Between prophylaxis and child abuse: the ethics of neonatal male circumcision

Opinion about neonatal male circumcision is deeply divided. Some take it to be a prophylactic measure with unequivocal and significant health benefits, while others consider it a form of child abuse. We argue against both these polar views. In doing so, we discuss whether circumcision constitutes bodily mutilation, whether the absence of the child's informed consent makes it wrong, the nature and strength of the evidence regarding medical harms and benefits, and what moral weight cultural considerations have. We conclude that nontherapeutic circumcision of infant boys is a suitable matter for parental discretion.     

正确看待新生儿包皮环切术

新生儿包皮环切术通常被认为能减少尿路感染、成人阴茎癌甚至艾滋病毒感染危险,许多国家和地区常规为新生儿行包皮环切术。但近年来许多学者从医学和伦理等角度对此提出疑问,主张慎重对待新生儿包皮环切术。     

Can Culture Justify Infant Circumcision?

The paper addresses arguments in the recent philosophical and bioethical literature claiming that social and cultural benefits can justify non-therapeutic male infant circumcision. It rejects these claims by referring to the open future argument, according to which infant circumcision is morally unjustifiable because it violates the child’s right to an open future. The paper also addresses an important objection to the open future argument and examines the strength of the objection to refute the application of the argument to the circumcision case.     

Ritual Male Infant Circumcision and Human Rights

Opponents of male circumcision have increasingly used human rights positions to articulate their viewpoint. We characterize the meaning of the term “human rights.” We discuss these human rights arguments with special attention to the claims of rights to an open future and to bodily integrity. We offer a three-part test under which a parental decision might be considered an unacceptable violation of a child's right. The test considers the impact of the practice on society, the impact of the practice on the individual, and the likelihood of adverse impact. Infant circumcision is permissible under this test. We conclude that infant circumcision may be proscribed as violating local norms, even though it does not violate human rights.     

On the Strength of Children's Right to Bodily Integrity: The Case of Circumcision

This article considers the question of how much weight the infringement of children's right to bodily integrity should be given compared with competing considerations. It utilises the example of circumcision to explore this question, taking as given this practice's opponents' view of circumcision's harmfulness. The article argues that the child's claim against being subjected to (presumably harmful) circumcision is neither a mere interest nor a right so strong that it trumps all competing interests. Instead, it is a right of moderate strength. Indeed, even the aggregate strength of children's rights against the practice of (presumably harmful) circumcision as a whole is not so weighty so as to always trump competing interests. The harms are not sufficiently serious to justify such a status. And the expressive wrongs associated with non‐negligently benevolent harming are much less serious than those associated with intentional harming. The debate over banning circumcision thus cannot be conducted only in terms of competing rights. Competing interests, such as those that would be set back by the departure of religious citizens, should be considered as well and might plausibly justify allowing even a rights‐infringing practice to continue.     

Personal Control as a Mediator and Moderator Between Life Strains and Psychological Well-Being in the Unemployed

This study surveyed 214 unemployed adults on well-being, the latent (status, social support, activity, time structure, collective purpose) and manifest benefits (financial strain) of employment, and personal control. We tested whether personal control would predict well-being over and above the effects of the latent and manifest benefits, and tested whether it moderated or mediated the relationship between the latent and manifest benefits and well-being. Personal control explained additional variance over and above the latent and manifest benefits; it moderated the effect of both activity and financial strain on well-being; and it mediated the relationship between financial strain, time structure, collective purpose, status, and well-being. Implications for theory and practice are discussed.     

不同浓度罗哌卡因复合利多卡因行骶管阻滞应用于痔上黏膜环切术的效果比较

本文通过将120位择期行痔上黏膜环切术的患者随即分为三组,仔细地比较了不同浓度的罗哌卡因复合利多卡因骶管阻滞在痔上黏膜环切术中的镇痛效果和运动阻滞程度,结果发现了0.2%罗哌卡因＋1%利多卡因骶管阻滞最适用于痔上黏膜环切术,它不但可以取得理想的镇痛效果,而且无明显的运动神经阻滞作用。     

包皮环切术的历史与宗教

探讨包皮环切术的历史与宗教起源。对包皮环切术的历史文献进行分析整理,归纳总结它们的历史。对于包皮环切术的起源肯定是在史前开始的。6000年以前的埃及木乃伊和浮雕上记录了最早的包皮环切术的过程。很多宗教都与包皮环切术有关系。包皮环切术有着很长的传统,与各民族和宗教的发展息息相关。     

The Effect of Religious Beliefs on the Publication Productivity of Countries in Circumcision: A Comprehensive Bibliometric View

