Foreskins vs. Lab Rats

You never know where you will encounter an ethical dilemma.  This article discusses how scientists are making significant progress toward phasing out animal experimentation by using cells from neonatal (human)  foreskins instead of animals in their research.   In many, if not most respects, this capability represents a tremendous leap forward.  Experimentation on animals results in the gruesome mistreatment and death of millions of animals annually (rats and mice are not even covered by the inadequate protections afforded other animals under the Animal Welfare Act) (see also here).

However, routine circumcision of infants is itself a highly problematic endeavor.  Consequently, substituting the one for the other is less a solution than a step along what one hopes will be a path toward a scientific method that does not rely on the suffering of any being at all.

David Cassuto

8 Responses

  1. The latest very large scale study with regard to circumcision indicates that the procedure significantly reduces the risk of incurring sexually transmitted diseases other than syphilis. Assuming the validity of this and similar studies, the cost-benefit ratio seems to favor circumcising infants.

    Any valid advance in medical or scientific experimentation that does not require live animals is very good news.

  2. Using purloined foreskin from the normal, intact bodies of non-consenting minors is a human rights violation. While we are protecting animals, why aren’t we protecting the right of babies to genital integrity and the right to their own body?

  3. “Using purloined foreskin from the normal, intact bodies of non-consenting minors is a human rights violation. While we are protecting animals, why aren’t we protecting the right of babies to genital integrity and the right to their own body?”

    *****

    “Purloined?” Your use of the word is divorced from both law and logic. Would you take away a parent’s right to make decisions about a baby’s/child’s health where permission for surgery is sought?

    Circumcision is mandated for members of the Jewish faith. Would you term that exercise of the parents’ First Amendment right as larceny?

  4. From The New York Times:

    March 27, 2009
    Circumcision Is Found to Curb Two S.T.D.’s
    By NICHOLAS BAKALAR

    Male circumcision, already shown to reduce the incidence of H.I.V. infection in men, also reduces transmission of both herpes simplex virus Type 2 and human papilloma virus, a study has found.

    According to the Centers for Disease Control and Prevention, at least 45 million people in the United States ages 12 and older have had herpes, or H.S.V.-2, the incurable infection that can cause recurrent painful genital lesions. About 20 million are currently infected with human papilloma virus, or H.P.V., which causes various genital cancers, including most cervical cancers. There is no treatment or cure for H.P.V., but there is a vaccine now licensed only for girls and women.

    The study, a randomized clinical trial published Thursday in The New England Journal of Medicine, assigned more than 3,000 uncircumcised Ugandan men who were not infected with H.S.V.-2 to undergo immediate circumcision or to be circumcised 24 months from the start of the investigation. A subgroup was similarly evaluated for H.P.V. infection.

    At 24 months, 114 men of the men initially circumcised and 153 of the noncircumcised tested positive for H.S.V.-2. After controlling for various health and behavioral factors, the researchers estimated that circumcised men had a 25 percent reduced risk of infection. The results do not apply to their partners.

    For the types of H.P.V. that cause genital cancer, the results were even more striking. About 18 percent of circumcised men were infected at the end of two years, compared with almost 28 percent in the control group. Even after adjustment for types of sexual practices, symptoms of sexually transmitted infections and other variables, the circumcised men had a 35 percent reduced risk of infection.

    The mechanism for the effect is unclear, but the authors suggest that the retraction of the foreskin during intercourse exposes the penis to infection, and that the moist area under the foreskin may then provide a protected environment in which the viruses can flourish.

    Asked about the applicability of the African results to men in the United States, the study’s senior author, Dr. Ronald H. Gray, a professor of reproductive epidemiology at Johns Hopkins, said, “There is no reason to believe that this is in any way unique to Africa.”

    The study confirms the results of two previous trials in South Africa, and Dr. Gray believes that taken together the studies have significant implications for public health.

    “The findings suggest that there are important lifetime health benefits to the procedure,” he said. “I think it’s important that pediatricians consider the lifelong benefits that might accrue from circumcision when they are advising parents on whether the procedure should be performed in baby boys.”

    Other experts agreed. Robert C. Bailey, a professor of epidemiology at the University of Illinois, Chicago, who has published widely on the subject, said the American Academy of Pediatrics and other professional associations “are not taking the lead in providing clinicians, nurses and midwives — the people who assist parents in making decisions,” with the information they need. “And so parents are not being fully informed,” he added.

