Wikipedia talk:Requests for mediation/Medical analysis of circumcision


 * The following discussion is preserved as an archive. Please do not modify it. Subsequent comments should be made on the appropriate discussion page.  No further edits should be made to this page.

Hi, I shall be mediating your case. In the next few days I shall put some questions on here which it would be great to get all your views on. We can then use this as the starting point for the mediation. If you need to contact me at any stage please either e-mail me or drop a message on my talk-page. --Wisd e n17 18:50, 19 May 2006 (UTC)

Right, now I've managed to read through the quite rigorous debate that all of you have had over this issue. Now I can see that this clearly is quite an emotive issue, perhaps surprisingly. What is also very clear from your debate is that all of you have the best interests of this article at heart, and all of you have been able to provide evidence and compelling arguments to support your side. What I see my job as is to try and resolve your differences, as much as possible, or to help you find a compromise solution.

I have not been involved in any way with the page, as you will all be aware, and had not come across the page until I took on this case.

Initial Questions
Initially I have some questions which I would like all parties opinion on, if possible, or if you feel that your view has been expressed already you need not answer, or you may simply want to indicate your support for it.


 * 1) There appears to be two quite distinct sides to this issue, and much reference has been made to WP:NOR. This does appear to be a central part of this argument, and so I would ask those that feel that the article should mention a risk of CA-MRSA infection being associated with circumcision to state quite clearly and concisely what they feel their evidence is.
 * 2) Secondly, what are all parties' views on the suggestion of creating an article which specifically is to do with Criticism of Circumcision, and perhaps link to this page from the Medical Analysis page?

Now if we take thess two questions to start with. We can then address the issue of whether there is a real faction of editors trying to impose their POV, and use RFAs to do this.

I think from looking at your debate so far it has been generally civil, but there have been occasional lapses. I would urge all parties to be Civil whilst the mediation is taking place.

The discussion on this pages needs to be as clear and concise as possible, as most of the issues and evidence and reasoning will have been raised before. --Wisd e n17 20:16, 23 May 2006 (UTC)

Superdix's view

 * 1) Bratu et. al. list "invasive or surgical procedures" as a risk factor in CA-MRSA infections for the pediatric population . To call the inclusion of this information original research implies that the Bratu and his colleagues forgot to add the words "excluding circumcision" in their list of risk factors. To explain this generalization in medicine, I quote Alberts et. al: "Wounds in barrier epithelia, including the skin, allow pathogens direct access to the interior of the host. This avenue of entry requires little in the way of specialization on the part of the pathogen" (Alberts et. al., Molecular Biology of the Cell, 4th. ed., New York: Garland Science, pp. 1434-1435). This is basic medical knowledge, which one has to acknowledge when reading the article in question, or any other article on the subject of infections for that matter.
 * 2) While covering this issue over several articles may be a quick solution to this debate (and countless others), I think ultimately the quality of the articles will suffer, and the public will have a harder time navigating the issue as a whole. Superdix 22:40, 23 May 2006 (UTC)

Alienus's View
I'd like to add that the link between CA-MRSA and circumcision is not something we came up here on Wikipedia as original research. As it turns out, a group known Doctors Opposing Circumcision (DOC) put out a widely-distributed press release on this topic.

One instance can be found here, although Googling turns up more. On their own site, they've put up a Special Statement on the issue. Before clicking on this link, please note that it contains some disturbing medical photographs. I mention this fact to avoid surprises, not because I suggest the inclusion of shock pictures in the article.

Based on prior experience, I'm going to anticipate that Jakew, Nandesuka and Jayjg will all deny that DOC qualifies as a reliable source, on the basis that it is a partisan group. Nonetheless, as Superdix shows, the medical community has ascertained that CA-MRSA is a risk for any procedure that cuts the skin, including circumcision. To the best of my knowledge, there is no verifiable basis upon which circumcision could be excluded from this.

As for a "Criticism of Circumcision" article, I think this would constitute a POV fork, which is not generally considered good Wikipedia practice. Al 04:33, 24 May 2006 (UTC)

Mediator's Response
I think the above two comments are clearly the one side in the debate, those who think that the article should make mention of a link. I would be very interested in Jakew, Nandesuka and Jayjg's view of DOC. I would also ask them to critique the above evidence provided and introduce any evidence they may have to support their 'side'. --Wisd e n17 14:19, 24 May 2006 (UTC)


 * I am following the discussion, but am currently occupied with work. I'll put my view up within the next couple of days.  Thanks! Nandesuka 17:03, 24 May 2006 (UTC)


 * As Alienus correctly notes, myself and other editors (Jayjg, Nandesuka) do not consider Doctors Opposing Circumcision to conform to Wikipedia's definition of a reliable source. The reasons are many, but here are a few which I have noted previously:
 * "Do they have an agenda or conflict of interest, strong views, or other bias which may color their report?"
 * Evidence: "With the formation of DOC (Doctors Opposing Circumcision), a campaign to ban routine infant circumcision is underway.384"
 * Conclusion: Yes, they have such an agenda.
 * "...editors should avoid using political groups with widely acknowledged extremist views, like Stormfront.org or the Socialist Workers Party."
 * Evidence: Groups including DOC are described as extremists in the Washington Post.
 * Conclusion: DOC may be reasonably described as extremist.
 * "Have they reported other facts reliably, including on different subjects? Cross-check with what you already know."
 * Evidence: Here is a DOC press release relating to an HIV study. It refers to a WSJ article, which may be found here. The study was later published here. There are several faults. Firstly, the author tries to imply bias, suggesting that Robert Bailey sponsored the study. In fact, as you can see from the links, the lead researcher was Bertran Auvert, and the study was sponsored by ANRS. Secondly, he claims that UNAIDS have cautioned against circumcision. If you read the UNAIDS/WHO joint statement, you'll see that they do nothing of the kind. The author claims that the WHO "fear a false security from having been circumcised, and reduced sensitivity in the penis, may cause an increase in risky, sexual behavior and a decline in condom use leading to increased transmission of the virus." In fact, if you read their statement, you'll see that they say nothing about penile sensitivity whatsoever - this is a misrepresentation.
 * Conclusion: DOC have misrepresented other facts.
 * "Certain "red flags" should prompt editors to examine closely and skeptically the sources for a given claim. ... Surprising or important facts which are not widely known. ... Claims which are not supported, or which are contradicted, by the prevailing view in the scientific community. ... Claims which strongly support one or another party in an ongoing dispute."
 * Evidence: The alleged MRSA link is a surprising or important 'fact' that is not widely known (go to the PubMed database of millions of peer-reviewed studies, and search for 'circumcision mrsa'. Only one result is found, and that doesn't directly link MRSA with circumcision). The claim, among other claims made by DOC, is not supported by the prevailing view. Note that the vast majority of their references predate the evidence-based policy statements from medical organisations that they criticise for being 'outmoded'. The claim also explicitly supports the anti-circumcision side of the circumcision dispute.
 * Conclusion: Red flags are raised.
 * "Cite peer-reviewed scientific journals and check community consensus ... Scientific journals are the best place to find primary source articles about scientific experiments, including medical studies. The best scientific journals are peer-reviewed, which means that independent experts in the field are asked to (usually anonymously) review articles before they are published. This usually results in corrections and improvement, sometimes substantial. Many articles are excluded from peer-reviewed journals because they report questionable (or perhaps merely unimportant, in the opinion of the editors) results."
 * (Self-evident; no evidence needed)
 * "Publications with teams of fact-checkers, reporters, editors, lawyers, and managers — like the New York Times or The Times of London — are likely to be reliable, and are regarded as reputable sources for the purposes of Wikipedia. ... At the other end of the reliability scale lie personal websites, weblogs (blogs), bulletin boards, and Usenet posts, which are not acceptable as sources. Rare exceptions may be when a well-known professional person or acknowledged expert in a relevant field has set up a personal website using his or her real name. Even then, we should proceed with caution, because the information has been self-published, which means it has not been subject to any independent form of fact-checking."
 * (Self-evident; no evidence needed)


 * Thus, I conclude that DOC does not meet the requirements of WP:RS.


 * I would additionally note that DOC's press release, while not hosted on their site, not only comes from such an organisation but is a press release - in other words, marketing material, not a scholarly source.


 * Superdix cites Bratu's paper, but I believe that he misunderstands the meaning of no original research. This policy is closely related to verifiability, which states in no uncertain terms that the standard for Wikipedia is verifiability, not truth. NOR forbits novel syntheses of facts, and since Bratu did not discuss circumcision explicitly, using it in this context would be forbidden by policy.


 * The fundamental problem here, as I've noted in my response to Alienus' points above, is that no reliable sources have identified MRSA as a risk of circumcision. Compare with bleeding, say, which is recognised and noted by every review paper on the subject, every national medical organisation's statements (at least as far as I know). Searching PubMed for 'circumcision bleeding' returns 150 hits, with about 1/3rd apparently relevant. It isn't remotely original to call it a risk of circumcision.


 * I therefore believe that it is inappropriate to discuss MRSA in the article until at least one peer-reviewed article in a medical journal (or something similarly reliable) has done so previously.


 * I am inclined to agree with both Superdix and Alienus regarding a 'criticism' article. Jakew 20:44, 25 May 2006 (UTC)


 * Please read my comments to Nandesuka's response, Jakew, as they apply to your claim of my misunderstanding of WP:NOR as well. Thanks. Superdix 23:06, 27 May 2006 (UTC)


 * Jake, for the most part you make a good case, but I have to protest. I don't think that Washington Post article says what you claim it does.  The word "extremists" is used only once in the article:


 * The anti-circumcision extremists are a small but vocal group of men and women fighting against an ambivalent medical profession.


 * The mention of DOC is in a subsequent paragraph with no specific phrase linking it to the groups being discussed above. It could be easily argued that WashPost did intend to call some groups extreme, but not DOC.  Just because some groups are called extremist in the article does not mean DOC was called extremist simply because it was also referenced in the same article.  Also, as a source, WashPost seems a bit confused about consensus.  First it says:


 * For the most part, doctors still say the procedure is a parent's decision, often based not on health issues but religious and cultural values. '


 * ...but then later in the same article it says:


 * There is little medical consensus. The American Academy of Pediatrics met last summer on the issue and is still considering whether to issue new guidelines.


