Monday, January 27, 2014

STRASBOURG: Hearing about circumcision to be webcast

Parliamentary Assembly of the Council of Europe
January 26, 2014

Hearing on the circumcision of young boys

A parliamentary hearing on the circumcision of young boys is to take place in Strasbourg at 2 p.m. on Tuesday 28 January 2014 on the margins of the plenary session of the Parliamentary Assembly of the Council of Europe (PACE).

The hearing – organised by PACE’s Committee on Social Affairs, Health and Sustainable Development – will bring together medical experts, including those representing the Jewish and Muslim communities, and parliamentarians, and will be streamed live over the web.

It follows the adoption in October 2013 of the Assembly’s resolution and recommendation on “children’s right to physical integrity” and aims to encourage the open debate between different disciplines called for by the Assembly in these texts.

Participants include:
  • Bernard Lobel, urologist, Professor at the Faculty of Medicine of Rennes (France), member of the French Academy of Surgeons
  • Mesrur Selçuk Silay, paediatric urologist, Assistant Professor at the Faculty of Medicine, Bezmialem Vakif University (Istanbul, Turkey)
  • Wolfram Hartmann, paediatrician and President of the Professional Federation of Paediatricians and Youth Doctors (Germany)
  • Ronald Goldman, researcher and Director of the Circumcision Resource Center (Boston, USA)
  • Marlene Rupprecht, former PACE rapporteur on this issue
Representatives of religious organisations, including the Conference of European Rabbis and the French Council of the Muslim Faith, are expected to attend, as well as NGOs active in this field. Members of the Knesset, which holds observer status with PACE, are also due to take part.

The 1995 television documentary “It's a Boy” by British director Victor Schonfeld, as well as extracts from another film – currently in production – putting forward the point of view of the Knesset observer delegation, will be screened prior to the hearing, at 1 p.m. in the same room.


Practical information
The hearing will take place from 2 to 3.30pm French time in Room 1 of the Palais de l’Europe in Strasbourg.

Web streaming: the hearing will be streamed live over the web, in the original language, English, French, German, Italian and Russian. A recording (original language, English and French) will be made available on the website of the Assembly.

Earlier story

MELBOURNE: 14-year-old hospitalised after backyard circumcision

the Herald Sun (Melbourne)
January 26, 2014

DHS wants teen returned to mum who held him down while circumcised by witchdoctor

by Shannon Deery
THE Department of Human Services is trying to force a 14-year-old boy who was pinned down by his mother while he was forcibly circumcised by an international witchdoctor to return to live with her.

The teen remained conscious throughout the procedure.

The boy has told authorities he was one of 13 young boys across Melbourne to experience similar backyard procedures by the visiting witchdoctor on Boxing Day, in line with his mother's South Pacific culture.

The boy was rushed to the Royal Children's Hospital in the days after the circumcision because of complications with his recovery.

The boy was in so much pain doctors had to anaesthetise him so they could remove bandaging from his genitalia.

The boy was removed from his mother's care under a protection order, but the Department of Human Services yesterday applied to have the order withdrawn.

The move is being opposed by the boy's father, who made a complaint to police after learning about the procedure.

It is believed the boy's siblings were home at the time and might have witnessed the operation.

Authorities have been told the boys' families paid for the witchdoctor's flights to and from Melbourne, and for each of the circumcisions he performed.

It is believed he performed the operations in suburbs including Springvale, Werribee and Point Cook.
The witchdoctor is believed to visit Melbourne regularly to perform the procedures for the small community who believe the circumcision of boys is an important rite of passage that marks them as men.

In the boy's family's country of origin, the culturally significant milestone is performed in hospital and paid for by the government.

Victorian Opposition spokeswoman for children Jenny Mikakos called on the State Government to explain if this had happened before and if it could happen again.

"How can the department allow this invasive procedure to occur when one parent and the child himself are vehemently against it?" Ms Mikakos said.

Australasian Institute for Genital Autonomy chairman Paul Mason called for moves to ban circumcision.

"In this instance it seems to have been a cultural practice, and many cultures have unnecessary genital surgery,'' Mr Mason said.

"In this country we've outlawed female circumcision, but for some reason it's still OK to circumcise a boy. I can't see why it's better to cut a boy than to cut a girl. There's no logic.''

