A couple filed a lawsuit against Pittsburgh rabbi Mordechai Rosenberg, alleging that he caused a “catastrophic and life-changing injury” to an 8-day-old infant during a circumcision ceremony on April 28 of this year (2013).
The baby had to be taken to a nearby hospital for emergency reconstructive surgery and leech therapy.
Leeches help a body accept reattached parts by promoting blood flow and tissue regeneration, so it is somewhat fair to assume that there was a partial or total amputation of the glans, an injury common to the Mogen clamp, the one commonly used by religious practitioners.
Rosenberg’s webpage says he’s a certified mohel, or ritual circumciser, who’s done the operations since 1990.
Mohels are not certified by a government agency because circumcision is considered a religious ceremony and not a medical procedure.
If circumcision is a medical procedure, then religious practitioners are performing unlicensed medicine and should be charged with a crime. If this is not a medical procedure, then how can we explain the use of scalpels on the body of a baby and the loss of tissue. And if this is not a medical procedure but just a religious ritual, then we need to consider this ritual abuse of a minor.
Laws against ritual abuse of minors often leave provisions for “activities, practices, and procedures otherwise allowed by law” (http://leg.mt.gov/bills/mca/45/5/45-5-627.htm) – a loophole no doubt enacted to allow cutting male babies’ genitals, while cutting female babies’ genitals is specifically prohibited and “In applying subsection (b)(1), no account shall be taken of the effect on the person on whom the operation is to be performed of any belief on the part of that person, or any other person, that the operation is required as a matter of custom or ritual.” (http://mgmbill.org/usfgmlaw.htm)
Memphis baby who suffered amputation of his penis during a circumcision in August, reported in November 2013
Saudi baby who had his penis partially cut off during circumcision, November 2013
Circumcision promoters such as Brian Morris boast how safe the procedure is. Yet here, in a matter of 2 months we learn of 3 babies who suffered this life changing injury – and all without medical necessity.
The majority of severe or even catastrophic injuries are so infrequent as to be reported as case reports (and were therefore excluded from this literature review). These rare complications include glans or penile amputation[...]
Isn’t it time somebody started collecting these case reports? Or do we not care about these babies, Dr. Diekema?
Johannesburg – “They killed my child.” These were the pained words of a Germiston father whose son had to be taken off life support on Wednesday evening after he was declared brain dead by two surgeons following a medical circumcision operation a week ago.
Reggie Mokalapa, 39, took his four-year-old son, Gugulethu, to Medicross Germiston for what doctors had assured him would be a “less than two-hour” procedure last Tuesday.
On Sunday, monitors showed that Gugulethu’s brain was not responding, and on Monday he was declared brain dead.
On Wednesday, a second doctor confirmed that Gugulethu was brain dead and the family elected for doctors to take him off life support.
“We are always advised to circumcise our children young, and we did this so that he’d be okay in future. Unfortunately, we took him to a slaughterhouse,” said Mokalapa.
Circumcision, like every other surgery, carries some risks. The problem is when promoters argue for a surgery without medical indication and minimizing every risk in order to entice the patients to undergo the procedure.
As we know, the West is currently promoting VMMC (voluntary male medical circumcision, safe male medical circumcision) in some countries of Africa as part of the package for HIV prevention. A lot of emphasis has been set on reducing the costs of the procedure by looking for new methods (such as the PREPEX, the TaraKlamp, the Shang Ring) and trying to perform the procedure without the need for a surgeon, with minimally trained personnel.
Of course this is going to lead to complications, such as what happened to Patrick Izimba in Uganda, reported on July 16th of 2013. Patrick Izimba was enticed by one of the signs offering safe male medical circumcision, and what followed is every man’s nightmare. His penis suffered gangrene and was transferred to a specialist. Plastic surgery will be used to reconstruct his penis, but he won’t be able to have sex.
Check out the explicit manifesto on their page: “Importance of establishing circumcision as a social norm is stressed“. It’s not about health, it’s not about preventing a disease, it’s about creating a social norm.
Risks As for any surgical procedure, there are risks associated with circumcision. While the benefits of circumcision may be wide-ranging and long-term, any problems generally occur during or soon after the procedure. They include:
•pain; •bleeding; •haematoma (formation of a blood clot under the skin); •infection at the site of the circumcision; •increased sensitivity of the glans penis for the first few months after the procedure; •irritation of the glans; •meatitis (inflammation of the opening of the urethra); •injury to the penis; •adverse reaction to the anaesthetic used during the circumcision.
These complications are rare when circumcision is performed by well trained, adequately equipped, experienced health care personnel, and are usually easily and rapidly resolved. Data from controlled trials show that fewer than 1 in 50 procedures result in complications.