 * The article, which is nearly ten years old, seems to have been written by someone who can't make up their mind as to whether there is medical consensus or not, and it doesn't seem to link DOC to extremism as you suggest. Kasreyn 16:42, 28 May 2006 (UTC)


 * P.S. I also don't believe that one source is enough to say that DOC's views are "widely" acknowledged as extreme. For that matter, having an "agenda" coloring one's report is a sticky issue as well - did DOC's opinion come first, and then they decided to oppose circumcision - or did their anti-circ agenda come first, after which they tailored facts to match their goals?  I think this line about agendas was regarding ulterior motives not directly in line with stated goals (ie., saying one thing but doing another).


 * It seems like a chicken and egg type question to me. Of course a group believing circumcision is harmful will take action opposing it - they'd have to be hypocrites, all talk and no show, if they didn't.  You're proposing a standard whereby organizations are considered unreliable if they take any actions in line with their own stated beliefs.  This would rule out all political parties as sources, for one thing.  I think this is an unreasonable requirement for sources.  In fact, I'd be less likely to trust an organization that fails to ever take action in line with its beliefs.  At least then you know they're sincere.  Cheers, Kasreyn 16:51, 28 May 2006 (UTC)


 * You raise some interesting points, Kasreyn, but I wonder whether you may be over-analysing the issues. Whatever the history of their members, DOC is clearly an organisation with an agenda. The name is a bit of a give-away.
 * Their opposition may not necessarily have anything to do with medical issues. From their 'about DOC' page: "We believe that male neonatal circumcision, by its inherent nature, violates laws and bioethical guidelines that have been enacted for the protection of children."
 * The question is this: given that they have this agenda, can they be trusted to present information neutrally and accurately? To put it bluntly, if you thought that something were unethical, possibly illegal, and perhaps, say, a human rights violation, might you be tempted to tell a little white lie to help stop it happening? More to the point, is it difficult to believe that others might do so? Can you trust them? Jakew 17:35, 28 May 2006 (UTC)
 * I see your point; DOC's motivation is from the ethical side of the issue, and therefore you worry that their honesty as regards the medical side of the issue is in question. I can only reply that any person or organization in a similar situation would feel a temptation to lie or distort in order to accomplish their goals.  Whether that temptation is acted upon is something we can only decide based on objective third-party reports upon that person or organization.  I still feel you haven't shown that DOC is "extremist" or "widely acknowledged" to be so.  Note that I'm not personally taking sides - I don't know DOC from Adam - I'm just saying that I don't think you've done enough to prove your contention.  Kasreyn 20:03, 28 May 2006 (UTC)

Jake wrote:
 * "...editors should avoid using political groups with widely acknowledged extremist views, like Stormfront.org or the Socialist Workers Party."
 * Evidence: Groups including DOC are described as extremists in the Washington Post.
 * Conclusion: DOC may be reasonably described as extremist.

As Kasreyn correctly pointed out the Washington Post article does not say DOC is extremist. To compare an organization that opposes medically unnecessary genital surgery on children with Stormfront.org or the Socialist Workers Party is over the top rhetoric. The Royal Australasian College of Physicians policy statement on circumcision says, "The possibility that routine circumcision may contravene human rights has been raised because circumcision is performed on a minor and is without proven medical benefit." Currently there is a debate over whether or not non-therapeutic circumcision of children is ethical. To characterize one POV in the ethical debate as extremist but not the other POV is not a fair or objective analysis of the ethical debate. -- DanBlackham 05:58, 2 June 2006 (UTC)

Jake wrote, "Secondly, he claims that UNAIDS have cautioned against circumcision. If you read the UNAIDS/WHO joint statement, you'll see that they do nothing of the kind." The DOC press release says:
 * UNAIDS has cautioned against circumcision.
 * "If circumcision were promoted as a way of preventing HIV infection, people might abandon other safe sexual practices, such as condom use. This risk is far from negligible - already, rumors abound in some communities that circumcision acts as a "natural condom". A sex worker interviewed in the city of Kisumu in Kenya summed up this misconception, saying, "I can sleep with circumcised men without a condom because they don't carry a lot of dirt on their penis". While circumcision may reduce the likelihood of HIV infection, it does not eliminate it. In one study in South Africa, for example, two out of five circumcised men were infected with HIV, compared with three out of five uncircumcised men. Relying on circumcision for protection is, in these circumstances, like playing Russian roulette with two bullets in a (five-shot) revolver rather than three."

The quote is from the UNAIDS document Prevention: daunting challenges ahead. The DOC statement "UNAIDS has cautioned against circumcision" is accurate. -- DanBlackham 06:29, 2 June 2006 (UTC)

DOC
Following the mention of DOC as a possible source of information I contacted their President and Chief Executive Officer Dr. George Denniston. Dr. Denniston replied very quickly to me, and here is his initial reply related to the question of infection:


 * Dear Mr. Coddington:


 * Newborn boys have an open wound that other newborn babies don't have. This increases the risk of infection. Staphylococcus aureus (SA) is passed around in hospital nurseries, so newborn circumcised boys are put at risk of SA.


 * Although infection with Staphylococcus aureus (SA) has long been a risk of neonatal circumcision, CA-MRSA is a new, emerging strain of an old bacteria, SA, that causes serious, life-threatening pathology, and new risk. The new strain has acquired new virulence, so the threat to health has increased. It has fulminating characteristics, so treatment should be immediate and aggressive. We believe that this new strain adds a new and dangerous factor to the inherent risks of neonatal non-therapeutic circumcision.


 * We have issued a warning on our website.


 * http://www.doctorsopposingcircumcision.org/DOC/mrsa.html


 * The warning is prospective, rather than retrospective, just as the warnings we are hearing about bird flu are prospective, because the bird flu epidemic hasn't happened yet.


 * If there is one paper that most supports our position, it probably is this one from the CDC:


 * Bratu S, Eramo A, Kopec R, Coughlin E, Ghitan M, Yost R, et al. Community-associated methicillin-resistant Staphylococcus aureus in hospital nursery and maternity units. Emerg Infect Dis [serial on the Internet]. 2005 Jun [date cited]. Available from http://www.cdc.gov/ncidod/EID/vol11no06/04-0885.htm


 * In my opinion, this warning about the emerging risk of CA-MRSA should be included in your medical analysis.


 * If even one death occurs from this cause, it is a doctor-caused death, because there are virtually no medical indications for circumcision.


 * George C. Denniston, MD, MPH
 * President, Doctors Opposing Circumcision
 * Seattle, Washington

Now this I would say perhaps makes DOC's view even clearer, in that they seem to admit that this is a view based merely on possibility (prospective, rather than retrospective). Again reference is made to the Bratu paper, which has been previously discussed at length.

The question I suppose then is would we wish there to be mention of a possiblelink on the article. My initial reaction is a resounding yes. Looking at the evidence presented if a group of professional doctors have raised the issue of a link, then putting it on Wikipedia would not be a breach of WP:NOR. The idea of verifibilty is extremely important, and of course when discussing medicine, esepcially, you could arguably never have truth.

The issue seems to be about what form any mention of any link should be. I would personally say that a mention of a possible link could be justified under Wikipedia's policies, and a link to DOC's website should be provided on the main article (in order for people to make their own minds up about the issue).

Now you may ask on what am I basing my reasoning. If we look at the evidence regarding circumcision there is clearly a debate about its risks. The key piece of research evidence appears to Bratu's paper. My own feeling is that for a proper page on a Medical Analysis of Circumcision you need to reflect the area of current debate. Clearly there is a number of people who have opinions that there is a link. By mentioning this link in the article it would not breach WP:NOR, as it clearly is not original to these contributors.

The point is that we want the article to be as complete as possible, and if there is a section on the page regarding Bratu's paper and the possible link then this can only benefit the site and article.

Science and medicine are constantly evolving and obviously people are also postualting ideas. This is clearly an idea, not a fact, about circumcision: DOC make this clear in their answer to me.

The point is though, that whilst it is only an opinion, it is one of some note. DOC are clearly an organisation, they have a website, they have a reasonably large membership. In order to have a proper analysis of the subject then reference needs to be made to the current debate.

I think the article should make it clear though, that, in the words of Dr. Denniston: The warning is prospective, rather than retrospective

Now, I welcome all your views on my suggestion. I have tried to address the points made, by both sides, and I would hope to see this as a compromise. The article, in my opinion, should make reference to a possible link. This should be made under reference to an analysis of Bratu's paper. The article should also have a link to DOC's page. The article cannot otherwise claim to be an accurate analysis if it fails to take account of a view which may have some basis in fact.

The article should allow people the opportunity to know that there is a debate about the procedure, in the medical sense, and what this debate hinges on. You cannot say that there is no original research but you may well say that this research is of a questionable or poor nature. But the article should still have this evidence included but with the caveat regarding its interpretation.

Now I would welcome all your views on this proposal. --Wisd e n17 23:57, 25 May 2006 (UTC)


 * I'm afraid I disagree. Anyone can start a website and claim to have large numbers of 'professional' members (it's interesting to note that of DOC's published letters to journals, almost all have been written by an attorney and/or a retired airline pilot) and so we must apply the policies. DOC do not, as I've demonstrated, meet the criteria of WP:RS.
 * Yes, DOC have an idea, but the fact is that millions of people have ideas. Some are submitted to journals, reviewed and approved by their peers, and are consequently published. Those are the ones that belong in Wikipedia. Not this.
 * Elsewhere in the article, we have applied our policies, and many possible complications are listed in the article. Every other source in the article, as far as I know, is in a peer-reviewed journal, as is proper for the subject matter. Why make an exception?
 * We must remember that Wikipedia is not a propaganda vehicle. Looking at the alarmist tone of DOC's press releases on the subject, it is hard not to regard their idea as a scare tactic. Whether or not it has merit, it's intended to influence, and that's propaganda by definition. To avoid becoming a vehicle for that propaganda, we must rigorously apply our policies.
 * A possible compromise might be to include a link to DOC's statement in the 'external links' section.
 * Additionally, I'd like to note that original research is that which has not been published in an RS. WP:V makes this quite clear: "Facts, viewpoints, theories, and arguments may only be included in articles if they have already been published by reliable and reputable sources." Jakew 09:34, 26 May 2006 (UTC)

Alienus replies
Wisden17, thanks for taking the step of contacting DOC. My take on this is that there should be some mention of CA-MRSA, since it's clear that actual doctors have considered this risk, so it doesn't run afoul of WP:RS, WP:NOR or WP:V. However, Jake is right in that there has not been an epidemic of CA-MRSA infections in circumcized boys, so we shoud be careful to say that this is a potential risk, not a plague. In short, I think it all comes down to how we explain this, not whether we do. Given what we know, to omit it would be a clear violation of WP:NPOV. Al 04:35, 27 May 2006 (UTC)

Nandesuka's View
The original research policy is one that gives people a lot of heartburn. A typical complaint is that when editors invoke WP:NOR, they are being silly, because the original research is "just common sense!" One question I've been asked repeatedly on this issue is "Are you saying that we can't include logical syllogisms? Are you saying that if I cite a source saying 'All men are mortal' and another source saying 'Socrates is a man' that I can't say 'Socrates is mortal'?"