Circumcision is one of the most common surgical operations in newborns, babies, and children due to cultural, religious, and medical reasons. Religious beliefs are known to have an important role in circumcision. Although bibliometric analyses have been performed about several topics with a lot of publications in literature, no studies in the literature were found to focus on male circumcision. This study aims to make a comprehensive bibliometric analysis of circumcision and investigate the relationship between publication productivity and religious beliefs of the countries. Web of Science was utilized to obtain the documents needed for bibliometric analyses. “Circumcision” keyword was used for search. The search included studies published between 1980 and 2018. The literature review indicated that there were 3694 publications about circumcision published between 1980 and 2018. Of these publications, 1770 (47.9%) were articles. This study provided a bibliometric summary of 1770 articles. The top five active countries about circumcision were the USA, England, South Africa, Turkey, and Kenya. The present study found that the religious beliefs of a country were directly related to publication productivity about circumcision. The top-cited study was the article entitled “Male circumcision for HIV prevention in young men in Kisumu, Kenya: a randomized controlled trial” written by Bailey et al. and published in the journal of Lancet. The keyword analysis results showed that HIV was the top keyword used in all articles about circumcision. This study is believed to help researchers interested in circumcision topic to access a summary of the literature, see contemporary and more important topics, and discover new ideas about the issue.

     

Beneficiary or benefactor: are people more prosocial when they reflect on receiving or giving?

Research shows that reflecting on benefits received can make people happier, but it is unclear whether or not such reflection makes them more helpful. Receiving benefits can promote prosocial behavior through reciprocity and positive affect, but these effects are often relationship-specific, short-lived, and complicated by ambivalent reactions. We propose that prosocial behavior is more likely when people reflect on being a benefactor to others, rather than a beneficiary. The experience of giving benefits may encourage prosocial behavior by increasing the salience and strength of one's identity as a capable, caring contributor. In field and laboratory experiments, we found that participants who reflected about giving benefits voluntarily contributed more time to their university, and were more likely to donate money to natural-disaster victims, than were participants who reflected about receiving benefits. When it comes to reflection, giving may be more powerful than receiving as a driver of prosocial behavior.     

Pluralism in Multicultural Liberal Democracy and the Justification of Female Circumcision

This article discusses the problems that a liberal, multicultural democracy has in dealing with cultural practices, such as female circumcision, which themselves suppress the liberal values of autonomy and pluralism. In this context I have chosen the justification of female circumcision as my issue for three reasons. First, with increasing immigration, in Western multicultural and pluralistic societies this practice has recently been given a good deal of public attention; second, I believe that it is time to put this cruel and discriminatory tradition finally in the past; and third, the paradox that the victims of this practice are also often its strongest proponents well demonstrates the problems that liberal democracies have in dealing with the question of autonomy and tolerance in real-life situations. My main argument is that, without giving up tolerance, we can show that there can be no moral justification for such a tradition as female circumcision, even within a multicultural and pluralist society.
I shall first show why neither female circumcision nor any other tradition that oppresses and harms individuals and is maintained by coercion can be satisfactorily defended by liberal arguments. Then I shall discuss why 'communitarian'counter-arguments which appeal to the significance of communal values and traditions or to cultural rights also fail to give any plausible support to the maintenance of this tradition. Finally, I shall consider in more detail how the value of autonomy should be normatively understood in a modern pluralist society [1].     

What is unrealistic optimism?

Here we consider the nature of unrealistic optimism and other related positive illusions. We are interested in whether cognitive states that are unrealistically optimistic are belief states, whether they are false, and whether they are epistemically irrational. We also ask to what extent unrealistically optimistic cognitive states are fixed. Based on the classic and recent empirical literature on unrealistic optimism, we offer some preliminary answers to these questions, thereby laying the foundations for answering further questions about unrealistic optimism, such as whether it has biological, psychological, or epistemic benefits.     

Moral dilemmas and moral rules

Recent work shows an important asymmetry in lay intuitions about moral dilemmas. Most people think it is permissible to divert a train so that it will kill one innocent person instead of five, but most people think that it is not permissible to push a stranger in front of a train to save five innocents. We argue that recent emotion-based explanations of this asymmetry have neglected the contribution that rules make to reasoning about moral dilemmas. In two experiments, we find that participants show a parallel asymmetry about versions of the dilemmas that have minimized emotional force. In a third experiment, we find that people distinguish between whether an action violates a moral rule and whether it is, all things considered, wrong. We propose that judgments of whether an action is wrong, all things considered, implicate a complex set of psychological processes, including representations of rules, emotional responses, and assessments of costs and benefits.     

La responsabilité médicale des accidents de la circoncision en Tunisie : à propos de trois affaires judiciaires

Circumcision is the most frequently performed surgical procedure worldwide, mainly as part of religious rituals. It may lead to serious complications. Although there is no specific law relative to circumcision accidents in Tunisia, the occurrence of complications of this act is likely to engage the penal, civil and disciplinary liability of the doctor. Prevention involves respecting the principles of the Medical Deontology Code, raising awareness about the need to practice circumcision in a medical environment and the promulgation of specific legislation regulating this act. The new Tunisian law on medical liability seems to offer a solution to solve the legal complaints concerning circumcision accidents by providing more opportunities for amicable settlement and at the same time guaranteeing adequate and rapid compensation of the prejudice. In this article, we discuss the medical liability of circumcision accidents through three medicolegal cases carried out at the Department of Legal Medicine of Ibn El Jazzar University Hospital, Kairouan, Tunisia.     