Mr Mason said he was shocked the procedure would be carried out in backyards, saying the risk of complications existed at the best hospitals in the world.

HS would not comment as the matter is before the courts.

STOCKHOLM: Swedish doctors want tighter rules for circumcision

Information (Denmark)
26. januar 2014

Svenske læger vil skærpe regler for omskæringer

Det kirurgiske indgreb burde erstattes af en symbolsk omskæring, mener lægeforening. Minister er afvisende.

Den svenske lægeforening mener, at omskæringer kun skal udføres efter samtykke fra drengen.
Anbefalingen støttes af samtlige medlemmer af foreningens etiske udvalg, skriver Svenska Dagbladet.

Hvis politikerne vælger at følge forslaget, vil det være en skærpelse af de nuværende regler for at omskære drengebørn.

Lægeforeningen begrunder sin indstilling med, at risikoen for bivirkninger ved det kirurgiske indgreb er urimelig høj.

Drenge skal tidligst blive omskåret i 12-13 års alderen. Indgrebet, hvor forhuden bliver fjernet, skal foretages på et hospital og først efter, at der er givet information om smerten og de eventuelle risici, som det kan medføre, mener rådet.

At gå så vidt helt at forbyde omskæringer, hvilket diskuteres i Finland, anses ikke for at være realistisk her og nu, skriver Svenska Dagbladet.

Men grundlæggende mener Läkarförbundet, at det kirurgiske indgreb bør erstattes af en symbolsk omskæring. For eksempel i form af en ceremoni af en eller anden slags.

Den mulighed vil lægerne nu drøfte med med jurister og muslimske repræsentanter.

- Vi er ikke religiøse eksperter, men af medicinske grunde kan vi ikke give vores opbakning til et indgreb, hvor man fjerner væv på kønsorganet, når der er så stor en risiko for alvorlige komplikationer, siger Thomas Flodin fra foreningens etiske råd.

Dansk forskning viser, at der opstår komplikationer i fem procent af samtlige omskæringer - også selv om indgrebet er foretaget af sundhedspersonale på hospitaler.

- At en ud af 20 personer lider af en infektion eller blødninger, er en alt for stor risiko. Især når indgrebet ikke er udført af medicinske grunde, siger Thomas Flodin.

Integrationsminister Erik Ullenhag fra Folkpartiet mener, at den gældende lovgivning er tilstrækkelig.
- Jeg har aldrig mødt en voksen mand, der oplevede omskæringen som et overgreb, siger han til avisen.

(Microsoft translation)
26 January, 2014

Swedish physicians will sharpen rules for circumcision

The surgical procedure should be replaced by a symbolic circumcision, doctors believe. Minister is dismissive.

The Swedish Medical Association believes that circumcision [should be] performed only after consent from the boy.

The recommendation is supported by all the members of the Association's Ethics Committee, Svenska Dagbladet writes.

If politicians choose to follow the proposal, it will be a tightening of the rules currently in force [concerning] circumcising of baby boys.

The Danish Medical Association justifies its recommendation [on the basis] that the risk of side effects from the surgery is excessive.

Boys may be circumcised [at] 12-13 years of age, at the earliest. The procedure, in which the foreskin is removed, must be carried out at a hospital and only after [parents are] given information about the pain and the possible risks it can cause, according to the Council.

To go so far as to completely prohibit circumcision, [being] discussed in Finland, is not considered to be realistic here and now, Svenska Dagbladet writes.

But the Medical Association fundamentally believes that the surgery should be replaced by a symbolic circumcision, for example, in the form of a ceremony of some sort.

They will now discuss the option with doctors, lawyers and Muslim representatives.

"We are not religious experts, but for medical reasons, we cannot give our backing to an intervention where one removes tissue from the genital organ, when there is such a high risk of serious complications," says Thomas Flodin from the Association's ethical Council.

Danish research shows that there will be complications for five percent of all circumcision, even if the procedure is carried out by health care professionals in hospitals.

"For one in 20 people to suffer from an infection or bleeding is too great a risk, especially when the surgery is not performed on medical grounds," says Thomas Flodin.

Integration minister Erik Ullenhag of the Liberal Party believe that the existing legislation is adequate.

"I have never met an adult man who experienced circumcision as an assault," he told the newspaper.