The policy clearly provides the answer: that's right. You can't say that. Please allow me to include an extended quote (from WP:NOR, emphasis in original):

(begin quote)

Editors often make the mistake of thinking that if A is published by a reliable source, and B is published by a reliable source, then A and B can be joined together in an article in order to advance position C. However, this would be an example of a new synthesis of published material serving to advance a position, and as such it would constitute original research. "A and B, therefore C" is acceptable only if a reliable source has published this argument in relation to the topic of the article.

An example from a Wikipedia article (note that the article is about Jones, not about plagiarism in general):

"Smith says that Jones committed plagiarism in Jones's Flower-Arranging: The Real Story by copying references from another book. Jones denies this, saying he is guilty only of good scholarly practice because he gave citations for the references he had learned about in the other book."

So far, so good. Now comes the new synthesis of published material:

"If Jones's claim that he always consulted the original sources is false, this would be contrary to the practice recommended in the Chicago Manual of Style as well as Harvard's student writing manual, both of which require citation of the source actually consulted. Neither manual calls violations of this rule on citing original sources 'plagiarism.' Instead, plagiarism is defined as using a source's information, ideas, words, or structure without citing them."

This entire paragraph is original research, because it is the editor's own synthesis of published material serving to advance his definition and opinion of plagiarism and whether Jones committed it. The editor is citing good sources about best practice (Chicago Manual of Style and Harvard's student writing manual). In an article about plagiarism, some of the points he makes might be acceptable, so long as he provided links or citations to the sources.

But in an article about Jones, the paragraph is putting forward the editor's opinion that, given a certain definition of plagiarism, Jones did not commit it. Regardless of the fact that his opinion appears to be supported, other things being equal, by the Chicago Manual of Style, it remains the editor's opinion.

For this paragraph to be acceptable in the article about Jones, the editor would have to find a reliable source who had commented on the Smith and Jones dispute and who had himself made the point that: "If Jones's claim that he always consulted the original sources is false, this would be contrary to the practice recommended in the Chicago Manual of Style..." and so on. That is, that precise argument, or combination of material, must have been published by a reliable source in the context of the topic the article is about.

(end quote)

It's my position that this is perfectly apposite to what has been done with MRSA on this article. There is no scholarly evidence &mdash; none whatsoever &mdash; that MRSA is associated with circumcision. So, a bunch of quotes about MRSA and MSSA are being strung together to create the impression that there is a link (eg, ) This is in support of a personal belief of the authors, and is the very definition of original research. Superdix himself acknowledges, implicitly, that Bratu is not discussing circumcision. In other words, Bratu is not talking about MRSA in the context of the topic the article is about. Applying his work to this topic is, therefore, original research, just as surely as the "Chicago Manual of Style" example given on the WP:NOR page is.

Also relevant here is the the concept of "undue weight" from WP:NPOV. Jimbo gave us a specific formulation that I find to be both concise and useful:

''None of this is to say that tiny-minority views cannot receive as much attention as we can give them on pages specifically devoted to them. Wikipedia is not paper. But even on such pages, though a view may be spelled out in great detail, it should not be represented as the truth. The inclusion of a view that is held only by a tiny minority may constitute original research because there may be a lack of sufficiently credible, third-party, published sources to back it up.''


 * If a viewpoint is in the majority, then it should be easy to substantiate it with reference to commonly accepted reference texts;


 * If a viewpoint is held by a significant minority, then it should be easy to name prominent adherents;


 * If a viewpoint is held by an extremely small (or vastly limited) minority, it doesn't belong in Wikipedia (except perhaps in some ancillary article) regardless of whether it's true or not; and regardless of whether you can prove it or not.

While i believe that there may be some appropriate way to incorporate DOC's fringe belief that circumcision causes facilitates the transmission of MRSA, that really isn't the central issue, and never has been. The issue is the attempt on the parts of some editors to use confusing writing and selective quotations from other publications to represent that fringe belief as the truth.

So. I'd like to propose that we try to answer the following questions about the DOC link. Does the DOC opinion that circumcision causes facilitates the transmission of MRSA constitute a significant minority, or an extremely small minority? (I am dismissing "majority" out of hand for the obvious reasons) If the former, a properly worded addition indicating that some believe yadda yadda may be appropriate. Evidence for this being a "significant minority view" might be other scholarly sources that make the link or claim to believe in a link (and in fact, maybe we can find a reliable source, which would let us avoid using the propaganda link at all.) If DOC consititutes "a vast minority", then the link is inappropriate, as it constitutes a violation of both WP:NOR and WP:NPOV, which are not really issues to be negotiated. I will propose that if the DOC link is the only direct statement we have, than it is by definition a "extremely small minority."

Hope that helps, Nandesuka 12:09, 26 May 2006 (UTC)
 * Nandesuka said "the DOC opinion that circumcision causes MRSA" No, DOC's opinion is that circumcision facilitates the transmission of MRSA - a far weaker claim. --Hugh7 04:19, 27 May 2006 (UTC)
 * Thanks for the correction. I've updated my paragraph, since the same logic still applies. Nandesuka 11:37, 27 May 2006 (UTC)


 * It's my view that you, Jake and Jay are misunderstanding Wikipedia rules, with the unfortunate result of raising the bar arbitrarily high when it comes to facts that happen not to fit your POV. I'm really not interested in Wikilawyering over this.  If the rules really say we can't mention something that's been revealed in press releases and studied clinically, then the rules are mistaken and we need to WP:IAR. Al 04:38, 27 May 2006 (UTC)


 * P.S.
 * And while this is happening, Nandesuka is edit-warring to remove the POV tag from Circumcision. This speaks for itself. Al 18:31, 27 May 2006 (UTC)
 * He's edit warring all by himself? Jakew 19:05, 27 May 2006 (UTC)


 * The hidden but false premise in your argument is that everyone involved in an edit war is equally guilty. In fact, it is against Wikipedia rules to summarily remove a POV tag, yet Nandesuka is happy to break that rule. Thank you for understanding the subtle distinction between cops and robbers. Al 19:08, 27 May 2006 (UTC)
 * This mediation isn't about that article, so I won't argue here. If this is to have a hope of succeeding, it might help if you were to present it as "N and I are currently involved in an edit war concerning..." Jakew 19:13, 27 May 2006 (UTC)


 * That would make sense, if only circumcision weren't the parent article to medical analysis of circumcision. And yet it is. Al 19:57, 27 May 2006 (UTC)


 * I had explained in detail why the tag was removed in the proper place. Since that discussion is only tangentially related to this discussion, I won't get into it unless the mediator so desires.  Nandesuka 19:35, 27 May 2006 (UTC)


 * Your explanation was unacceptable, hence the return of the tag. Al 19:57, 27 May 2006 (UTC)


 * I'm afraid your interpretation of my statement is wrong, Nandesuka. My point, in providing the Alberts citation, is that you cannot escape the fact that medical journals are written by medical professionals to be read by their peers. You simply cannot ignore this utterly basic nature of scientific articles. They're meant to be read and understood by medical professionals, to whom any cut in the skin constitutes an increased risk for any infection. There is no original research in using the Bratu reference, because the umbrella term invasive or surgical procedures includes circumcision.
 * As for DOC, I would like to point out that they are in fact doctors, which tends to get overlooked here. Yes, they do have a stated mission -- to eradicate routine neonatal circumcision -- but that doesn't mean they're not doctors, or professionals, or both. Superdix 23:04, 27 May 2006 (UTC)
 * Superdix, please review the policy. Original research is any interpretation, synthesis, etc that has not previously appeared in WP:RS. That is precisely what you're doing. You seem to be arguing that it's not original research because it is/should be obvious, but policy does not make such an exception.
 * According to Marilyn Milos, Denniston created and named DOC in order to give activists more credibility. It's true that DOC have at least two doctor members, but it's erroneous to state that they're all doctors, or even professionals in the field. George Hill, their "Vice President for Bioethics and Medical Science" is a retired airline pilot, which must surely raise an eyebrow. It seems somewhat pointless to discuss, since whatever their qualifications, they must still meet the requirements of WP:RS in order to be cited. Jakew 11:09, 28 May 2006 (UTC)

So what you're saying is that at least two doctors endorse this press release about CA-MRSA risk but you know better than they do? Please help me understand. Al 21:00, 28 May 2006 (UTC)
 * Technically, we don't know if any doctors endorse other than Denniston the release, or even whether the (unknown) author is medically qualified. We don't know their internal procedures, and have no idea who must endorse a release before it goes out to the public.
 * Nor am I saying that I know better. There's not much point discussing my opinion, since NOR forbids me from inserting it into articles.
 * What I am saying is that their release does not qualify as a reliable source, according to our policy. And because it hasn't appeared in an RS, we can't repeat their argument without performing OR.
 * However, in the event that they publish their hypothesis in a peer-reviewed journal, I have no objection to its (appropriately worded) inclusion, because it would then conform to policy.
 * I hope that helps. Jakew 21:16, 28 May 2006 (UTC)

A review of the thoughts - so far
This mediation has clearly got started. We have now got input from a number of parties.