Case vignette: child abuse or acceptable cultural norms -- child psychiatrist's response; ethical issues in culturally relevant interventions; cultural contexts

Three families from the nation of the Gambia have become socially acquainted in the greater Metropolis area where they have relocated from their native country. All three families have preadolescent daughters. None of the girls has as yet undergone the ritual "female circumcision" commonly practiced in their native country. Five of the six parents think it would be a good idea to hold such a ritual ceremony in Metropolis next month. The sixth parent is uneasy about the procedure and wonders if it is appropriate anyway. The parent comes to talk with you, a physician or mental health professional, about this. The parent describes concerns about the procedure and the practice in general, but notes that some groups in the United States do "similar things," referring to the ritual circumcision of Jewish boys at 8 days of age. The parent adds that if the procedure is not possible in the United States, it could be done in the Gambia when the family returns there on holiday. Discussants were asked for their opinions regarding advice to the parent's ethical obligations (especially in the case of mandated reporting of suspected child abuse).     

任务转换加工机制的研究述评

本文重点介绍了任务转换加工机制的三种主要假设：任务重建、任务重复优势和线索重复优势。任务重建假设认为转换加工是一种根据个体行为意图的自上而下的执行控制过程,而任务重复优势假设和线索重复优势假设均认为转换加工是一种由外部刺激启动的自下而上的自动控制过程。三者差异的焦点在于：转换加工过程中是否有执行控制参与。本文围绕这一争论进行了讨论和分析,并对相关领域进行了展望。     

The International Student: Female Circumcision Issues

The authors describe the process and practice of female circumcision, the impact it may have on circumcised female international college students, and some counseling strategies for the college counselor.     

Mental Transformation Skill in Young Children: The Role of Concrete and Abstract Motor Training

We examined the effects of three different training conditions, all of which involve the motor system, on kindergarteners’ mental transformation skill. We focused on three main questions. First, we asked whether training that involves making a motor movement that is relevant to the mental transformation—either concretely through action (action training) or more abstractly through gestural movements that represent the action (move‐gesture training)—resulted in greater gains than training using motor movements irrelevant to the mental transformation (point‐gesture training). We tested children prior to training, immediately after training (posttest), and 1 week after training (retest), and we found greater improvement in mental transformation skill in both the action and move‐gesture training conditions than in the point‐gesture condition, at both posttest and retest. Second, we asked whether the total gain made by retest differed depending on the abstractness of the movement‐relevant training (action vs. move‐gesture), and we found that it did not. Finally, we asked whether the time course of improvement differed for the two movement‐relevant conditions, and we found that it did—gains in the action condition were realized immediately at posttest, with no further gains at retest; gains in the move‐gesture condition were realized throughout, with comparable gains from pretest‐to‐posttest and from posttest‐to‐retest. Training that involves movement, whether concrete or abstract, can thus benefit children's mental transformation skill. However, the benefits unfold differently over time—the benefits of concrete training unfold immediately after training (online learning); the benefits of more abstract training unfold in equal steps immediately after training (online learning) and during the intervening week with no additional training (offline learning). These findings have implications for the kinds of instruction that can best support spatial learning.     

Freud's Jewish identity,circumcision, and the theory of castration anxiety: problem or pride?

In this work the author reflects on the Jewish identity of Sigmund Freud. It is acknowledged that Freud, even though he seemed ambivalent towards Jewishness and even though anti-Semitism was omnipresent, not necessarily perceived his Jewish identity as problematic. Rather, it seems as if Freud had a positive Jewish identity, which was connected to profound knowledge in Jewish religion and tradition, even though he declared himself as a Godless Jew. Both his Jewish identity and his knowledge in Judaism seemed to have contributed to some of his insights into the human psyche. The impact of the traditional Jewish circumcision and the insights connected to the theory of castration anxiety are specifically discussed. The author suggests that Freud's positive Jewish identity, and the significance of circumcision, contributed to his insights into the prerequisites of human development and how we as individuals are shaped both by our interpersonal relationships and by the cultural context.     

Enhancing retention through reconsolidation: negative emotional arousal following retrieval enhances later recall

When information is retrieved from memory, it enters a labile state rendering it amenable to change. This process of reconsolidation may explain, in part, the benefits that are observed in later retention following retrieval of information on an initial test. We examined whether the benefits of retrieval could be modulated by an emotional event occurring after retrieval. Participants studied Swahili-English vocabulary pairs. On a subsequent cued-recall test, each retrieval was followed by a blank screen, a neutral picture, or a picture inducing negative affect. Performance on a final cued-recall test was best for items whose initial retrieval was followed by negative pictures. This outcome occurred when a negative picture was presented immediately after (Experiment 1) or 2 s after (Experiment 2) successful retrieval, but not when it was presented after restudy of the vocabulary pair (Experiment 3). Postretrieval reconsolidation via emotional processing may enhance the usual positive effects of retrieval.