This is more than a three months old. I never posted it because I wasn’t quite happy with it. It’s not current, but as long as Schoen is promoting circumcision or being listened to by parents, doctors, and educators, it’s relevant to publish.
Dr. Edgar Schoen wrote an essay on the end of the ballot initiative in San Francisco that would’ve extended equal protection to male minors against non-therapeutic genital cutting. Schoen, being the advocate that he is, again deals in misdirections and half-truth omissions to sell his unethical view. From the beginning, he refuses to play fair.
Fittingly, Judge Loretta Giorgi ordered the removal of the proposed San Francisco initiative to criminalize infant circumcision from the ballot. However, supporters of the measure continue to voice their undocumented and erroneous claims that circumcision has harmful emotional effects and no medical benefits.
That’s an interesting way to phrase opposition. I have no doubt he’s aware of individuals who state that circumcision has harmful physical effects in spite of the potential medical benefits. His equation is only the side he wants. If it doesn’t help his case, he ignores it and pretends that it’s a lie sold by people who don’t care about the health of children, which can only be achieved through circumcision. Somehow. He’s nothing but a propagandist.
These â€œintactivistsâ€ ignore the overwhelming evidence and the multiple health benefits of circumcision from infancy through old age, including a 60% protection against the heterosexual transmission of HIV/AIDS.
“Overwhelming”, being an adjective, is subjective. Declaring the potential benefits from non-therapeutic circumcision to a healthy child to be “overwhelming” is to ignore evidence in the way he mistakenly accuses others of ignoring evidence. That 60% protection against female-to-male HIV transmission also contains the caveat of high-risk population (i.e. sub-Saharan Africa rather than the United States). That 60% figure is relative risk reduction to normal genitalia (among adult volunteers in a high-risk population), not absolute risk. The absolute lifetime risk of female-to-male HIV transmission to American males is in the low single-digits, regardless of circumcision status. He’s playing loose with the facts because dealing with them honestly demonstrates how absurd it is to declare the potential benefits “overwhelming”.
Schoen continues this pattern with his standard talking points on the potential benefits, except he omits the potential aspect. Rebuking every claim he makes would be tedious rather than productive. Antibiotics, condoms, etc. His bias is decipherable (and embarrassing) once you see his only trick. Instead, it makes more sense to address his ethical and logical lapses.
The neonatal period is ideal for performing the procedure, as circumcision is quicker, less traumatic and has fewer complications than when performed on older patients. Newborns are very resilient and uniquely equipped to deal with stress, having high levels of stress hormones as well as pain-relieving hormones. The thin foreskin means that sutures are not usually needed like in older patients, and local anesthesia is effective at numbing the area to further minimize pain.
“Ideal” conditions for non-therapeutic surgery do not overcome the ethical violation inherent in imposing that non-therapeutic surgery on a non-consenting individual. He ignores the patient’s preference, the physical harm to each recipient, the implications of the complications that do occur to healthy children, and the physical differences between neonatal and adult circumcision. His approach implies that there are no trade-offs, that the potential benefits of non-therapeutic child circumcision are a surgical “free lunch”. He never acknowledges that the foreskin offers benefits, too. (He relies on the silly notion that the foreskin is an accidental leftover from evolution.) Dr. Schoen is either ignorant or dishonest.
Opponents of circumcision have no problem making up unintended side affects that can result from this safe and accepted procedure. …
This is ad hominem. For someone who cites women’s sexual preference for a circumcised penis as a benefit to neonatal circumcision, he should tread carefully with his ridiculous accusations. Either call out examples of lies, or don’t write the charge.
Defending circumcision as “accepted” is a logical fallacy. A popular position can be wrong. The principle matters, not the irrelevant opinion of everyone other than the male upon whom this violation is imposed.
The crux of his failure to address all aspects of this debate is this:
As study after study shows the benefit of circumcision throughout the male life span, one has to wonder what motivates supporters of this extreme initiative. No one is forcing them to circumcise their child, yet they will continue to take that choice away from other parents regardless of the available medical evidence.
“Throughout the male life span” includes the majority of his life when the male is an independent individual with the power to consent or refuse. Circumcising a healthy infant creates a circumcised adult, eventually. That is the ethical issue he fails to address. Yet, he only offers the irrelevant “no one is forcing them to circumcise their child” trope. True, but the actual issue is that someone is forcing another person to be circumcised forever, regardless of whether he wants to be or not, and in direct contradiction to his obvious, objective lack of any need for the intervention. That is unethical. Non-therapeutic genital cutting on a non-consenting individual is wrong.