Let me take the issues raised so far, and offer ways forward in discussing them.


 * 1) I'll take DOC to start. I've contacted Dr. Denniston again to find out about membership numbers and the number of qualified doctors it has in that membership, as this seems to be an issue which can easily be resolved with a few simply facts (whatever they may show).
 * 2) Next, there has been mention of the removal of the POV tag from the Circumcision page, and I would ask that any further edits to clearly relevant pages are left until after this mediation. I can understand the logic behind the removal, with regard to the inteniton and design of POV tags. However, I think that common-sense may have suggested that the timing of such a removal was not brilliant. And so I ask that all involved parties do not edit relevant pages to this mediation (which the Circumcision page clearly is) until the resolution of this RfM.
 * 3) Turning to the issue of debate and elaborating on points above. The main area of contention seems to be regarding how to apply Wikipedia's policies to this situation. Now there are several ways of looking at ways forward. Option 1: mention a possible link, but without any source. Option 2: mention a possible link and use DOC as a source. Option 3: mention a possible link, and use DOC and Bratu's research as supporting material.
 * 1) Next, there has been mention of the removal of the POV tag from the Circumcision page, and I would ask that any further edits to clearly relevant pages are left until after this mediation. I can understand the logic behind the removal, with regard to the inteniton and design of POV tags. However, I think that common-sense may have suggested that the timing of such a removal was not brilliant. And so I ask that all involved parties do not edit relevant pages to this mediation (which the Circumcision page clearly is) until the resolution of this RfM.
 * 2) Turning to the issue of debate and elaborating on points above. The main area of contention seems to be regarding how to apply Wikipedia's policies to this situation. Now there are several ways of looking at ways forward. Option 1: mention a possible link, but without any source. Option 2: mention a possible link and use DOC as a source. Option 3: mention a possible link, and use DOC and Bratu's research as supporting material.
 * 1) Turning to the issue of debate and elaborating on points above. The main area of contention seems to be regarding how to apply Wikipedia's policies to this situation. Now there are several ways of looking at ways forward. Option 1: mention a possible link, but without any source. Option 2: mention a possible link and use DOC as a source. Option 3: mention a possible link, and use DOC and Bratu's research as supporting material.

Looking at the three options it would appear none is ideal. There may well be a link but there does not at the present time appear to be a reliable source which shows that link.

Saying that, if DOC get back to me with membership figures that represent a large number of doctors then this view may need to be revised slightly.

I suggest that we await DOC's response, and also that we continue further discussion on the issue here. I would be interested to know on what basis you would argue that you can add the views of DOC to this article, when even they admit that warning is prospective, rather than retrospective, meaning that any evidence will be purely 'guesswork' (for want of a better word).

Also I would welcome people's views on the suggestion of adding a link to the DOC's page under external links section, in order that people can look at all sides of the debate for themselves (without having to bear in mind Wikipedia's policies).

My next suggestion is that some of you may like to look at debating the content of Wikipedia's policies, in the relevant places, as some of you clearly seem a bit disillusioned by them. All of Wikipedia's policies are open to change and debate, indeed they may well need it. Wikipedia is run by the community and so the community have a say in its policies. If you feel that they need chaning then propose revisions to them and let the community comment on them.

Another point is that you may wish to look at this pageand try to get evidence to support a claim via that route.

Essentially we need to discuss what the best way to include a reference to a view that there is a link would be. So should it be a mention in the artilce, or link?

Two other points need to be considered, as the mediation was not only about a possible link being mentioned in the article.

Additionally the RfM mentioned:


 * An RFA has been used to remove one anti-circ user already and a new one is on the way to remove another. Is this in good faith or a sign of abuse?
 * In general, is there a group of people acting as a unit so as to intimidate new editors, impose their POV and own the article?

I don't really wish to discuss RfA's as I feel that the specific arbitration hearing is the place to do such a thing.

The second point, though, may be worth discussing. I think the problem boils down to how to implement Wikipedia's policies, but also do so in a manner which does not insult or offend other people. From looking at the evidence I cannot see that there is a group that seem to 'own' the article, but that there is a group that seem keen to ensure that the article is as accurate as pssible and conforms to Wikipedia policies and guidelines.

A common problem with Wikipedia is to do with its policies and not with its editors. The issue in this case may well be to do with WP:NOR. If this is indeed the case, I have said above that you may wish to look at proposing changes to that policy and awaiting the community's view.

I look forward to reading you views to the questions presented above. --Wisd e n17 16:36, 28 May 2006 (UTC)

Alienus's view

 * 1) The party line by Jakew, Nandesuka and Jayjg has been to remove all mention of CA-MRSA. I'm arguing that, as per your three options, we make some mention of CA-MRSA as a possible risk in circumcision, clearly citing the source so that people can decide for themselves just how credible it is.  In other words, I don't think that decision is up to us.  Last time I checked, none of these three pro-circ activists are doctors.
 * 2) I really don't know the precise number of doctors in DOC, and I'm not sure that it matters for our purposes. To avoid WP:OR, what matters is that at least one doctor has done the synthesis, and we're just reporting it.  Now, if someone thinks DOC is not sufficiently reliable, they're free to cite sources that contradict them, but not free to remove all mention of what they said.
 * 3) A key issue is how credible DOC's claim of a CA-MRSA risk is. In other words, is it obviously nonsensical?  Well, we know that it's based on their original research, synthesizing two facts: CA-MRSA infects open wounds in a medical setting and circumcision creates such wounds.  Note that neither of these two facts is at all controversial, and while we are not permitted to synthesize them here, nothing prevents DOC from doing so.  We also know that two or more doctors came up with this and that their press release was widely distributed.  In short, it appears that the claim, while perhaps false, is at least credible.
 * 4) My problem is not with Wikipedia policies but with biased misinterpretation by self-style wikilawyers. The purpose of rules like WP:OR, WP:RS and WP:NPOV is to make the articles better, not to eliminate all mention of opposing views.
 * 5) The removal of one anti-circ editor and the targeting of others is not something I can ignore. If you won't deal with it, fine; I'll go elsewhere. Al 21:39, 28 May 2006 (UTC)

Response by Nandesuka

 * I've told you before that I find your description of me as a "pro-circ activist" to be not merely untrue, but incivil. That you would repeat this baseless charge in mediation speaks volumes.  Nandesuka 21:48, 28 May 2006 (UTC)

Response by Alienus
That's fascinating, but fails to address any of the issues I brought up, so it's hardly productive. Speaking of issues, I was amused by some text recently added to Talk:Medical_analysis_of_circumcision (search for "Did we read the same article? ") by a guy calling himself User:Tzaddik. A quick google confirmed the meaning of his nick, which pretty much told me in advance what his view was.

Anyhow, the text was trying to praise the neutrality of the article, but managed to do quite the opposite, with such unintentional humor as: "It left me a slanted conclusion... pro circumcision; which seems to be the correct one, given my understanding of the different studies and data quoted. In fact, although my mind was made up from the start, the article kept me guessing throughout the read, as to where the data would lead." I don't know whether to laugh or cry. Al 00:34, 29 May 2006 (UTC)

Response by Jakew

 * The issues you bring up are the result of misunderstanding Wikipedia policies, or perhaps thinking that they say what you think they ought to say. Policy does not state that something may be included if at least one doctor has stated it, it requires that the statement has been made in reliable sources. If has not, it should not be included. You argue that we're not free to remove all mention, but WP:RS states: "bear in mind that edits for which no reliable references are provided may be removed by any editor."
 * We cannot build a credible encyclopaedia by including anything and everything that someone, somewhere has stated on a web page. We must select the wheat from the chaff. That is our role, our decision, and contrary to your claim that it is not up to us, WP:RS actually requires us to do it.
 * The issue of credibility only comes into play (and then only minimally) when a reliable source has been provided.
 * Finally, I must agree with Nandesuka. Please concentrate on the issues rather than slinging insults about. Jakew 09:55, 29 May 2006 (UTC)

Response by Alienus
First of all, your consistent assumption of bad faith does not constitute an insult on my part. Second, your beliefs about Wikipedia policies do not have much bearing on the truth. Third, if you have nothing to say about the matters brought up in this RfM, please do not fill up this page with irrelevancies. I urge you to put aside your squabbling and personal attacks so that you can be productive. Al 17:49, 29 May 2006 (UTC)

Response by Jakew
Unfortunately, Wisden, it seems that DOC's policy prevents them from giving any verifiable information about their membership:
 * We do not disclose our membership list in order to protect our members from economic pressure by those in the medical community who want to preserve an entrenched but outmoded surgical procedure. We speak for those members.

I would not be opposed to including an 'external link' to DOC's hypothesis, as long as the wording is suitable (something like "statement proposing a possible link between circumcision and MRSA, from Doctors Opposing Circumcision"). However, until such time as mention is made in a reliable source, I can't see any way of including it in the article itself in a way that conforms to policy.

While I personally feel that policy is working well on the whole, I would certainly endorse your suggestion of raising objections to policy at the relevant pages. Jakew 17:53, 28 May 2006 (UTC)

A question of policies
The issue that seems to be causing contention is the intent behind the three relevant Wikipedia policies. Alienus, you seem to suggest that because DOC have suggested a possible link that this provides a reliable source, and that it provides evidence of synthesis. However, I feel I must ask you to look again at WP:RS, and WP:NOR. The following phrase is key:

Reputable publications include peer-reviewed journals, books published by a known academic publishing house or university press, and divisions of a general publisher which have a good reputation for scholarly publications.

Does a report by DOC, meet that requirement: no. Does the Bratu report meet that requirement: yes. But the problem with Bratu's report relates to the question of synthesis, and whilst there has been synthesis performed by DOC in their report this report does not meet with the above requirement.

I would ask again that we try to keep this mediation as civil as possible. Obviously when edit conflicts arise it can lead to quite strong emotions, especially when people delete your edits. However we will get nowhere in this mediation if we cannot remain civil.

With regard to the question of RfAs and the related matters this is not the place to discuss them. The RfA is that place, and you should present any evidence you have regarding these issues there, and if necessary you could contact Jimboif you feel that the RfA has been unjust in any way.