Did I miss loss of the penis? Or is the loss of the penis darkly lumped into “injury to the penis”? When considering the reality of a man who just lost his sexual organ, does it make sense that these complications are rare and easily and rapidly resolved?
“Lidocaine with epinephrine must not be used because there is a risk of constriction of the blood vessels to the whole penis, which can cause gangrene and loss of the penis”.
Is this what happened? Was he told that gangrene and loss of the penis were possible risks of the procedure? If not, his consent was not informed consent.
Page 148 of the manual also states indicates:
Worsening wound infection with signs of gangrene. A rare risk of genital surgery is infection with multiple bacteria, causing progressive skin loss. In this situation, the blood supply is cut off, and the skin becomes necrotic and turns completely black. This condition is known as Fournier’s gangrene (synergistic gangrene or necrotizing fasciitis) and is more common in men who have diabetes. Any man with signs of spreading infection or black gangrenous skin should be urgently transferred to a referral centre. At the referral centre, it is usually necessary to give a general anaesthetic and remove all the dead skin
And while we are in page 148 of the manual, let us wonder if men are advised about the possible late sexual complications, or are they reassured that their sexual function won’t be impacted? Page 148-149 describes late complications such as:
In the long term, the client may complain of:
• decreased sensitivity of the glans;
• oversensitivity of the glans;
• unsightly circumcision wounds, ragged scars or other cosmetic concerns;
• persistent adhesions at the corona and inclusion cysts. These problems can be avoided if the foreskin is fully retracted during the operation and all adhesions carefully divided;
• discomfort during erection from the scrotal being skin pulled up the shaft of the penis and a tight scrotal sac. This can result from removal of too much skin during the circumcision. These problems can be avoided by careful preoperative marking of the incision lines.
• torsion (misalignment) of the skin of the penile shaft. This can be avoided by taking care during the operation to align the midline raphe with the frenulum.
Is this the new social norm? Males with unsensitive glans, unsightly scars and uncomfortable erections when the scrotum is pulled up by the penis because it doesn’t have enough skin to accommodate a normal erection? Is this the American gift to Africa? Are we transferring the American wound?
Appendix 6.2 of the WHO’s Manual shows a sample consent form for a minor. The consent form does not list the risks and complications of circumcision. It merely states that the parents were counseled on the existing risks. Without a written record, how are they to ensure that providers won’t be lying about the complications and exaggerating the benefits, when their expressed intention is to establish circumcision as a social norm?
Gangrene and loss of penis is a frequent complication of traditional African circumcisions, due to the risk of infections and terrible conditions in which the procedure is usually carried. However, loss of the penis also occurs in sterile conditions. It happened in 2012 to a man in China, 2 weeks before his wedding. In 2008 a man in Kentucky had his penis removed without consent during a circumcision because the doctor found a cancerous tumor; the man sued on grounds that he should have been waken up and given information prior to the amputation, and yet the court sided with the doctor as the consent form enables the doctor to perform any other procedure deemed necessary.And of course there is the well known case of David Reimer, who lost his penis while being circumcised as a baby, was raised as a girl until his teenage years, was reverted (breast reduction, penile reconstruction…), and committed suicide at 39 years. Circumcision for HIV prevention remainsnothing but speculation about a protective effect, with no proven causal reason. The African studies have been challenged by scientists and general public, but for some reason the UNAIDS and the WHO continue to promote circumcision as part of the HIV prevention package without stopping to think critically, sponsored by PEPFAR and the Bill & Melinda Gates Foundation.
A boy loses 20% of his glans during a circumcision. The boy cries in horrible pain.
This video may have been posted by the parents, who wrote:
l’assassin est docteur BOUHDI FOUAD Bd Fida à casablanca et le complice Docteur FAYSSAL LAZRAK de clinique ATFAL Oasis à casa: le premier a causé la coupure pendant la circonciosion et a mis des sutures en fermant carrément le canal d’urtine et le 2ème a refusé de délivrer le compte rendu avant et après opération qu’il a effectué sur mon enfant pour sauver le fonctionnement d’urine
(the murdererisDr.FouadBOUHDIBdFidain Casablancaand the accompliceDoctorFAYSSALLAZRAKclinicalAtfalOasiscasa: the firstcaused thebreak forthecircumcision and putsuturesclosingoutrightthe urinarychannelandasecondrefused to issue areportbefore and after theoperation heperformed onmychild to allow urination)
Partial and total amputation of the glans is one of the “low incidence high severity” complications of circumcision, one which leaves life long complications. EVERY CIRCUMCISION exposes the child to this risk, even if with a low incidence.