COPENHAGEN: Popular song given to Intactivist campaign

Ekstra Bladet
24. januar 2014

Shu-bi-dua donerer sang til forhuds-kamp

Den danske forening mod børneomskæring - Intact Denmark - får nu hjælp fra et af Danmarks mest folkekære bands
Af: Rune Melchior Sjørvad
Det har længe stået højt på ønskesedlen hos Intact Denmarks talskvinde at få lov til at bruge en helt speciel Shu-bi-dua-sang i foreningens kamp for et forbud mod omskæring af raske, danske drengebørn.


Nu er drømmen gået i opfyldelse, og Shu-bi-dua har kvit og frit stillet nummeret 'Den lille mands sang' til rådighed for foreningen.

Nationalhymne
For de, der ikke måtte kende den 17 år gamle sang, kan det oplyses, at den meget tydeligt opfordrer til at sætte en stopper for omskæring af drenge.

Blandt andet lyder det i sangen: ' Vi må og skal gøre op med en skik - Et af oldtidens regulativer - At skære et stykke af barnets pik'.

- Det har længe været en slags 'nationalhymne' for foreningen, så at få mulighed for at bruge den lune, humoristiske sang i vores kampagner er en drøm, der er gået i opfyldelse, siger Intact Denmarks talskvinde Lena Nyhus til Ekstra Bladet.

Hun forklarer, at Shu-bi-duas tidligere guitarist Michael Hardinger og sanger Michael Bundesen begge har sagt ja til, at sangen kan bruges som underlægningsmusik i foreningens kommende video-kampagne, uden at Intact Denmark skal betale for det.

Grotesk handling
Om sanggaven fortæller Michael Hardinger via mail fra sit hjem i Las Vegas til Folkets Avis:
- For en del år siden indspillede vi med mit gamle band Shu-bi-dua 'Den lille mands sang', som handlede om omskæring. Måske ikke det mest populære emne hverken dengang eller nu når man skriver popmusik. De andre var meget imod 'Den lille mands sang', som egentlig startede i mit hoved ved, at jeg hørte en stand-upper i USA sige: 'Jøderne er det mest optimistiske folkefærd på jorden. De klipper et stykke af penis, inden de ved, hvor lang den egentlig bliver.' Men den groteske handling krævede, i min hjerne i det mindste, at der blev sat spotlight på denne mishandling af børn, siger Michael Hardinger.

Foreningen Intact Denmark oplyser, at Shu-bi-dua blot er de første af en række danske musikere, der har sagt ja til at støtte op om kampen for et dansk forbud mod omskæring.

Shu-bi-dua. 'Den lille mands sang'
Vi må og skal gøre op med en skik
et af oldtidens regulativer
at skære et stykke af barnets pik
før man ved hvor lang den bliver
Eksperter hævder mod al sund fornuft
at længde er ej lig med lykke
vi siger til manden med saksen: forduft
vi behøver hvert eneste stykke
Og elskovsnatten kan blive til gru
hvis klokkerne slet ikke ringer
ofte man hører: er den inde nu,
eller bruger du stadig din finger?
Så op alle mand - så' det helt op at stå
kæmp for den hud I fortjener
lad kraverne dække de kongeblå
så bli'r de osse lidt pænere

(Microsoft translation, with help)
January 24, 2014

Shu-bi-dua donates song to preputial battle

The Danish Association of child circumcision, Intact Denmark, now gets help from one of Denmark's most beloved bands
by Rune Melchior Sjørvad

It has long been high on the wish list of Intact Denmark's spokeswoman to be allowed to use a very special Shu-bi-dua-song in the Association's campaign for a ban on the circumcision of healthy Danish boy children.

Now the dream has come true, and Shu-bi-dua has given 'the little man's song' to the Association, absolutely free.

National Anthem
For those who may not know the 17-year-old song, it can be reported that it very clearly calls for putting an end to circumcision of boys.

Among other things, it says in the song: 'we must and should do away with a practice - one of the ancient regulations - To cut a piece of child's dick'.

"It has long been a kind of 'national anthem' for the Association, so to get the opportunity to use the warm, humorous song in our campaigns is a dream come true," says Intact Denmark's spokeswoman Lena Nyhus to Ekstra Bladet.