Now looking forwards towards a possible solution. What are your views on there being a link to the DOC page in the external links, with a description along the lines of:

A site with information from an anti-circumcision group, who postulate a possible link between circumcision and CA-MRSA.

Obviously that description is not perfect, but how about something along those lines; what are your thoughts? --Wisd e n17


 * That phrasing works for me. Nandesuka 20:45, 29 May 2006 (UTC)

The problem is that it makes DOC look like a one-trick pony. In fact, CA-MRSA is only one of the issues they're concerned about. There should definitely be a link to DOC, but it should be described more generally, as an anti-circumcision medical advocacy group.

Now, if we wanted to link directly to the page on the DOC site that has their statement on CA-MRSA, that would be a different matter.

In any case, I do not see an synthesis problem with the Bratu source. There is no synthesis in noting that circumcision involves cutting; it's part of the definition. If anything, it would be OR on our part to reinterpret it so as to somehow exclude circumcision. In other words, Bratu suffices even if DOC is problematic.Al 21:18, 29 May 2006 (UTC)


 * Whether or not any given surgical procedure is invasive enough to cause an elevated risk of MSRA is, in fact, a medical judgment; a judgment that Wikipedia editors are not qualified to make (as a matter of policy, entirely apart from the matters of fact). To use reductio ad absurdum, one could point out that taking a blood count via a prick is "cutting" or "invasive" by some definition, and therefore we need to make sure that the Blood test article has a reference to Bratu.  There are three problems with your failure to see a synthesis problem with claiming that the Bratu source claims that circumcision is a risk factor for MRSA.  The first and most obvious problem is that Bratu doesn't say that, and so right off the bat we are beyond the bounds of WP:NOR.  Second,  you are proposing we take a term of art &mdash; "surgical or invasive procedure" &mdash; and apply a commonsense meaning to it.  This is unwise, particularly since neonates, particularly sick ones, undergo many surgical procedures that are far more invasive than circumcision.  Lastly, if you actually read Bratu's paper, it becomes apparent that DOC is taking a single item out of a laundry list of much more significant risk factors (premature birth, low birth weight, prolonged hospital stay, and prolonged exposure to antimicrobial agents -- I say these are "more significant" because Bratu's references so designate them), then their agenda is clear.   It is surely DOC's prerogative to play fast and loose with the evidence if that's how they choose to conduct themselves.  It is not Wikipedia's mission, however, to perform the same sort of synthesis in support of a political agenda, or indeed for any reason whatsoever.
 * It may very well be that someday a reliable source will perform research which shows that circumcision is a risk factor for MRSA. When they do, we should update the article to reflect that.  Until such time, it's my opinion that presenting that idea as fact is thoroughly inappropriate.
 * On a related note, I don't see how the description proposed by Wisden implies that DOC does not have opinions on other issues. Perhaps you could explain it better so that I understand.  Nandesuka 22:54, 29 May 2006 (UTC)


 * Well if we are talking about improving the description of the link how about:

A site with information from an anti-circumcision group, who, amongst other things, postulate a possible link between circumcision and CA-MRSA.


 * On a further point, Alienus do you take Nandesuka's point regarding how one could extend your logic? I think the issue with relation to this case is a 'rpoblem' with Wikipedia policy, which I have already mention may well be worth discussing in the relevant places. To that end, Alienus would you not see an external link to DOC, with a description, alon gthe lines, of the revised one above as a suitable compromise? --Wisd e n17 23:12, 29 May 2006 (UTC)


 * Personally, I would be happy with this description. As I suggested above, though, it might be better to link directly to DOC's statement. This would make the page the focus, rather than DOC themselves, which should avoid the situation that Alienus is concerned about. Jakew 15:15, 30 May 2006 (UTC)

Actually, I didn't even bother responding to his example because it's so obviously flawed. It would require a combination of medical ignorance and outright malice to arrive at his conclusions. In short, he proves my point for me.

Once again, there are two places for DOC in this article. The first is as a generic external link, the second is in specific mention of CA-MRSA. I don't see how these can be combined. Al 03:01, 30 May 2006 (UTC)
 * I agree that my example is obviously flawed. That's exactly why it's called reductio ad absurdum.  "If I use your reasoning, I arrive at this ridiculous result.  Therefore, your premise is false." The premise I was analyzing is your statement that since circumcision involves "cutting", it is not synthesis to claim that Bratu's article states that circumcision causes MRSA.  That premise, as I have demonstrated, is flawed. Nandesuka 03:29, 30 May 2006 (UTC)
 * Even if it were not flawed, it would still be forbidden by policy. Jakew 15:15, 30 May 2006 (UTC)
 * Before presenting your demands 'once again', it would be helpful if you would address the issues that others have raised. Specifically, specific mention of MRSA cannot go into the main text of the article because DOC do not meet the criteria of RS, and Bratu cannot be included without OR. The relevant sections of these policies have been quoted to you, so please could you explain how we 'misunderstand' them? Is it because a) the quoted sections do not exist, or b) we misunderstand them by taking to mean what they say? Please restrict your answer to what policy actually says, rather than what you think it ought to say.
 * If you cannot address these issues, then you are demanding the inclusion of text that is forbidden by policy. It is long overdue for you to address this issue. Jakew 15:15, 30 May 2006 (UTC)

It looks like you're suggesting that DOC get two links at the bottom, one to the home page and the other to the CA-MRSA page. I'm not sure that this is a particularly good idea, though. Al 19:08, 30 May 2006 (UTC)
 * There are four possibilities that are compatible with policy:
 * Add a link to DOC's MRSA hypothesis.
 * Modify the link description of DOC to note their MRSA hypothesis.
 * Replace the link to DOC with a link to their MRSA page.
 * Omit mention of DOC's MRSA hypothesis altogether.
 * As long a link descriptions are neutral and accurate, I'm happy with any of these options. Personally, I don't think that we need to make particular note of every web page out there, so the last would be my preference, but either of the first three seem a reasonable compromise. Which would you prefer? Jakew 19:51, 30 May 2006 (UTC)

Compatible with your view of policy, anyhow. I'm sure you'd love to Omit mention of CA-MRSA, as that has been your stated goal all along. However, that is not a reasonable choice. Likewise, neither Add, Modify nor Replace are acceptable. As I pointed out earlier, there are really two separate things to link to: the site in general and the CA-MRSA page in specific. However, it seems awkward to place them both at the bottom as external links. Al 19:55, 30 May 2006 (UTC)


 * If you wish to suggest that my 'view' of policy is incorrect, you need to explain how it is incorrect. Until you do so, the explanations of policy and how it applies that have been provided must be used. To repeat my earlier question: Is it because a) the quoted sections do not exist, or b) we misunderstand them by taking to mean what they say? Please restrict your answer to what policy actually says, rather than what you think it ought to say.
 * Do you intend to answer this? I'd appreciate a straightforward answer. If you don't, I suggest dropping the issue from this mediation, and moving onto remaining issues. Going around in circles wastes everybody's time. Jakew 20:48, 30 May 2006 (UTC)

I believe I've already explained, though it turns out that we disagree. Al 21:10, 30 May 2006 (UTC)
 * I'm sure it's an oversight on my part, but I don't see where you explained how the understanding of policy Jakew and I have is wrong.  Can you please point it out to me?  Thanks.  Nandesuka 21:40, 30 May 2006 (UTC)

Jayjg's view
The main issue here has been outlined fairly succinctly. The problem with trying to make a specific connection between CA-MRSA and circumcision is that there are no reliable sources which make this connection, and so the attempt to link the two in any specific way is original research. As Jakew has clearly shown, the one source trying to make this connection is almost the epitome of what Wikipedia considers a non-reliable source.

This issue is compounded by the fact that some of the editors trying to make this link are inexperienced an unfamiliar with policy. Even worse, the one editor who is somewhat more experienced has developed an intractable bad faith attitude towards Jakew, Nandesuka, and me. This is evidenced by, for example, his continual use of the term "pro-circumcision advocates" to describe Nandesuka and me, even though we've patiently explained we are not. As well, in a "pre-emptive" move he has put a notice on his Talk page stating that anything we post there will be reverted. It's even gotten to the point where he's accused me of "vote stacking" (which, to his credit, he retracted), but then, rather hypocritically, attempted to vote stack himself, on an topic in which I am quite interested but in which he has heretofore evinced no interest. So, in the end, what should have been a very simple decision to exclude the original research, based on policy, has become a protracted battle based on personal animosity. Jayjg (talk) 21:58, 30 May 2006 (UTC)


 * It's interesting that you accuse me of violating WP:AGF when I made a reasonable error and corrected it quickly. What's worse is that you now accuse me of vote-stacking because I brought up a censorship issue on "Wikiproject Wikipedians against censorship", of all places, and didn't call for anyone to join the vote.  Of course, this false accusation is itself a breach of WP:AGF, which puts you in a rather interesting position.
 * The reason I remove anything you three post on my talk page is that it's become painfully clear that none of you are willing to work productively with me. This is a case in point. I'm really not interested in discussing this with you unless a moderator can reign in your tendencies towards countproductive speech. Al 23:15, 30 May 2006 (UTC)

See above for further examples of the problem. Jayjg (talk) 23:19, 30 May 2006 (UTC)

I think that whilst both of you make interesting points it does little to help us achieve a consensus. It seems obvious to me that this article has produced a good level of debate, which should be encouraged as it shows dedication to making Wikipedia as comprehensive as possible. However, we must make sure that debate does not turn into insult and that we keep the arguments to facts as opposed to opinions, and that we should AGF.