Not only is the boy traumatized, but he may have problems with urination and sex for the rest of his life.
The purpose of this study is to compare two commonly used circumcision clamps (Gomco and Mogen) to see which results in less neonatal pain. Neonatal pain will be assessed by change in salivary cortisol level pre and post procedure. Secondary to that they will study which one causes more bleeding, requires more time, which one is followed by most parental satisfaction (what about the satisfaction of the adult that the baby will become?) on a follow up visit, which one causes more need for revisions (including recircumcisions) within 6 weeks, and which one is more likely to cause infections.
Bleeding is measured by weight of blood soaked gauzes after the procedure.
Other outcome measures include neonatal pain score and a standarized score including vital signs and facial expression.
Evolution of the facial expressions of a baby during circumcision
They are starting from the hypothesis that the Mogen technique of circumcision is less painful, faster, and associated with less bleeding for newborns when compared to the Gomco technique after a resident circumcision standard teaching curriculum.
The participants are euphemistically called “volunteers”, and they should be male babies 4 days or less, born healthy from pregnancies without complications.
Now, what could be wrong with this?
Let’s start with the obvious. They are not pretending that the procedure is painless. They know that the procedure hurts, and that’s what they want to compare.
The action of inflicting severe pain on someone is called torture. They are torturing babies. But then of course, every forced circumcision of a minor is torture.
Now, in order to do this they obtain consent from the parents. But parents are often unaware of how much pain a circumcision really causes until they see a video of the procedure. I would have to wonder how much information the parents obtain prior to consenting to the study.
In this video, you can hear the dad freaking out as the baby starts crying. The doctor says the baby is “excited”.
Calling the baby a “volunteer” is such a horrible stretch. With the Gomco clamp I’m very sure they have to use a circumstraint, a board with Velcro straps to hold the baby still while they perform the procedure. Volunteers normally don’t have to be forcefully restrained. In fact, I know of a lawsuit in the 1980s that successfully charged that the baby was falsely imprisoned due to the use of restraints. Most health professionals are aware that forcefully restraining an adult has legal and ethical implications, but why is it that they don’t seem to have the same consideration to minors?
Baby strapped on a circumstraint
1984 NOCIRC newsletter detailing lawsuit including charges for battery and false imprisonment.
But not only do they know that the procedure is painful, they are also aware that there are risks and complications, and they DO expect to see those risks (infections and bleeding being the most common) and complications (including adhesions although they didn’t mention them, and the need to repairs and recircumcisions). In other words, they are running a medical experiment on human babies, knowing that those babies are going to suffer pain and that some are going to need additional surgeries or may suffer even more severe complications.
Skin bridge (adhesion) on a circumcised penis, a common complication that can cause pain during sex
Now, the real messed part is that they are using the mogen clamp. It sounds innocent enough, the more common methods used on newborns are the plastibell, the gomco clamp and then the mogen clamp (which is favored by Jewish mohelin but not so much by the medical community). So what can be wrong with assessing which one is best?
Well, for one, the mogen clamp is far from having a clean record. The “Manual for early infant male circumcision under local anaesthesia” published by the World Health organization in 2010 details that both the mogen clamp and the gomco clamp have an increased risk for penile laceration and amputation, but extends to say that “penile amputation can occur even under ideal circumstances” with the mogen clamp.
Now, has this ever happened? Yes, it happened in Israel in June of 2012 to a Muslim baby. It also happened in Illinois in February of 2007 in a medical circumcision, and also in Florida in 2004 in a Jewish circumcision (the mohel, Daniel Krimsky, tried to conceal the error causing loss of time and damage to the tissue, which failed to reattach). The same year it also happened to a baby circumcised by doctor Haiba Sonyika, who also failed to react timely, resulting in significant injury and iatrogenic hypospadias (in other words, the baby urinates through a new hole misplaced because of surgical mishap) and will require counseling and surgeries along his life. And it also happened in 2003 in L.A.
I am 24 years old and lost my entire glans penis, the head of my dick, in a botched circumcision. Basically I have a shaft but there’s no head at the end. Unfortunately, I was left with my balls so I still have a sex drive, but it’s nearly impossible for me to climax. When I was much younger, around 14 to 16, I could sometimes masturbate to a climax, but after a couple of years I stopped being able to do this. Some of the women I’ve been with never saw the condition of my penis, and failed to notice when I didn’t come. Others have seen my condition before intercourse and refused to have sex with me, while still others found out afterwards, after I wasn’t able to come, and then never wanted to have sex with me again. Of course I never dare to ask anyone to suck me, although this might provide the necessary extra stimulation and actually help me climax.