She explains that Shu-bi-Dua's former guitarist and singer Michael Bundesen Michael Hardinger has said yes to that song being used as background music in the Association's upcoming video campaign, without Intact Denmark having to pay for it.

Grotesque act
About the gift of the song Michael Hardinger told the people's newspaper by email from his home in Las Vegas:

"A few years ago we recorded with my old band Shu-bi-dua ' the little man's song ', which was about circumcision. It might not be the most popular subject when one writes pop music, either back then or now. The others were very much against 'the little man's song', which actually started in my head know that I heard a stand-up [comedian] in the United States say: 'The Jews are the most optimistic people on Earth. They cut a piece of the penis before they know how long it actually will be.' But the ludicrous action required, in my brain at least that there was put spotlight on this abuse of children," says Michael Hardinger.

The Association Intact Denmark says Shu-bi-dua is just the first of a number of Danish musicians who have said yes to supporting the fight for a Danish ban on circumcision.

Shu-bi-dua. ' The little man's song '
We must do away with the practice
of ancient regulations
to cut a piece off a child's cock
before you know how long it'll be.
Against all sense, "experts" claim
that length does not equal joy.
We say to the man with scissors: Vanish!
We need every inch!
And a night of love can become gruesome
If the bells don't ring at all
You often hear: is it in yet,
or are you still using your finger?
So get up, guys, completely erect
and fight for the skin you deserve!
Let the hoods cover the royal blue
Then they look a bit nicer too.

LONDON: Gilgal Society head Vernon Quaintance pleads not guilty to crimes against boys

South London Today
January 24, 2014

Pensioner denies string of child sex accusations

A MEMBER of an ancient religious order denied a tring of child sex offences when he appeared in court on Tuesday.

Vernon Quaintance, 70, of Hetley Gardens, Upper Norwood, was a sacristan - responsible for the upkeep of a church building - in the Hospital of John & St Elizabeth in St John's Wood, north London, where the ancient Catholic religious Order of Malta conduct its Masses. The retired telephone engineer is also the founder of the controversial Gilgal Society, which is dedicated to promoting male circumcision.

He denied 10 charges relating to young boys between 1966 and 2011 when he appeared at Southwark Crown Court. Quaintance is accused of foul charge of indecency with children under 16 between 1966 and 1974.

He also faces one charge of sexually assaulting a young boy in 1974 and a further charge of indecent assault on another young boy in 1966.

The four remaining charges relate to indecent images of children ranging from level one to level five in severity discovered at his home in 2011.

Quaintance spoke only to confirm his name and plead not guilty to each charge.



Emeritus Professor Brian Morris's pro-circumcision website still has a list of of "Possible Circumcisers in Australia and New Zealand" carrying the Gilgal Society logo, even though Morris's own "Circumcision Foundation of Australia" publishes a nearly identical but updated list.

Earlier story

DARWIN: Three botched boys "not abused"

ABC News
January 22, 2014

Anger in NT community after circumcision rite ends with three boys airlifted to hospital

by Norman Hermant and Alison McClymont
There is still anger in a remote Northern Territory community after three teenage boys had to be medically evacuated following an Indigenous initiation ceremony which went horribly wrong.

The boys were part of a group of about 20 who were circumcised two days before Christmas near the small Gulf of Carpentaria town of Borroloola, 700 kilometres east of Darwin.

They were so badly cut during the procedure that they had to be taken to Darwin for urgent treatment.
Local ambulance driver William Miller arrived at the ceremony to find his 17-year-old grandson Bryce severely injured.

"I took one look at him and he was sitting in a pool of blood ... and that really hurt me, that did," he said.

"I wasn't happy at all, with the whole people who done the job."

Bryce Miller, who had to be airlifted to hospital, had pushed his grandfather to allow him to participate in the ceremony.

"When I got cut, and I seen the blood squirting through on the wrong side, it was bad. Squirting out bad ... heaps. And losing a lot of blood," he said.

The ABC understands instruments from the local health clinic were used in the ceremony and have regularly been supplied in the past, in line with Health Department guidelines.

Nurses and doctors from the clinic have also attended previous ceremonies, but were not present at last December's ritual.

Some of the clinic's health professionals have told the ABC they were appalled by the injuries they saw. But none is willing to speak publicly for fear of dismissal.