5 thoughts on “Flawed Circumcision Defense: Dr. Edgar Schoen”
[Editor note: I’m leaving this as is, but I don’t think discussion of Schoen’s Judaism is necessary here. He gives ample evidence that his scientific focus is flawed. We can critique that more effectively, since it’s fact-based and easily rebutted.]
It needs to be pointed out that as a doctor who performs (or performed) circumcision for a living, and a Jew, Schoen has glaringly obvious conflicts of interests.
In the words of Upton Sinclair: “It is difficult to get a man to understand something when his job depends on not understanding it.”
Schoen says: “…supporters of the measure continue to voice their undocumented and erroneous claims that circumcision has harmful emotional effects and no medical benefits.”
Calling a dog’s tail a leg doesn’t make it one. The harmful and emotional side effects are actually rather well documented; he is simply refusing to acknowledge their existence because it is devastating to his cause. As a circumcising doctor and a Jew, Schoen cannot acknowledge work that forces him to question the propriety of a procedure that is important to him financially, as well as culturally and spiritually. Additionally, intactivists acknowledge that circumcision *might* have benefit; the problem is circumcision isn’t a requirement to achieve these same benefits.
Schoen says: “These â€œintactivistsâ€ ignore the overwhelming evidence and the multiple health benefits of circumcision from infancy through old age, including a 60% protection against the heterosexual transmission of HIV/AIDS.”
“Overwhelming,” sure, if you choose to ignore all the evidence against you. The “studies” from which this 60% figure is derived are actually rather flawed. This number itself is a relevant figure that applies only to a tiny subgroup of men who acquired HIV. When the thousands of other men are taken into account, the 60% figure shrinks down to 1.31%, and it isn’t so impressive anymore. But assuming that the 60% figure was true, Schoen seems to be reluctant to admit that this “benefit” is better afforded by condoms which protect over 95% of the time.
Schoen says: “The neonatal period is ideal for performing the procedure, as circumcision is quicker, less traumatic and has fewer complications than when performed on older patients.”
This he says without citing any study whatsoever. A pattern intactivists ought to take note of concerning circumcision advocates is their blindness to their own projection. Note earlier in Schoen’s essay he accuses us of “undocumented and erroneous claims,” but then proceeds to engage in this very act himself. From where does he get that there are “fewer complications than when performed on older patients?”
Beyond the “ideal period,” how about addressing medical necessity of a procedure on healthy, non-consenting individuals? And how about actually talking about the actual risks that attend specifically infant circumcision? Like hemorrhaging, infection, partial or full ablation (there have been a few law suits against both doctors and mohels in the recent years), and even death? (RIP, Amitai Moshe, Connor James, Joshua Haskins and others…)
Schoen continues: “Newborns are very resilient and uniquely equipped to deal with stress, having high levels of stress hormones as well as pain-relieving hormones.”
Right, but why should they have to deal with stress and high levels of stress hormones and pain-relieving hormones in the first place? The question remains; is this procedure absolutely necessary? Can the “benefits” not be achieved by other means?
“The thin foreskin means that sutures are not usually needed like in older patients…”
But this doesn’t mean that the procedure is still risk free; in at least two deaths this year, babies bled to death. In Josh Haskin’s case, doctors didn’t catch the nicked vein from which he was bleeding until 6 hours later, when they decided he needed a suture, by when it was too late.
“…and local anesthesia is effective at numbing the area to further minimize pain.”
When and if it is used. According to CNN:
“Up to 96 percent of the babies in the United States and Canada receive no anesthesia when they are circumcised, according to a report from the University of Alberta in Edmonton.
Continues Schoen: “Opponents of circumcision have no problem making up unintended side affects that can result from this safe and accepted procedure.”
First of all, the accusation of “making up” side effects. Tell that to the parents whose children died due to circumcision, and the children who have to live with deformed penises for the rest of their lives.
And “accepted.” “Accepted” by whom? Why is it no medical organization in the world recommends the circumcision of infants?
The blogger makes an excellent point:
“Defending circumcision as â€œacceptedâ€ is a logical fallacy. A popular position can be wrong.”
Exactly. Let us remember that female circumcision was also “accepted” in this country for a time. Blue Shield paid for it, and actually, female circumcision did not become illegal until 1996.
“As study after study shows the benefit of circumcision throughout the male life span, one has to wonder what motivates supporters of this extreme initiative.”
Spoken like the true propagandist that he is.
Of course, “study after study” also shows that circumcision doesn’t provide any said “benefits,” and worse, that it may actually be detrimental to a man’s sexuality. But let’s not pay attention to those.