So my problem, Dan, is twofold: I can’t come and I can’t get anyone to stick around and help me try to come. Can you suggest any special techniques for someone in my condition? Any help would be appreciated. I’m very miserable, frustrated, and lonely.
In fact, these cases have been so common and so catastrophic that Mogen Circumcision Instruments Company went out of business in 2010 after paying several millionaire lawsuits. The clamps however were not recalled.
Not only were the clamps not recalled, but they are still in use, being favored by the often mentioned Dr. Neil Pollock in Canada (also a mohel), and recently received favorable reviews in a 2012 paper about the safety of over 1,200 infant male circumcisions in Kenya (in which there was one adverse event involving partial amputation of the glans)
In a 2013 study by Rebecca Plank in Botswana, the mogen clamp and the plastibell were compared. The adverse events with the mogen clamp were considered to be more frequent but “minor” (removal of too little skin and development of skin bridges and adhesions). Bleeding was more frequent with the mogen clamp as well.
So, what the big picture tells us is that what these researchers at TriHealth Good Samaritan Hospital in Cincinnati, Ohio, are doing, is an experiment on human, American babies, which knowingly causes pain, without any existing condition or disease removes normal healthy and functional erogenous tissue from non-consenting “volunteers” (with no regard for the future preference of the adults they will become), subjects healthy individuals to amputative surgery, and risks causing iatrogenic harm to those babies, practicing a XIX century “elective” surgery (which again, they did not elect) with obsolete and dangerous equipment.
Mechanical function of the foreskin during sexual activity – a pleasure denied to circumcised men
Comparison of an intact penis with its frenulum, and a circumcised penis missing the frenulum and with keratinized glans
Personally, it bothers me that the 3 listed researchers are females. I wonder if I’m the only one who sees something wrong in 3 female researchers looking for the best way to slice and skin babies penises. In a way they are doing to babies almost the same thing that Lorena Bobbitt did to her husband, except that they are doing it protected under medical license and with the subterfuge of research.
I’m reminded of a 1959 American researcher, W. G. Rathmann MD, who invented a clamp for female circumcision, as a cure for frigidity. At least he wasn’t targeting infants.
Rathmann Clamp for female circumcision
Rathmann clamp in action – clamping the clitoral hood, the female equivalent of the male foreskin
Promoters of female circumcision were in the wrong side of history, and so are promoters and researchers of infant male circumcision. The fact that it is an unnecessary operation, that it has risks and causes pain, that it provokes sexual changes, and that it is performed on a healthy normal baby who does not have a disease or condition, should be reason enough to stop right now.
Perhaps it is time they run a clinical trial to compare the pain and risk of complications between circumcised babies and “uncircumcised” babies (intact babies). I dare you AAP.
“[I]t can no longer confidently assume that circumcising a healthy boy will be viewed by him later as beneficial. Increasingly, circumcised males are learning the functions of intact genitals, documenting the harm from circumcision and pursuing genital wholeness. They will undoubtedly increase their pressure on circumcising societies to affirm male genital integrity and to prevent involuntary nontherapeutic circumcision.“
Hammond, T. (1999), A preliminary poll of men circumcised in infancy or childhood. BJU International, 83: 85–92. doi: 10.1046/j.1464-410x.1999.0830s1085.x http://www.noharmm.org/bju.htm
PS, while we are at it, this page: http://www.cincinnatichildrens.org/health/m/male-anatomy/ states that “Other boys are not circumcised and may have skin that covers the tip of the penis. If circumcision is not done the skin must be pulled back for proper cleaning” — The problem with this is that it does not specify any age. The foreskin at birth is sealed to the glans, and it CANNOT be retracted. Retracting the foreskin of a child who has not yet separated can result in pain, bleeding, infection and development of adhesions. In turn, this can result in scar tissue that will become acquired phimosis and MAY require circumcision. See how bad this advice is?
Please let these guys know that they need to be clear. Nobody needs to retract a child’s foreskin. Cleaning inside the foreskin can wait until the child becomes retractable (which may take until puberty – 17 years is not an uncommon age to become retractable) and should only be done by the child himself, not by the parents. It is not advisable to use soap in cleaning inside the foreskin as this can cause irritations and infections. Retract, rinse and replace, that’s all it takes to wash the penis of a male who can already retract.
It is fair to acknowledge that on this other page: http://www.cincinnatichildrens.org/health/u/uncircumcised/ they provide better advice regarding age of retraction. But they still recommend soap, and this is a common reason why many “uncircumcised” males complain of irritation and infection. Soap disrupts the delicate pH and bacterial environment of the foreskin and may cause irritations. Soap, if used, should be mild, unscented, and rinsed completely. Better yet, just use warm water.