Investigators say injuries do not constitute child abuse
The Northern Territory Government says it is aware of the case, and so far its investigators have found the injuries do not constitute child abuse.

The NT Child Abuse Taskforce received two notifications about the incident, leading to an investigation by two police officers and the Department of Children and Families.

But their enquiries found that the children had not been harmed as defined by the Care and Protection of Children Act.
[Huh? Why not?]
The Department said it would continue to conduct enquiries into the wellbeing of the young men.
NT Attorney-General John Elferink said any suggestion of child abuse was taken very seriously.

"A more fulsome investigation was done in this instance because of the sensitivities involved," he said.

"No abuse was found to have occurred and in the absence of that and in the absence of criminality ... it's a parental decision on how to bring up the kids."

Mr Elferink says he has lived and worked in remote communities and understands how traditional practices occur.

But he believes there should always be checks for child abuse.

"There are number of cultures that operate in the NT and even more Australia-wide - Islamic cultures, Christian cultures, Aboriginal cultures, other religions and other cultural practices," he said.

"So long as those practices don't amount to child abuse, there is no role for the state. So long as those practices don't amount to criminality, there is no role of the state. It's called a free country."

Elders say ceremony a critical cultural step for young men
The circumcision ceremony dates back thousands of years and is common practice in traditional and remote communities across northern Australia.

Elders say the ceremony is a critical cultural step where boys become men.

The elders who supervised the circumcision said the injuries were likely caused by a visiting family member who is still learning the ritual.

"I think some place he make mistake, some place he don't, you know?" said traditional Garrawa elder Keith Rory.

Mr Rory said he had been conducting the ritual for 20 years.

"This ceremony is really strong. It goes back, way back to the old days when it first started," he said.
"People used different sort of stuff with young men ... these days we get it from the clinic but in those days they used stone and stuff they made it themselves.

"It is traditional stuff and it's sacred stuff."

Borroloola's former doctor, Dr Peter Fitzpatrick, says it is not the first time young men have needed medical care after initiation.

"They're doing lots of young men and it's a remote area and I've seen and evacuated young men myself," he said.

Dr Fitzpatrick, whose own sons have been initiated, says with any surgical procedure there are sometimes complications.

"These events occur in remote areas... they're not actually occurring within cooee of an A&E department, and people live in remote areas, that increases the risk," he said.

"The ceremony is very, very important to Indigenous communities.

"As long as there's some procedures and understanding and harm minimisation is there then its maybe at an acceptable level to the community."

Injured teenager has 'no regrets' over ritual
Bryce Miller has recovered from his injuries and says he has no regrets participating in this initiation into manhood.

His grandfather William, on the other hand, says no other family members will ever take part again.

Others in the community, including Garrawa man Gadrian Hoosen, say the ceremony will continue.

"[There's] no point talking about our ceremony because that's not going to stop us from carrying that culture," he said.

"We're going to carry it on."

FLORIDA: "Boys not cut at birth may be later, so taxpayer should foot bill"

the Wall Street Journal
January 20, 2014

Circumcision Coverage Comes Into Focus

Revised Study on Procedure's Benefits Spurs Some States to Reconsider Ending Routine Medicaid Funding for Newborns
by Arian Campo-Flores
Saleem Islam, a pediatric surgeon in Gainesville, Fla., was surprised a few years ago when he started receiving a steady stream of referrals for older boys from low-income families to be circumcised.

"When we ask the parents, 'Why did you not get it done when the child was a baby and when it would have been safer?' they say, 'We couldn't afford it,' " Dr. Islam said recently.
[In other words, these babies never needed it, the parental whim had just overflowed. It is not safer as a newborn.]

Like a dozen other states, Florida ended Medicaid coverage of routine circumcisions for newborns after the American Academy of Pediatrics issued a lukewarm statement on the practice in 1999. While the organization concluded that removing the penis's foreskin has potential benefits, it found the data were insufficient to recommend it as a routine procedure. [If the data are insufficient to recommend it, how can the price make it recommendable?]

So Florida lawmakers justified their decision in part as a way to save money on what the AAP had deemed an unnecessary procedure.

Now, a revised policy statement by the AAP that takes a more favorable stance toward circumcision, along with a series of academic studies examining the impact of reduced coverage of the procedure, has cast a new spotlight on the decision by Florida and other states not to cover it under Medicaid.

