to me how you think this violates SYNTH. First of all, SYNTH requires citing two or more sources, and we cite one. Second, we're paraphrasing the conclusion of a source which doesn't restrict its scope to African men. So how can that possibly violate SYNTH? Your argument doesn't make any sense. Jakew (talk) 08:17, 26 April 2012 (UTC)

I think it makes perfect sense Rip-Saw. I feel that its a dangerous and misleading extrapolation in its present form and have lobbied to remove the HIV paragraph completely from the lead but kept in the HIV section. Garycompugeek (talk) 13:48, 26 April 2012 (UTC)

You are ignoring the topic entirely, clinging to WP: POLICY to base your arguments on. What kind of original research it is is irrelevant; OR is not allowed on Wikipedia. The lead currently takes data based in Africa, that can only apply to Africa, and then removes the Africa part entirely. Yes, a scientist will read the lead and realize the studies only apply to Africa, but a layman may think the studies apply to everywhere, just as laymen here thought that from reading the abstract, despite the fact that the entire article is talking about African men. Rip-Saw (talk) 17:02, 26 April 2012 (UTC)

It's not OR to accurately paraphrase the conclusions of a source. Jakew (talk) 17:08, 26 April 2012 (UTC)

Exactly. Jayjg ^(talk) 22:43, 26 April 2012 (UTC)

The studies were done in Africa. The results of the trials only apply to Africa. Do you understand that? The lead does not accurately reflect this fact. Do you understand that? If you fail to understand either of these points, and no one else chimes in, this is going to dispute resolution. Rip-Saw (talk) 22:45, 26 April 2012 (UTC)

Which reliable source states that the results of those trials apply only to Africa? Certainly not the source itself. Jayjg ^(talk) 23:27, 26 April 2012 (UTC)

That's why the pov tag belongs. The AIDS/HIV African results scaremongers the average reader. The research doesxn't support the ovesrgeneralization to the world at large. Robert B19 (talk) 23:32, 26 April 2012 (UTC)

Which specific NPOV issue are you referring to? Please quote the policy sentences, and explain how they apply. Jayjg ^(talk) 00:02, 27 April 2012 (UTC)

Which reliable source states they apply to the entire world? Certainly not the source itself. And if you argue the source itself states that, then I will escalate my dispute to having the source removed entirely, as I have found several sources that are similar enough to replace it that won't support your OR. Rip-Saw (talk) 23:57, 26 April 2012 (UTC)

The article accurately summarizes the source. Again, summarizing a source is not WP:NOR. Please review that policy. Jayjg ^(talk) 00:02, 27 April 2012 (UTC)

I think it is way past time for dispute resolution on this point. It's been argued about for months, with no budging. All that comes back is the party line, or 'you misunderstand', or obfuscation. It certainly was Original Research when I slightly paraphrased a source. I couldn't even touch the date without getting reprimanded. I am tired of abiding by rules, getting shot, and then having someone else do the same action, and it is miraculously OK. This needs to go beyond the current participants, like nutrition needs to go past an intestinal block. Tftobin (talk) 00:13, 27 April 2012 (UTC)

"Even with well-sourced material, if you use it out of context, or to advance a position not directly and explicitly supported by the source, you are engaging in original research." Show me where the authors directly and explicitly claim that their results apply to Americans, Europeans, Asians, or Eskimos. Or anyone NOT Africans. Rip-Saw (talk) 02:45, 27 April 2012 (UTC)

We don't explicitly claim such a thing, either, so there's no reason why the source should. The fact is that the source doesn't restrict its statement to a geographical region, and Wikipedia's sentence doesn't do so either. That's not OR. But adding a geographical qualifier not present in the cited source would be OR. Jakew (talk) 07:43, 27 April 2012 (UTC)

I read Rip-Saw's reasons for why it would make sense not to have the article generalize the Africa study's finding to the world, and they make sense to me, although by strict Wikipedia standards, putting Rip-Saw's qualifier in fails WP:NOR. I also looked at the abstract of the Xu, et al publication Rip-Saw was talking about that agree with what Rip-Saw is saying. I understand Wikipedia WP:V policy that expressly forbids us from putting qualifiers in the the article's summarizing of the original Africa report's findings that are not in the report itself. I also understand that it is WP:SYNTH to combine the summary of the Africa report with the Xu, el al publication and put "African" in. I am actually not sure "African" is even the right qualifier because I don't think "Africa" is adequately culturally homogeneous, given the 3 study locales--Kenya, South Africa and Uganda. I'm stuck now, clearly Wikipedia policy should allow the sentence to stand without qualifier, but Rip-Saw's apparent expertise in the area, some common sense, and the Xu, et al publication make me feel that what Wikipedia policy should yield here isn't "The Right Thing." Is this a case for "Ignore all the rules"? Not sure what to do. Zad68 (talk) 14:59, 27 April 2012 (UTC)

The CDC's factsheet includes some discussion of US studies. I think it would be rather US-centric to discuss it in the lead, but I wouldn't be opposed to adding a sentence to the HIV section in the body of the article. Jakew (talk) 15:13, 27 April 2012 (UTC)

Thanks Jakew. After reflecting on this, I've come to realize that we cannot put "African men" because the study did not compare the HIV acquisition rates of African men vs. non-African men. I would expect that a study that produces a result for "African men" would have had to have compared African men vs. a control group of non-African men. That did not happen and it is absolutely inaccurate to say "African men." But I do get Rip-Saw's point about cultural groups. So, I'm offering a change for discussion below: Zad68 (talk) 17:58, 27 April 2012 (UTC)

Proposed change of lead sentence regarding African study

To help try to drive this discussion to consensus and a close, I'm proposing that the part of the lead sentence that reads:

Strong evidence from Africa indicates that circumcision reduces the risk of HIV infection in heterosexual men by 38-66%

to

Studies in sub-Saharan Africa showed strong evidence that circumcision reduced the risk of men acquiring HIV infection from heterosexual sex by 38-66%

The wording on this more clearly and closely ties the cultural area where the study was done with the study results, without going so far as to say the results are only applicable to the cultural area (which the report does not say explicitly). I think this eliminates the danger in the original sentence of a reader entirely ignoring the cultural area where the studies were done, and the interested reader can click through to the study itself. Thoughts? Zad68 (talk) 17:58, 27 April 2012 (UTC)

Insertion of the words "from Africa" was a compromise that I've never been completely happy about (because the strong evidence is really the sum of all studies to date, conducted in Africa and elsewhere; the African RCTs are indubitably the strongest, but not the only part). In some ways I prefer "Studies in sub-Saharan Africa showed strong evidence"; in others I prefer the present wording. I'm not sure, however, about changing "reduces the risk of HIV infection in heterosexual men by 38-66%" to "reduced the risk of men acquiring HIV infection from heterosexual sex by 38-66%"; the latter seems a little awkward. I'm not strongly opposed to it, but I wonder if you'd mind explaining why you think it's necessary? Jakew (talk) 18:46, 27 April 2012 (UTC)