    An editorial published with the study said that rates of circumcision in the United States were declining, and that they were lowest among black and Hispanic patients, groups with disproportionately high rates of H.I.V., herpes infection and cervical cancer. There are 16 states in which Medicaid does not pay for routine circumcision, and this may exacerbate the problem among the poor, the editorial said.

    The authors acknowledge that both intervention and control subjects were self-selected, and that compliant subjects might be at lower risk for infection to begin with. That could result in an underestimation of the effect. Since the men were evaluated only at 24 months, it also is difficult to determine whether the lower rate of infection was because of a reduced rate of acquisition or an increased rate of infection clearance.

    Still, considering the results of their own and previous studies, the researchers conclude that circumcision should now be accepted as an effective intervention for H.S.V.-2 and H.P.V. prevention, even though they emphasize that the procedure is only partly effective and that the promotion of safe sex is still essential.

    This article has been revised to reflect the following correction:

    Correction: March 28, 2009
    An article on Friday about a study that found that circumcision reduces transmission of two sexually transmitted diseases described incorrectly the way in which one of the diseases manifests itself in the body. Infection with H.S.V.-2 can cause genital lesions, not genital warts.

  5. All sexually transmitted diseases can be prevented through “safe sex.” The purported advantages of circumcision are slim and, over time, disappear if individuals engage in risky sexual practices.

    Medical circumcision, removing a healthy body part from a non-consenting infant violates all accepted principles of bioethics. Yes, parents have the right to consent to medical treatment on behalf of their children. The operative word here is “treatment.” Routine infant circumcision is not medical treatment, because the child is not sick. Proxy consent is limited to cases where the life or health of the child is threatened (or where herd immunity, as in the case of infectious airborne diseases, is desirable). The foreskin — a normal body part that all children, male and female, are born with, is not a birth defect, nor a disease, nor a life-threatening condition. Removal of the foreskin of a newborn child in the hospital, usually by the mother’s obstetrician, is a cultural practice, one that took hold in American medicine during the past century. It is not an accepted medical practice anywhere else in the world.

    Furthermore, routine male circumcision is rarely discussed in our culture, so parents who consent to it (or who are pressured into consenting to it) are ignorant of the fact that it is not a minor “snip,” that babies can and do get infections, lose part of their penises, and even bleed to death from this surgery. Parents are almost never told that it is a painful and protracted procedure, one in which the baby is strapped down, and then stroked to give him an erection, at which point the physician inserts a metal probe between the foreskin and the glans (head) of the penis to which it is attached (the foreskin separates later in the child’s life; at birth, it is attached to the glans), and then clamped or severed with a scalpel. The screams of a baby who is being circumcised, and the state of shock that ensues, would disabuse any witness of the notion that this is a minor intervention. The fact that it is medically unnecessary only further adds to its lack of justification. It is more than ironic that we celebrate the use of a – yes, purloined; yes, ripped off – foreskin from a newborn baby who, if asked, would certainly not have agreed to be circumcised, as something that spares another helpless being from suffering.

    It is extraordinary that we have prohibited so much as a pinprick of a girl’s genitals, calling it “mutilation” and condemnning cultures for cutting their girls, while we tolerate – indeed, condone – the mindless mutilation of over a million baby boys each year in American hospitals.

  6. It’s deeply offensive that we escalate from cruel treatment of animals to cruel treatment of newborn humans.

  7. Using an infant’s foreskin for research is just as unethical whether you remove it first, or left it attached and perform your research on the infant.

    The circumcision isn’t the issue here. It is the boy’s protection from being demoted from a human being to a lab rat.

    Girls are protected from genital harm. Heck, even dogs are protected from genital harm.

  8. The Holy Roman Catholic Inquisition once broke people on the wheel. Catholics long since ceased such practices. They changed, became more peaceful. Why is it that Jews cannot change? The got circumcision from the Egyptians, not from God (Titus chapter one). They were marked as slaves. Upon exiting Egypt, they used it as a sign of tribal unity. Today its practice socially sanctifies sexual sadists posing as benevolent practitioners. Come on MD’s, admit you get erections while you torture. “They howl and scream–we shoot some cream–it fulfills our sexual dream!” Studies show what penis torturers want studies to show (like Big Pharma!)

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