Friday, January 14, 2000

The sharp debate on circumcision

The study sounded promising. It looked at several hundred thousand infants born in Washington State to see if those who were circumcised (about one-third) incurred any benefits or complications from the procedure. Here at last, I thought, was some data to answer the question that's been filling adoption e-mail lists for years: Is circumcision a benign and health-promoting procedure, or needless and potentially disastrous mutilation? It's a question that obsesses some folks to such a degree that it makes the debate over fur look like a cozy chat.

I'm not one of them. We didn't circumcise our son after we adopted him at age 2, but not for ideological reasons. Like most decisions in our house, it sort of made itself by virtue of our never deciding anything one way or another. I can't say I worry about it a lot--he seems pretty happy with his equipment the way it is, and frankly, if little boys check each other out and notice discrepancies, I don't want to know about it. But when the debates flare up on the lists, which they do with the approximate frequency of bogus virus alerts and get-rich-quick chain letters, I do wonder: Have we overlooked health issues? Have we made a political choice? Have we really thought about what's involved with cleaning this thing? Have we maybe been reading too much e-mail?

So the item in the January 11 Intelihealth newsletter got an immediate click on the link. "Study examines circumcision risk," it said. And why not? Enquiring minds want to know. The report, the result of ten years of research, came to this startling conclusion: Six of one, half dozen of the other. "Circumcising newborns causes virtually no medical harm, but offers practically no benefit, either." Well, thanks for that.

The researchers found a 1-in-476 chance of complications, which makes circumcision more than 20 times safer than LASIK eye surgery, another elective meddling-with-nature procedure that I really don't want to hear any details about. There did seem to be fewer urinary tract infections, but not enough to make up for the complications, although the complications were easily treatable, but so were the infections, and . . . oh, muddle, you parents all just go decide for yourselves.

This is what you've got to love about American medical research--countless hours and dollars spent in the tireless pursuit of conclusions that are completely meaningless. Which isn't to say the results won't be useful; both sides are sure to jump on them to confirm their pre-existing beliefs. Which means that the Circumcision Wars will continue unabated.

I'd tell them just to cut it out, but that might be seeming to take sides.

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