For his own convenience, he ignores the ethic of cutting off part of a healthy, non-consenting individual’s penis. And then he wonders “what motives we have.”
It’s called basic human rights.
Additionally, he seems to have trouble with the idea that the “benefits” that circumcision is supposed to afford can already be achieved by non-invasive means. Let’s not talk about those either.
“No one is forcing them to circumcise their child, yet they will continue to take that choice away from other parents regardless of the available medical evidence.”
It is mistaken, the belief that abuse and the violation of basic human rights can be legitimized by citing “medical evidence.”
Would there ever be enough “studies” and “medical evidence” to legitimize female genital mutilation? Because for better or worse, laws that ban this practice takes away this “choice” from parents.
Let it be clear; “religious freedom” and “parental choice” have lost their validity as alibis for male infant genital mutilation. Hence the “study after study” written by the self-same circumcision propagandists, hence the litany of “benefits” a child doesn’t need from circumcision.
Schoen doesn’t admit the risks and harms of circumcision, nor the fact that it is not needed to achieve “benefits” that can be achieved by other means, and he never will.
To admit them would put him in the awkward position of questioning the propriety of a procedure he and his colleagues reap profit from, and of the most important blood ritual in his Jewish faith.
In reply to the editor:
I think that whenever we’re discussing circumcision “experts,” it is important that we bring attention to any conflict of interest s/he may have.
Flawed science should be critiqued, I agree, but I also think it is important to point out when an avid purporter of circumcision also happens to belong to a community, culture or ethnic group where circumcision is a norm, if not a cultural or social requirement.
I think people should know whenever a circumcision advocate is interested in more than just public health.
Whenever we critique the Pope’s stance on condoms, I think it’s ignoring the elephant in the room to fail to point out that he is, well, the Pope.
I’d like to see intactivist bloggers criticize potential conflicts of interests in further blog posts.
Thank you for allowing my comment, for lack of a better word, uncut.
I don’t think your comment was problematic. I worried about it briefly, but as I read it, I understood where you’re coming from.
My concern is primarily in the p.r. aspect. A small population of opponents – Jewish and not – like to toss around false accusations of anti-semitism with regular abandon. It’s wrong, and we can counter it when it happens. But I don’t like give something they can perceive as ammunition.
My only reservation is that membership in a group does not guarantee or imply universal adherence. As i wrote in my latest entry, I’m a vegan. I have never protested for animal “rights” or agitated for anyone to give up meat. Yet, I’m lumped in with “the vegans” who firebomb animal testing clinics in the minds of many. That’s unfair.
Granted, I think Schoen’s Judaism likely influenced/influences him. Maybe it was just at the beginning of his career. And we can’t hide from it, or shy away from any discussion just because religion is involved. But it’s not enough. I’m not aware that it’s something we can prove from his writing. (I’d have to re-read his awful book.) Mere vigorous irrational advocacy is not enough. I don’t think his writing is enough, since he relies on his implied authority as an MD. That alone is a lot of the critique.
Basically, addressing that Schoen is Jewish is fine if there’s a point to be made. Without some specific “I’m an MD, but God says to do it, so it’s ‘good'”, it’s similar to the Pope’s opposition to condoms, but too dissimilar to rely on. The pope is directly anti-science because of his beliefs. Circumcision fits within science, even if Schoen’s “all the healthy infant males” position omits all consideration of ethics and the portion of the science addressing the normal, healthy human body.
“My concern is primarily in the p.r. aspect. A small population of opponents â€“ Jewish and not â€“ like to toss around false accusations of antisemitism with regular abandon. Itâ€™s wrong, and we can counter it when it happens. But I donâ€™t like give something they can perceive as ammunition.”
I’m afraid it is this fear of being labeled an anti-Semite that puts a lid on the discourse surrounding circumcision. I’m of the opinion that this proverbial pussy-footing has gone on long enough. It may take surgical-strike argument techniques, but I think it’s about time we stopped walking around egg-shells and face our fears head-on.
“My only reservation is that membership in a group does not guarantee or imply universal adherence.”
You make a very good point, except that with Judaism, historical authorities attest to the fact that circumcision is near-universal among Jews. There are some Jews who have chosen to abandon circumcision, but these are few and far between.