I would ask both of you to look at a way forward to reach a consensus. Alienus you do not seem overly keen on my proposal so what do you suggest exactly? Do you think that a link should be provided in addition to information in the main-page, if so what would be the wording you would like to see of any text? Jayjg, do you feel a link to DOC is an acceptable compromise? --Wisd e n17 23:26, 30 May 2006 (UTC)


 * That's a correct summation. I think the best solution is to briefly mention CA-MRSA in the article body, linking to the appropriate sub-page on the DOC site, and whatever other citations we have.  We can then leave the link to the home page down below among the other external links. Al 23:30, 30 May 2006 (UTC)

Something for you all to look at
Dr. Dennison has sent me the link to an interesting article (I note he made no answer to my request for membership numbers!). I would suggest you all take a look at it, whilst it clearly does not meet any of the Wikipedia guidelines for a RS etc. it may well be worth considering linking to the page as a further example of empirical evidence. --Wisd e n17 23:26, 30 May 2006 (UTC)


 * It looks like a reprint of a Newsday article. Now, while Newsday's not exactly the Washington Post, it's also not the National Enquirer, so why do you say it's not a WP:RS? Al 23:30, 30 May 2006 (UTC)


 * Sorry I should have been more clear. In the context of this article and what the Newsday story is suggesting it would not be acceptable to simply use that as the basis for any inclusion of there being evidence for a link between circumcision and CA-MRSA. For such a link to be made peer-reviewed scientific work would be needed, which specifically addressed this issue. However, the Newsday article is interesting as empirical evidence and there may be a case for including it in the external links section. I would welcome people's thoughts. --Wisd e n17 00:05, 31 May 2006 (UTC)


 * I'm beginning to wonder if we need a rule for No Original Desynthesis. We have one source saying there's a link, but you won't allow it because they're an activist group.  We have a newspaper offering incidents that strongly suggest a link, but you won't allow it because it's not a medical study.  We have a medical study that admits that any cutting is linked, but you won't allow it because it expects doctors to know that circumcision involves cutting.  We have a site that mentions all three pages, but you won't all that because, once again, the site is considered partisan, even though it includes the opinions of doctors.  We could point out the links ourselves, but you won't allow that because it would be original research (even though, in fact, it's not at all original). Round and round we go... to extraordinary lengths to avoid mentioning the obvious.
 * I'm sorry, but I find this ridiculous. We have verifiable facts here and yet there is opposition.  I can't explain it while simultaneously assuming good faith, so I'm just going to throw my hands in the air. Either you are misunderstanding the rules or the rules do not apply here. Al 00:11, 31 May 2006 (UTC)


 * I can understand your frustration at the situation as you see it. However I think you put it quite simply when you look at the three pieces of evidence. Now my reading of the situation is that as it stands you do not have any evidence which meets Wikipedia's guidelines and policies for inclusion. Now, once again, it appears that your main problem lies with what Wikipedia policy is. YOu may well be not the only editor to have a problem with this particular policy (or in this case perahps policies). I would suggest then that you look at coming up with some proposals of how to amend the current policies and look to the Wikipedia Community to get their view on any changes you may have.


 * Now I'd like to hear what the other parties invovled in this case feel but I would suggest that the best way forward is: the inclusion of two external links, namely to DOC and to this Newsday article; and for Alienus to look at ways that he feels current Wikipedia policy should be amended, and look to pursue this in the relevant way. --Wisd e n17 00:21, 31 May 2006 (UTC)

Actually, I don't think that Wikipedia policy is the problem. My conclusion is that there is a misunderstanding of policy that is being used to prevent the inclusion of what is obviously neither original nor unverifiable. Reasonable people can disagree. Al 00:33, 31 May 2006 (UTC)


 * My opinion is that the DOC statement at least asserts the matter under discussion. That is to say, the DOC link makes the assertion -- whether or not I disagree with it -- that circumcision is linked to MRSA.  The Newsday article, contrariwise, makes no such connection; rather, it has one phrase, highlighted by a third party which is, essentially, the sound of a dog not barking.  Since DOC is making the claim, it's fine for us to link to them in a properly-worded manner.  Since Newsweek is not making the claim, it's inappropriate for us to be making that link in the article (just as it would be inappropriate for us to link to it from, say, the article on Male &mdash; "100% of the infants that died of MRSA at this hospital were boys!.")
 * Incidentally, the DOC statement uses the Newsday article as a reference. So anyone who wishes to find it can find it there.  When Newsday publishes an article that links circumcision and MRSA, we should link to it &mdash; but this Newsday article doesn't actually do that.  DOC is free to believe that it does, and make synthetic statements to that effect.  We are not. Nandesuka 00:57, 31 May 2006 (UTC)
 * I agree. That news report refers to three babies and two mothers who were infected. The article noted, in passing, that all three babies were circumcised, but went on to note that the infection occurred elsewhere. One could use this as evidence for or against DOC's hypothesis, but since the article itself made no further mention of it, and concluded nothing, it seems inappropriate to link to it. Jakew 09:50, 31 May 2006 (UTC)


 * I'd also point out that, when reasonable people disagree, they present their reasoning. Indeed, a good test of whether someone is indeed being reasonable is whether they address reasoned arguments raised by others, or simply wave their hands and say 'you're wrong'.


 * For the last time, Alienus, do you intend to address my question or not? Jakew 09:50, 31 May 2006 (UTC)


 * I'm in the middle of my exams so please excuse me for being absent. Here are some thoughts of mine:
 * Medicine isn't an absolute science. Multifactorial disease and psychosomatic disorders are just two examples. I'm not going to claim a link between MRSA and circumcision with basis in the Newsday article, but the fact that the babies were circumcised cannot be ignored. It is a 'potential' factor, illustrated in the Zafar article: "Of particular interest was the fact that all 22 infected neonates were male and all but two were circumcised." While they do not claim any statistical significance for this claim, it is presented in a peer-reviewed journal and the observation is noted as of particular interest. This is in part the way medicine works: isolate the potential risk factors, then avoid them, until they are disproven as risks.
 * This article tries extremely hard to cover every aspect of circumcision, probably as a result of two factions editing it. This fact warrants the mention of any potential elevated risk or benefit, no matter how small. Superdix 14:53, 31 May 2006 (UTC)


 * The trouble with including Zafar's study is that they didn't identify it as a potential risk factor. Indeed, they explicitly stated that no conclusions could be drawn: "In our study, however, none of the MRSA infections were at the circumcision site, although many were in the genital region. No conclusions could be drawn to explain the fact that only male infants were infected with MRSA in this outbreak."
 * True, they did state that it was of interest, but the article is not list of things relating to circumcision that have been identified as 'interesting'. It's about medical aspects of circumcision, and again, Zafar did not identify MRSA as a risk factor, nor even speculate that it might be. Thus, NOR prevents us from doing so.
 * Once again, if you can find an RS that does identify MRSA as a risk of circumcision, then by all means include it. But this isn't it. Jakew 17:53, 31 May 2006 (UTC)


 * I don't think you quite caught my point. I did not claim the link on the basis on the Newsday source, nor on the basis of the Zafar study. What I'm trying to get at here is the big picture (Zafar also mentions previous articles that speculated that the circumcision site may be particularly susceptible to bacterial growth). All of these point in the direction of a possible link between MRSA and circumcision. Perhaps something useful can come from this mediation the moment everyone can assert that a potential risk exists.
 * Please, Jake, put down your policy shield for a couple of days and let's debate the issue at hand instead of dismissing everything firsthand in the role of prosecutor, juror and judge at the same time. Superdix 21:25, 31 May 2006 (UTC)


 * Superdix: so you're suggesting that if we take the various pieces of the puzzle and put them together, they combine to suggest that circumcision is linked to MRSA? I can certainly believe that that is a valid interpretation.  But, at the same time, that's almost the dictionary definition of "synthesis". Nandesuka 22:06, 31 May 2006 (UTC)


 * Superdix, the issue here is policy; these pages aren't for debating the "truth" about circumcision, they're about deciding whether edits meet Wikipedia's content policies. Jayjg (talk) 22:10, 31 May 2006 (UTC)


 * And here I was, thinking our ultimate goal was to make a better article, not to find a way to push our separate POVs through Wikipedia policies. Again, I remind you that a policy is just a policy, and not an interpretation of it. Interpretation is subjective, which is why I asked that we discuss the issue for once without constantly denying every trace of information linking MRSA to circumcision by quoting a policy. Please remember, we're talking about potential and prospective risks. That's about as vague as it gets. Let people make up their own mind instead of us trying to do it for them.
 * We can assert here, on the talk page that a potential risk exists. That would be a milestone. Then we could decide on how to best present this information to the public. Superdix 06:48, 1 June 2006 (UTC)


 * Superdix, the point of policy is to ensure that articles are of a high quality. In this particular case, they ensure that we provide reliable, established, widely accepted facts (RS), and that we do not invent/discover/etc new ones (NOR).
 * The obvious reason for that is that Wikipedia should itself be credible and reliable. We're not at the 'cutting edge' of medical research - that's for the journals. We just summarise the existing knowledge.
 * Now, in this case, any possible association between MRSA and circumcision is not an established, widely accepted fact. It isn't even mentioned once in a peer-reviewed journal. That in itself should tell us that it does not belong here. Jakew 09:38, 1 June 2006 (UTC)


 * Once again you refuse to discuss the issue on any other terms than regarding the policies. If you ever wonder why some people feel you are a pro-circ pushing your POV, this is probably the reason. Discrediting DOC on the basis of some members' previous jobs is another -- Mr. Denniston has been published in several reputable peer-reviewed journals and there is no reason to assume bad faith in his correspondence. I'm curious: do you or do you not believe there exists a possible link between MRSA and circumcision? Superdix 10:21, 1 June 2006 (UTC)
 * One cannot discuss whether or not material belongs in an article expect in reference to Wikipedia's content policies. This is fundamental; Wikipedia only includes information that conforms with its policies. That is what this whole mediation is about, and it is impossible to make the determination on any other grounds.  Material which contravenes policy cannot be included. Jayjg (talk) 17:05, 1 June 2006 (UTC)


 * Dude, the reason I asked that people look beyond the policies on the talk page for just a day or two was that we might better understand each others viewpoints. Again, a policy is just a policy. By applying any policy to any issue you are making a subjective decision. Therefore, some real communication beyond constantly interpreting policy would be a good idea -- perhaps people from different viewpoints could even appreciate that the "other" faction is in fact trying to improve the article. Superdix 19:02, 1 June 2006 (UTC)

The issue here is again, I feel a misunderstanding of the nature and use of Wikipedia's policy. POVs can easily be imagined out of following correct Wikipedia policy. There is no RS of a link and so to include it would be wrong. Wikipedia is not meant to be a reference site without any guidelines or policies on its information. I can understand the frustration that some of you have with the feeling that the article should take all possible steps to ensure that people are aware of the full picture. However, as it stands with Wikipedia's policy you cannot include reference to a link, as it would constitute OR. The policy seems to be where the disagreement lies. And I should reiterate that whilst the RS is only a guideline it is one that needs to be followed in relation to this article, as otherwise no agreeable solution will be found.