In 2012, the AAP concluded that the benefits of circumcision outweigh the risks and justify "access to this procedure for families who choose it." The organization stopped short of recommending routine circumcision, however.

Public funding of routine circumcisions for newborns has been hotly debated in recent years. Supporters of the practice say it helps prevent urinary tract infections in babies and sexually transmitted infections, including HIV, later in life. But groups opposed to circumcision say the procedure is medically unnecessary and an unnatural, antiquated practice. [Also harmful, risky and a human rights violation.] In the case of the older boys referred to Dr. Islam, complaints ranged from inflammation to difficulty with the foreskin.

Ending Medicaid coverage of routine circumcisions may have stuck the state with a bigger bill instead, according to a group of University of Florida Health researchers that includes Dr. Islam. Costs for circumcisions more than doubled in the five years after the 2003 policy change, the study asserts. That was largely because families were opting to have the procedure done when boys were older—a more costly operation that Medicaid still covers if it is deemed medically necessary.

The number of boys ages 1 to 5 who were circumcised each quarter during the study period reached almost 1,000 in the third quarter of 2008, compared with a little over 500 in the fourth quarter of 2003. In every quarter, those figures exceeded the number of circumcisions for newborns.
[But raw numbers explain nothing withut context: birthrate and neonatal circumcision rate. If the neonatal rate is 100% the number of older boys available for circumcision is 0, so the only way it can go us up, whether there is any medical need or not.]

That helps explain why Medicaid costs for circumcisions in Florida climbed to $33.6 million in 2008 from $14.9 million in 2004, according to the study. [But so does inflation.] While the procedure costs as little as $250 for newborns, it can run more than $6,000 for older boys because they require general anesthesia and sometimes an operating room. Older kids also face a higher risk of complications, doctors say. [This is not true.]

"Given the costs to the state, it would make sense for the state to reverse" its decision, Dr. Islam said.
The Florida Agency for Health Care Administration, which administers Medicaid, said in a statement that the study "contains interesting points for discussion, but does not appear to provide conclusive medical evidence to allow for coverage of elective circumcisions."

Using a different database, the agency provided data showing circumcision costs under the traditional "fee-for-service" system in Medicaid dropped to $1.2 million last year from $2.3 million in 2002. But those figures don't include other ways Medicaid money pays for the procedure, such as through managed-care plans, Dr. Islam said.
[And his study doesn't include other costs of circumcision, such as the cost of repairing botches.]

Of the 18 states that no longer cover routine circumcisions, 12 made the decision in the wake of the AAP's 1999 policy statement. When the AAP came out with its revised position in 2012, some states weighed changing their policies. Medicaid officials in Utah recommended restoring circumcision coverage in 2013, but the legislature hasn't acted. Another effort by Colorado lawmakers to reinstate such funding failed last year, though the issue is likely to come up again this year.

Studies show the prevalence of circumcision has declined as more states have stopped paying for it. A 2009 paper published in the American Journal of Public Health found that hospitals in states where Medicaid covered the procedure had circumcision rates 24 percentage points higher than those in states that didn't, leading to potential health disparities.

Overall, newborn circumcision rates in the U.S. have been falling, to 58.3% in 2010 from 64.9% in 1981, according to the Centers for Disease Control and Prevention.

In preparing its 2012 statement, the AAP's task force on circumcision considered the fallout from the 1999 declaration, said Douglas Diekema, one of the members. The previous task force "had not foreseen that their statement would lead to a decrease in insurance coverage," he said.
[Yes, and it's all about the money.]
 
Around the same time, a team of Johns Hopkins University researchers published a study estimating that a 20-year decline in U.S. circumcision rates had resulted in $2 billion in health care costs to treat sexually transmitted infections and other illnesses in uncircumcised men and their female partners.
Anti-circumcision groups questioned the legitimacy of the Johns Hopkins analysis. And they cited a published response to the AAP statement by a group of mostly European doctors who said it reflected "cultural bias" in favor of the procedure.
[Not just any "group of mostly European doctors" but the heads or spokespeople for most of the paediatric associations of Europe.]

Dr. Islam said his stance on circumcision is neutral. "But if a family wants it done and we're going to fund it," he said, "it makes sense to fund it at the right time."
[Those are two big ifs, and why should they be connected?]

Earlier story