In the case of Judaism, circumcision happens to be a cherished ritual that, if historical sources are correct, they have been fighting to preserve since Greco-Roman rule. At this very moment, Jews celebrate Chanukah, which celebrates the Maccabees winning their freedom to practice Judaism, particularly the circumcision of infants. Jews often boast circumcising their infants in defiance of government bans in the countries where they lived. Tales abound of Jews circumcising their children despite bans in Russia, and in the face of Nazi Germans. Many Jewish authorities, including at least one intactivist, Leonard Glick, attest to the fact that circumcision is practiced even among the most liberal of Jews. It is often seen as the final bastion of their Jewish identity, and many who say they do not practice Judaism, still feel an obligation to circumcise their children. Some rabbis bless infant circumcision as “having the weight of all 613 mitzvot.” (So why even bother with the rest of the 612?)
For further reading on the history of circumcision throughout the centuries, I recommend “Marked in Your Flesh” by anthropologist Leonard Glick. As a Jewish man himself, he is a well-versed authority.
“As i wrote in my latest entry, Iâ€™m a vegan. I have never protested for animal â€œrightsâ€ or agitated for anyone to give up meat. Yet, Iâ€™m lumped in with â€œthe vegansâ€ who firebomb animal testing clinics in the minds of many. Thatâ€™s unfair.”
There’s a slight difference however; being vegan isn’t really a divine commandment in any sort of religion, is it. Well, there’s Hinduism, but there’s a clear difference in practicing being a vegan or vegetarian because one adheres to Hinduism, and one who practices being a vegan or vegetarian because this is what they want to do, and it has nothing to do with religion. But if a Hindu told you that s/he practices being a vegetarian, and s/he encourages others to forgo eating meat, and even writes papers and studies on the subject, but it has absolutely nothing to do with his/her faith, what would you think? Would you really expect a scholar to ignore the fact that such a person promotes a lifestyle that happens to coincide with his/her faith?
“Granted, I think Schoenâ€™s Judaism likely influenced/influences him. Maybe it was just at the beginning of his career. And we canâ€™t hide from it, or shy away from any discussion just because religion is involved.”
“But itâ€™s not enough. Iâ€™m not aware that itâ€™s something we can prove from his writing. (Iâ€™d have to re-read his awful book.) Mere vigorous irrational advocacy is not enough. I donâ€™t think his writing is enough, since he relies on his implied authority as an MD. That alone is a lot of the critique.”
You seriously don’t think it’s enough that Schoen happens to adhere to a faith where circumcision is seen as a divine commandment from god, as a “covenant” around which the whole of Judaism, and even Christianity is centered around? Sorry, but I do.
“Basically, addressing that Schoen is Jewish is fine if thereâ€™s a point to be made.”
Addressing that Schoen is Jewish is imperative, as it points to a conflict of interest, where he is attempting to justify circumcision through medicine and sound logic, and he has convictions to a religion, culture, ethnic-group etc. where circumcision is seen as a divine commandment and a covenant with god and Judaism, and its propriety is never to be questioned.
“Without some specific â€œIâ€™m an MD, but God says to do it, so itâ€™s â€˜goodâ€™â€, itâ€™s similar to the Popeâ€™s opposition to condoms, but too dissimilar to rely on.”
No, I’d say it’s essentially the same. Except, as an MD who is trying to defend circumcision using science and logic, I expect him to deny his faith has anything to do with it.
“The pope is directly anti-science because of his beliefs. Circumcision fits within science, even if Schoenâ€™s â€œall the healthy infant malesâ€ position omits all consideration of ethics and the portion of the science addressing the normal, healthy human body.”
Circumcision may “fit within science,” but it also happens to be a religious practice, particularly in Judaism, where it is seen as a divine commandment and an unbreakable covenant between Jews and god. Schoen may defend and promote circumcision from a position of science, medicine and logic, but his faith presents a clear conflict of interest, and this is something that he is obliged to, but fails to declare.
A person’s religion, country of origin, culture, ethnic-group etc. may influence his/her “research,” and/or the “research” s/he may present in favor of his/her position, or may not, but this is why it’s called a conflict of interest.
Pointing out Schoen’s faith may seem like a shameless act of ad hominem, but there is a difference in a personal attack, and pointing out a conflict of interest.
The following is found on Wikipedia, in the article on ad hominem:
“Conflict of Interest: Where a source seeks to convince by a claim of authority or by personal observation, identification of conflicts of interest are not ad hominem â€“ it is generally well accepted that an “authority” needs to be objective and impartial, and that an audience can only evaluate information from a source if they know about conflicts of interest that may affect the objectivity of the source. Identification of a conflict of interest is appropriate, and concealment of a conflict of interest is a problem.”
The difference between Schoen and the Pope is that while Schoen can hide behind a veil of science and medicine, the Pope cannot deny the fact that he is the Pope.
Just ran across this, and I thought it might be relevant to the discussion: