DALLAS: Ob/Gyns may now treat men - but could always cut boys

NY TImes
November 26, 2013

Gynecologists May Treat Men, Board Says in Switch

by Denise Grady
A professional group that certifies obstetrician-gynecologists reversed an earlier directive and said on Tuesday that its members were permitted to treat male patients for sexually transmitted infections and to screen men for anal cancer.

The statement from the American Board of Obstetrics and Gynecology eased restrictions announced in September, which said that gynecologists could lose their board certification if they treated men. Exceptions were made to allow certain procedures, ...

The ABOG website says: In addition, to remain certified by ABOG the care of male patients is prohibited except in the following circumstances: Active government service, Evaluation of fertility, Genetic counseling and testing of a couple, Evaluation and management of sexually transmitted infections, Administration of immunizations, Management of transgender conditions, Emergency, pandemic, humanitarian or disaster response care, Family planning services, not to include vasectomy, Newborn circumcision, and Completion of ACGME-accredited training and certification in other specialties (see below). [Which raises the question, if not vasectomy, which protects women against pregnancy, why newborn circumcision? It looks as though the answer is "because it is there".]

... but screening men who were at high risk for anal cancer was not permitted, so the September decision left some gynecologists struggling to find colleagues in other specialties to treat their male patients and to track those who were enrolled in studies.

Like cervical cancer, anal cancer is usually caused by the human papillomavirus, or HPV, which is sexually transmitted. This type of cancer is rare, but its incidence is increasing, especially among men and women infected with H.I.V.

Experts in anal cancer asked the board to reconsider its position, and some started letter-writing campaigns. Patient advocacy groups expressed worry that the prohibition would interfere with research and make it harder for male patients to find screening and treatment.

The board had said it wanted to protect the profession as a female specialty and limit the nongynecological work performed by its members. But Dr. Kenneth L. Noller, the board’s director of evaluation, said board members had reconsidered and realized that gynecologists had a long tradition of treating sexually transmitted infections in both men and women, and that HPV and problems related to the virus fell into that category.
...

LONDON: Newborns know they own their bodies

NPR
November 21, 2013

Babies Seem To Know Themselves Soon After Birth

by Thomas Andrew Gustafson
Understanding you exist as a person happens a lot sooner than you might think.

A study involving 40 cute, pudgy babies found that they were aware of their bodies — and even displayed a sense of ownership of them — less than two days after being born.

Both of those qualities are key ingredients in realizing your own existence, says the study's lead author, Maria Laura Filippetti, a doctoral candidate specializing in cognitive development at Birkbeck College, University of London.

"Body awareness refers to the feeling of being alive," she told Shots. "Body ownership refers to the feeling of having a body, the sense that this body belongs to me."

Past studies reveled how important these two aspects of human life were for infants, but this study was the first to discover it in newborns at birth.

How did the researchers figure it out? Filippetti and her colleagues tested the infants' ability to recognize themselves using a test similar to the old rubber hand illusion.

That test tricks the mind into thinking a fake rubber hand actually belongs to a person's body. Researchers lightly stroke a person's real hand with a paintbrush while it's hidden from his or her view. Simultaneously, the researchers stroke a rubber hand that's in plain sight. Stroking the two at the same time and in the same places means the person feels the paintbrush while seeing the action elsewhere.

Normally, a person's brain associates the feeling of one's hand with the sight of the hand. But the brain can be confused by a trick like this and start to think the rubber hand is the one it should pay attention to.

For the infants, the test was very similar. Again, a paintbrush was used, but this time the researchers stroked the babies' cheeks as they watched a video of the same thing happening to another baby.

The researchers tested how the babies behaved when the paintbrush was touched at different times and at the same time on their faces. Since babies can't talk, their researchers gauged the babies' reactions by measuring how long they looked at the baby in the video, Filippetti says.

"A longer looking time for a stimulus compared to another one is a measure of discrimination and preference for that stimulus," she tells Shots.

The newborns did watch the other baby in the video longer when the paintbrush strokes on both happened simultaneously, rather than at different times, or not at all. That response to simultaneous stimulation shows a sense of body awareness and ownership, the researchers say. Here's a of how the test went.

The researcher also performed a second experiment with a twist: They showed the babies the same video turned upside down. The babies tested didn't respond to the simultaneous paintbrush strokes.
...

PROVIDENCE, RHODE ISLAND: Intacitivist touring protest hits town

The Phoenix
November 20, 2013

'Intactivists' take to the streets in Providence

by Steve Ahlquist

A COLORFUL PROTEST Brother K

“The destruction to the male genitals is absolute,” says Brother K. “Total. You’re left with a fraction of what God and nature intended. It’s appalling.”

It’s Sunday morning on Hope Street in Providence and cars are whizzing by. Some honk their horns in solidarity; others carry passengers clearly confused as to the necessity of a demonstration against circumcision featuring men in white jumpsuits with large red bloodstains on their crotches

...

Rest of story. Has this link failed?

SUSSEX, ENGLAND: Circumcision-botch doctor turns amateur

BBC News
November 17, 2013

Circumcision doctor in GMC investigation to quit NHS

by Nicola Dowling
A doctor under investigation by the General Medical Council after circumcising a child says he is resigning from the NHS.

Dr Muhamad Siddiqui, a hospital surgeon, had conditions imposed on his GMC registration after a complaint by the parents of the toddler.

The doctor, who carried out the procedure at the child's home, denies all the allegations.
Dr Siddiqui operated his own mobile circumcision service outside the NHS.

The GMC investigation was launched after a complaint by Kelly Braiha and her husband Ghali, from Littlehampton in West Sussex.

They claim their 23-month-old son Najem was left traumatised and suffered an infection because Dr Siddiqui, who works at University Hospital Southampton NHS Foundation Trust, did not take hygienic precautions.

Mrs Braiha says she believes home circumcisions should now be banned.

Dr Siddiqui is also accused of failing to obtain indemnity insurance for his private work and of carrying out regulated procedures without the necessary Care Quality Commission registration.
He denies all the allegations against him.

After an initial investigation by the GMC, the case has been referred to a fitness-to-practise hearing.
In the meantime, the GMC issued an interim order banning Dr Siddiqui from carrying out circumcisions anywhere other than in a hospital or clinical setting.

Regulatory loopholes
But when researchers from the BBC Radio 5live Investigates programme contacted him this week, days after the interim order came into force, he said he would be happy to carry out a circumcision at a private address in Southampton.

After the arrangements for the procedure were agreed, the programme contacted Dr Siddiqui again and told him the call had been made by a researcher posing as the father of a boy he wanted circumcised.

Dr Siddiqui said he wanted to continue performing home circumcisions but he was in the process of resigning from his NHS job and surrendering his GMC registration.

This would mean he would not be able to practise as a doctor but because of regulatory loopholes he would be able to carry on performing circumcisions privately.

[In fact anyone at all, with no qualificaitons whatsoever, may genitally cut a boy.]

Asked why he had agreed to carry out a home circumcision when there was a GMC order preventing him from doing so, he said he would not have carried out the procedure until his resignation had been formalised.

Dr Siddiqui said: 'I don't agree with the limitations the GMC has imposed on me. I don't want to be at odds with the GMC."

Healthcare workers have to be registered with the CQC if they want to perform home circumcisions but Dr Siddiqui felt he did not have to be.

Those who have no formal medical training, however, are not required to be registered with any of the regulators.

5live Investigates has also spoken to consultants who have told the programme they are concerned about the number of children they are seeing with medical complications after some home circumcisions.

They are now calling for tighter controls.

'Children have died'
Consultant surgeon Feilim Murphy, secretary of the British Association of Paediatric Urologists, said: "The biggest issue is there are a number of children who are circumcised by people who are not experienced and don't understand what is required, and there can be significant complications with that."

He said this could include bleeding, which is particularly dangerous for babies, pain, damage to the penis and loss of the top of the penis.

[Circumcision always causes damage to the penis....]

He added: "Unfortunately children have died in the last number of years in Britain and Ireland from circumcision-related complications.

"It does make sense that everybody should register, that everybody should be on the same playing field.

"It makes sense for the child it makes sense for the family it makes sense for everyone."

[What would make sense for the child is not being genitally cut before they could give informed consent.]

FRANKFORT, KENTUCKY: Doctor failed to check under foreskin for cancer, gets off

Fox17
November 15, 2013

Ky. high court turns away penis amputation lawsuit

FRANKFORT, Ky. (AP) -- A Kentucky man who sought damages from a doctor who removed a cancer-riddled section of his penis during what was scheduled to be a simple circumcision has lost his final appeal.

The Kentucky Supreme Court opted not to take up the case of Phillip Seaton of Waddy. The court did not comment on its reasons for turning down the case.
 
Seaton sued Dr. John Patterson over the amputation.

A jury in Shelby County ruled in favor of Patterson at trial. The Kentucky Court of Appeals upheld that decision, finding that the jury correctly concluded that Seaton consented to allow Patterson to perform any procedure deemed necessary during the Oct. 19, 2007, surgery.

The Seatons also sued Jewish Hospital, where the surgery took place. The hospital settled with the couple for an undisclosed amount.

Earlier story

EMIRATES: Another botched circumcision

Emirates24|7
November 14, 2013

18-day-old baby's organ partially cut off during circumcision

An Arab doctor accidentally cut off the top of the genital organ of an 18-day-old Saudi boy during circumcision, prompting the hospital to call a well known pediatric surgeon for an urgent operation, a newspaper in the Gulf Kingdom reported on Thursday.

The doctor tried to correct his mistake by stitching the severed part but the bleeding did not stop and the boy could not stop screaming of pain, Sabq said.

“The hospital then called a pediatric surgeon from King Abdul Aziz Hospital for an urgent surgery…the doctor managed to stop the bleeding and restore the severed part,” the paper said in a report from the western Saudi town of Taif.

FLORIDA: Fewer babies cut, hence more older boys

There are lies, damned lies, and statistics.


Health News Digest
November 13, 2013

Circumcisions in Older Boys and Related Costs Skyrocket in Florida

(HealthNewsDigest.com) - GAINESVILLE, Fla. - Circumcisions in Florida boys over the age of 1 have increased dramatically in recent years, doubling costs to the state, a study by University of Florida Health surgical researchers shows.

Saleem Islam, M.D., an associate professor in the College of Medicine department of surgery's division of pediatric surgery, said he and his study collaborators believe the state's decision to terminate Medicaid funding for routine circumcisions in babies under 1 month old has led to the increase in circumcisions for older boys. The study was published in the September issue of the journal The American Surgeon.
[Is anyone surprised? More intact babies means more boys available to be circumcised later. It would be surprising if a fall in newborn circumcisions did NOT lead to a rise in later circumcisions.]

Islam said families should decide for themselves whether to have their sons circumcised, but emphasized that circumcision in the newborn period is preferable for several important reasons.
[NOT circumcising at all is preferable to either early or late - especially to the penis's owner - for several important reasons.]
"The benefits are that the child does not have to undergo general anesthesia, there is much less cost to public monies, it's safer for the kids to get it done [Ther is no evidence for this] and that's the right age, as well," he said.
[Not circumcising has all those benefits and more. And what does "the right age" mean?]
 
Because newborns require only local anesthesia for a circumcision, newborn circumcisions are safer and much less expensive. They also have a lower risk of complications. Circumcising older boys requires general anesthesia to ensure the patient remains still during the procedure. [Yes, a baby can simply be strapped down.]

Florida was one of numerous states to stop Medicaid coverage for routine newborn circumcisions after a 1999 report from the American Academy of Pediatrics said the procedure may not be medically necessary.
[May not be? 2,000,000,000 happily intact males in the world prove it IS not medically necessary.]

Islam explained that circumcisions can increase hygiene in the penis, and some uncircumcised males suffer from recurrent urinary tract or penile infections. Some parents will choose circumcision because of these potential problems or for religious or cultural reasons. Islam said he does not take a firm stance either for or against circumcision, but prefers for parents to decide.

The state cut off Medicaid coverage for the procedure in 2001. Many insurance companies also stopped paying for newborn circumcisions after the report. Funding remains available for circumcisions in older males when the procedure is deemed medically necessary, such as when repeated infections occur.

In 2012, the American Academy of Pediatrics reversed its stance on routine newborn circumcisions, citing research indicating they may help protect against HIV and provide other benefits. [They did not reverse their stance, nor recommend it, they just shifted their collective bottom on the fence.]

UF Health researchers' study of data from 2003 to 2008 shows publicly funded circumcisions increased at a rate more than six times greater than the increase in privately funded circumcisions. They also cost approximately $111.8 million over the five-year time period, an amount estimated by medical facility charges during the study period. Fees for health care providers were excluded from the study, meaning the actual amount paid for the procedures was probably greater. The study results also showed that circumcisions in boys over age 1 were more common each year than those performed on newborns.
[What's missing here is, what proportions of babies and older boys were circumcised before and after funding was ended? When funding is ended and fewer boys are circumcised, the vast majority never need to be circumcised, saving public funding. (Even fewer are ever circumcised where circumcision has not been customary for more than a generation, doctors or their partners have foreskin asn the know its value, they are taught more about the foreskin than how to cut it off, and their anatomy texts actually show the foreskin.)]

By 2008, yearly Medicaid costs for circumcision in boys through age 17 reached $33.6 million, compared with $14.9 million in 2003. Meanwhile, private charges for circumcisions in Florida rose from $9.3 million to $14.1 million. Circumcisions in 2008 accounted for 30 percent of the estimated total costs for the procedure during the five-year window.

Islam said the increase in circumcisions among older boys likely stemmed from parents, supported by referring physicians, who had hygiene or medical concerns, but were unable or unwilling to pay for the procedure during the newborn period. UF Health pediatric surgeons noted they had talked with some of their own patients' parents about the decision to have an older boy circumcised and found that many parents would have opted for newborn circumcision if public funding were available.
[So what? Doubtless many parents whose son's DIDN'T have issues would have opted to cut them if the taxpayer paid for it.]

The American Academy of Pediatrics' new stance on the issue may lead states and insurance companies to restore funding for the procedure in newborns, a change Islam would welcome.

"It would make a lot of sense to offer it (newborn circumcision) to families who otherwise perhaps may not be able to afford it," he said, "and then say, ‘Here, we are offering it to you when your child is a newborn. You have a choice to make here. If you choose to get it done now, there are a lot of benefits over having it done later.'"
[And he says he's not pro-circumcision....]