We need to look at what that solution should be. A number of possibilities have been presented below. I've decided to make it clear what solution we are working towards. A number of alternatives have been presented and meet with justifiable resistance, based on Wikipedia's policies and guidelines. So I ask you all take a look at the options I've presented below and give your thoughts without entering into too long a discussion. We've had a long enough discussion and we are starting to go around in circles. We need to resolve this issue and decide on a course of action. --Wisd e n17 20:50, 1 June 2006 (UTC)

The article has a large section on prostate cancer and circumcision, however a relationship between prostate cancer and circumcision status is not a "reliable, established, widely accepted fact". None of the professional medical organizations that have policies on circumcision even mention prostate cancer. Only pro-circumcision web sites suggest a connection between prostate cancer and circumcision status. If the goal is an article with "widely accepted facts", the paragraph on prostate cancer should be removed. -- DanBlackham 10:33, 1 June 2006 (UTC)


 * I think either you misunderstand what Jakew was saying, or alternatively he said it poorly. The widely established fact isn't that "zomg! cirumcision soooooo totally causes prostate cancer!", but rather that there is research by reliable sources on the topic (specifically, the scholarly articles cited in the text: , , , ,.
 * For what it's worth, I agree with you that the first two paragraphs of the prostate cancer section are kind of touchy-feely, and I would not cry crocodile tears if they were rewritten to avoid using "dogs not barking" sorts of references.
 * Lastly, I'm really not sure it's fair to characterize Medline and the National Institutes of Health as a "pro-circumcision web-site", yet they host most of the articles above that suggest that connection. Nandesuka 12:02, 1 June 2006 (UTC)


 * As always, it seems that anything that is not avowedly anti-circumcision is characterized as "pro-circumcision". Jayjg (talk) 17:05, 1 June 2006 (UTC)

Yes, there are a few articles that mention a relationship between prostate cancer and circumcision status, but the medical community does not give them much weight. The American Cancer Society does not even mention circumcision in relation to prostate cancer. The policy statements on circumcision by professional medical organizations do not mention prostate cancer. If you look at general articles about prostate cancer or general articles about circumcision by reliable sources, they do not mention an association between prostate cancer and circumcision. -- DanBlackham 07:21, 2 June 2006 (UTC)

What is the compromise?
I don't like having to repeat things that have already been said on this page, especially as it is rather long already. However, I feel that to focus this issue I need to repeat what Jakew has said:


 * There are four possibilities that are compatible with policy:
 * Add a link to DOC's MRSA hypothesis.
 * Modify the link description of DOC to note their MRSA hypothesis.
 * Replace the link to DOC with a link to their MRSA page.
 * Omit mention of DOC's MRSA hypothesis altogether.

Alienus, you have already replied to this suggestion, but not in the most helpful of ways. I have a further suggestion which may please both sides:


 * Doctors Opposing Circumcision A site with information from an anti-circumcision group, who, amongst other things postulate a possible link between circumcision and CA-MRSA.
 * Doctors Opposing Circumcision A site with information from an anti-circumcision group, who, amongst other things postulate a possible link between circumcision and CA-MRSA.

This would allow both links to be combined into one entry in the externals link section. I do not think that there is any justification to add information regarding the CA-MRSA link in the main artilce text as there is no evidence of an acceptable standard to justify this, as we have discussed at length above.

What I would like is for all parties to say as succinctly as possible their views on this as a compromise solution. --Wisd e n17 13:01, 31 May 2006 (UTC)


 * Fine with me. Nandesuka 13:36, 31 May 2006 (UTC)
 * Me too (I've taken the liberty of fixing the typo). Jakew 18:03, 31 May 2006 (UTC)
 * We really shouldn't include the link at all, since it not from a reliable source. However, since it is only in the external links section, and in the spirit of compromise, I would go along with this. Jayjg (talk) 17:05, 1 June 2006 (UTC)
 * My reasoning precisely. Another alternative might be to mention it in the page on DOC instead. (I'm not entirely convinced that DOC are notable enough to have a page dedicated to them, and perhaps an AfD should be raised, but assuming they are, policy permits us to use such organisations as sources about themselves, and by logical extension, their opinions.) Jakew 17:54, 1 June 2006 (UTC)

My interpretation is that stating that CA-MRSA is a risk would be OR, due to a lack of such conclusive support. However, reporting that DOC and others have expressed concern about this risk is entirely within the spirit and letter of Wikipedia rules. Therefore, I do not believe that these four options are what we should limit ourselves to. Al 16:41, 1 June 2006 (UTC)


 * So what is your actual solution. What, if anything, would you actually write in the article? What would you use to describe a link to DOC, what do you think of my suggestion above? We need to look now at practical solutions not simply saying I want to do this or that, show people what you would actually do. --Wisd e n17 19:20, 1 June 2006 (UTC)


 * I'll compromise for something along those lines -- "While there have not been any reported incidents conclusively linking Methicillin-Resistant Staphylococcus Aureus (MRSA) to circumcision, Doctors Against Circumcision, a Seattle-based group working to stop neonatal circumcision, have expressed concern of the possibility of such an infection." Superdix 18:54, 1 June 2006 (UTC)


 * That seems like a good compromise. What do people think to that as a solution? --Wisd e n17 19:20, 1 June 2006 (UTC)


 * Superdix' version isn't bad at all, but I was thinking of the following:
 * Some advocates against routine circumcision have raised the issue of community-associated methicillin-resistant Staphylococcus aureus, an emerging risk that they see as relevant to circumcision, though studies have not shown clear support for a link.
 * What do you think? Al 19:32, 1 June 2006 (UTC)


 * Could you explain how, exactly, that's a compromise? Jakew 19:20, 1 June 2006 (UTC)


 * Well, it's not what we'd want or what you'd want, but it's within the rules. Hence, it's a compromise.  Clear enough? Al 19:32, 1 June 2006 (UTC)


 * I think Alienus' is a much better compromise. What Jake do you think of that? I agree on second thoughts Superdix's was not brilliant. However, there may well be objection to the word 'clear' in Alienus' version. Do people suggest a different choice of word? --Wisd e n17 19:44, 1 June 2006 (UTC)
 * Quite frankly, I think it's absolutely atrocious. It dedicates six links and (if I count correctly) thirty-six words to something that has never been linked to the subject of the article in reliable sources. That's not a compromise; it's a joke, and an insult to our policies and to my intelligence.
 * If and when someone proposes in an RS that circumcision and MRSA are (or even may be) associated, then there is justification for discussing such material, both for and against, in the body of the article.
 * Until that time, there are an infinite number of subjects which haven't been linked to the subject in RS, and there is no more reason to include MRSA than, say, the orbital period of Ganymede.
 * Policy requires reliable sources. That is not negotiable. In spite of reservations that Jayjg has eloquently explained, the offer of a compromise in the 'external links' has been made, only to have it thrown back in our faces with this insult of a 'compromise' that a) ignores policy, and b) is essentially what was demanded in the first place. Jakew 20:03, 1 June 2006 (UTC)
 * Exactly right; policy is non-negotiable. Feel free to put this kind of stuff on your blog, not on Wikipedia. Jayjg (talk) 20:43, 1 June 2006 (UTC)
 * Jake, I'm confused. You've explained in the past why you consider DOC and CIRP unreliable.  Are you now maintaining that UCLA is also unreliable?  The reason Alienus provided 6 links was probably because he knew what high standards you demand in articles.  Your exacting standards have improved the article a great deal, but I get the feeling you're beginning to knee-jerk that any source you disagree with is unreliable.  Furthermore, Alienus's version does not make specific claims about a link but in fact goes out of its way to state that the link is merely putative.  On notability grounds, aren't the activities of activists notable to some degree?  Kasreyn 00:33, 2 June 2006 (UTC)
 * It is a compromise in that it denies me in writing that it is a definite elevated risk -- I explained this with the Bratu study earlier; medical journals need to be read with a fundamental understanding of the human body and, in this case, the pathways of pathogens. Now, I am compromising by using the DOC link. I'd like to take this opportunity to remind you that WP:RS is a guideline, not policy. We have a statement on DOC's website as well as our own correspondence from a doctor at DOC (who happens to be published in several different peer-reviewed journals), that references this possible link. Now, unless you have some evidence to prove that Mr. Denniston is in fact the copilot of the vice president's airplane, and not a qualified medical professional, I have a really hard time seeing why we should let you be, sorry for repeating myself here, the prosecutor, juror and judge over sources in this article. Superdix 20:25, 1 June 2006 (UTC)


 * It is Wikipedia policy that is the "prosecutor, juror, and judge" here, and Jakew has ably explained why DOC does not count as a reliable source. Why can't you simply come up with a peer-reviewed medical study linking the two?  That shouldn't be hard, if there is a real link. Jayjg (talk) 20:43, 1 June 2006 (UTC)


 * So, if you were to commit a crime, and I observed the felony, you wouldn't mind me acting as juror, judge and prosecutor in your case? Policies, like laws, are just that. They're general and superficial. They're not perfect, and any application of policy to actual incidents is subjective, not objective. I can only tell you from a medical point of view, Bratu et. al. links any invasive or surgical procedure, which includes circumcision, to an elevated risk for MRSA infections. Superdix 21:22, 1 June 2006 (UTC)


 * RS may be a guideline, but verifiability, which requires that sources meet it, is policy. Any private correspondence is obviously unverifiable, and thus irrelevant. It doesn't matter who Denniston is or what his qualifications are, nor does it matter that he's published previously in peer-reviewed journals (unless he covered this topic there). What matters is that the sources cited are reliable.
 * Since Bratu cannot be mentioned without conducting original synthesis, policy prohibits its inclusion. It is thus unclear to me why you are 'compromising'.
 * As for your comment about juror, judge, etc, I remind you that nobody has yet to address the analyses of how policy relates to this issue. There is nothing else before the court (to use your analogy). If you think it is mistaken, then for goodness sake explain why. If you provide no rebuttal, then one can only assume that is because you cannot. Jakew 20:47, 1 June 2006 (UTC)


 * All right, let's look at WP:V. Under "sources":
 * Articles should rely on credible, third-party sources with a reputation for fact-checking and accuracy. Any evidence that DOC does not meet these criteria?
 * For academic subjects, the sources should preferably be peer-reviewed. This one is not, but that does not exclude it.
 * Sources should also be appropriate to the claims made: outlandish claims beg strong sources. Claiming a potential risk, considering the generic nature of pathogenic pathways, can hardly be called an outlandish claim.
 * In general, sources of dubious reliability are sources with a poor reputation for fact-checking, or with no fact-checking facilities or editorial oversight. Again, do you have any evidence of poor fact-checking or lack of editorial oversight?
 * Self-published sources Nobody has been able to discredit DOC as an organization, and in this respect DOC's statement is no more excluded than a statement from the APA.
 * This is what the policy says about sources. None of the above excludes DOC. What's interesting here is that you don't even care about Mr. Denniston's qualifications, or the correspondence we have had with him. All you care about is your own interpretation of Wikipedia policy. Now, if Mr. Denniston was not an M.D., had not provided sources for his statements, or published articles in reputable journals, I would not spend my time trying to include a reference to the DOC statement. But, as it is, I have yet to see any evidence that excludes DOC. Superdix 21:22, 1 June 2006 (UTC)


 * Did you read Jakew's explanation of why the source isn't reliable? Please do so before commenting again. In addition, it has been explained to you why personal correspondence etc. violates Wikipedia's WP:V policy. I don't know how many times I'll have to repeat this; content on Wikipeida must comply with Wikipedia policy. Find a peer-reviewed medical journal which makes this connection, and stop wasting our time. Jayjg (talk) 21:26, 1 June 2006 (UTC)


 * You're losing your grip on reality here. I did not in any way signal any intent on publishing anything relating to our correspondence with Mr. Denniston. My point was that as a reasonably intelligent human being, one can say that Mr. Denniston is not trying to publish propaganda. Add to that basic medical knowledge, and one is able to understand that nobody here is trying to cook up anything. We are merely stating a fact, namely that DOC has published a statement detailing a possible elevated risk.
 * And Jake quoted WP:RS, not WP:V. One of these is a policy, the other is a guideline. Superdix 21:48, 1 June 2006 (UTC)

Interpretation of policy
How Wikipedia policy is interpreted seems to be influenced at least in part by the desired result.

In the Breastfeeding article Jake argued that two letters written by International Board Certified Lactation Consultants published in the Journal of Human Lactation are not a reliable source. Jake also said The Womanly Art of Breastfeeding and The Breastfeeding Answer Book published by La Leche League International are just "opinion pieces". Two editors familiar with breastfeeding verified that The Breastfeeding Answer Book is an "authoritative reference" in the field of breastfeeding. 

Later Jake argued that Otto Verdoner's rather strange letter to the editor published in a weekly newspaper in Boulder, Colorado is a reliable source for the National Organization of Circumcision Information Resource Centers article. -- DanBlackham 10:51, 1 June 2006 (UTC)


 * Uh, yeah, I've been saying all along that the mediator is mistaken to accept Jake's interpretation of policy. Al 16:38, 1 June 2006 (UTC)

This information is not relevant to the mediation. We have discussed at length the quesion of policy, and it has been discussed before on the article's talk page. We are now at the stage where we need to decide on actual solutions, so I would ask both of you to comment on my proposal above, or produce your own proposal. --Wisd e n17 16:50, 1 June 2006 (UTC)


 * I agree in that this information is irrelevant to the mediation. It does, however, shed some light on what is a major obstacle in this mediation, namely that some users constantly push their own interpretation of a policy or guideline without even discussing the issue at hand. Superdix 20:39, 1 June 2006 (UTC)

Possible Solutions
The only thing that can be agreed upon is that there should be an external link to DOC. Does everyone still agree that we should have this (at least) on the article, and if so does the following format appear acceptable:


 * Doctors Opposing Circumcision A site with information from an anti-circumcision group, who, amongst other things postulate a possible link between circumcision and CA-MRSA.
 * Doctors Opposing Circumcision A site with information from an anti-circumcision group, who, amongst other things postulate a possible link between circumcision and CA-MRSA.

Alienus and Superdix have suggested an inclusion in the main article text, which has been met with opposition. Do you feel that a link on its own is acceptable, or is it simply more confusing; should there be any reference made to the link below, something along the lines of:

DOC have many concerns, of a medical nature, regarding circumcision (none of which have been proven).

The wording is not brilliant, but it cannot be too different, the article cannot claim that there is proof to support their claims as according to Wikipedia's policies there is not. Again some of you may have a problem with policy more than with the article.

So the questions which I want brief answers to is this:


 * 1) Do you accept an external link, in the format above, to the DOC page?
 * 2) Do you think there should be any article text to help explain why there is an external link, (And if so what article text), or are you happy for the external link to be there on its own?
 * 1) Do you think there should be any article text to help explain why there is an external link, (And if so what article text), or are you happy for the external link to be there on its own?
 * 1) Do you think there should be any article text to help explain why there is an external link, (And if so what article text), or are you happy for the external link to be there on its own?

Lets not descend into more protracted discussions which are covering the same ground. I want to get a solution to this issue, and to that end, I want you thoughts as briefly as possible to the two above questions. --Wisd e n17 21:00, 1 June 2006 (UTC)


 * Yes.
 * No. (You did ask for brevity.) Jakew 21:12, 1 June 2006 (UTC)


 * Yes. No, not unless the compromise text I suggested is shown to be against Wikirules. So far it has not.
 * Yes. At risk of exceeding brevity, I agree fully that the article must not claim proof of the CA-MRSA claim, as there is currently insufficient confirmation. I therefore suggest reporting the allegation while making it clear that there is no proof. My last edit showed the text I recommend. Al 21:33, 1 June 2006 (UTC)


 * Yes. Minor violation of policy, but acceptable under circumstances.
 * No. Major violation of policy, mediation cannot trump policy in this way. Jayjg (talk) 21:41, 1 June 2006 (UTC)


 * Yes, if text is included.
 * Yes, compromise text as proposed earlier. Superdix 21:49, 1 June 2006 (UTC)


 * Yes.
 * No, for all the reasons I discussed above. Nandesuka 22:14, 1 June 2006 (UTC)

Right, from this I see what I guessed would be the answers. Let me responded to Jayjg's comments regarding the 'mediation trump[ing] policy'. The idea of getting you to answer briefly to the above questions is to help bring this mediation to a close. What is noticeable is that you have all answered yes to the first questions, thus we have an obvious compromise there. Whilst some of you are keen to include information in the article, many of you are not, and clear policy related arguments have been used. I would therefore suggest that we conclude this mediation. I shall insert the above link into the article, and I suggest that Alienus and Superdix that you look to propose changes to Wikipedia's relevant policies as you are clearly not happy with them. You may well like to use this case as an example as what you see as the problems with the current policies (you feel that the article cannot be as comprehensive as possible due to the fact that the policy is 'tying your hands'). If you would like any help about what steps are necessary to go about proposing changes to the relevant policies I would be happy to help in that regard.

I appreciate some of you will not be entirely happy with the outcome of this mediation, however, both sides have compromised and we have reached a good solution, which is acceptable to both sides (neither side objects to it). One side clearly wants to have information in the article, but has been explained above this is not the consensus view, and more importantly is not allowed by policy.

I have addressed above the other points raised in the initial RfM, and do not wish to discuss those matters further. As I have said above the relevant place to do so if individual RfA's and I do not wish to take the place of an RfA.

If any of the parties would like further help regarding this article or related articles in the future then I would be happy to help.

I hope that all of you can use this compromise solution as a new-leaf and look at developing all the related articles in as civil and healthy a manner as possible. --Wisd e n17 22:50, 1 June 2006 (UTC)
 * And I have removed the (lengthy) discussion of MRSA from the text.
 * Thank you, Wisden17, for your time in this mediation. Jakew 09:53, 2 June 2006 (UTC)

Upon due consideration, I have changed my vote -- see above. My support for first option must be understood as dependent upon the second one being removed due to rule violation. Despite much hand-waving, it has very clearly not been. It is consistent with WP:V and avoids WP:NOR by accurately reporting the beliefs of a notable group as beliefs rather than fact. It's not entirely clear whether WP:RS would interfere, but as it is only a guideline, we are free to ignore it if it doesn't make sense in this context.

In short, I am not satisfied with a mention in External Links if we can place a careful compromise sentence into the article body without violating any rules. I flatly disagree with and will not accept the misinterpretation of the rules by the pro-circumcision trio. There is no reason whatsoever why we cannot mention the simple fact that some people claim there's a connection, despite the lack of evidence. This is notable, relevant and verifiable.

There are also many precedents. Consider that, on emergency contraception, we bend over backwards to mention the completely unsupported claims of various activist groups, including misdefinitions of pregnancy, false allegations of interference with implantation and so on, just to be fair. The claims may be nonsense, but they're someone else's nonsense, so we're allowed to repeat them, despite WP:NOR. Of course, we also state that there is no medical support for them. In contrast, the proposed solution for this article is to relegate everything to a footnote, which is highly partisan.

With all due respect, this mediation must either be considered still in progress, or a failure. I am willing to continue to discuss these issues and work towards an acceptable compromise. If they're not, then it's time for the next step. Al 18:47, 2 June 2006 (UTC)


 * I agree with you Alienus, and my main problem with this mediation is that Jakew's interpretation of WP:RS somehow set the standard for considering DOC as a source. As you quite rightly state, RS is a guideline, not policy. Add to that the very vague nature of our MRSA claim (prospective, possible risk), as well as the generic nature of pathogenic pathways, I feel our viewpoint hasn't received a fair trial (WP:V: "outlandish claims beg strong sources" -- this is hardly an outlandish claim). I am also really getting tired of the lack of real discussion, and the fact that the entire MRSA paragraph is discredited as "nonsense" by one party really speaks volumes. Should the mediation continue, please note that I won't be back here on Wikipedia until the last week of June. Superdix 21:00, 2 June 2006 (UTC)

Circumcision is usually an "elective" procedure.
It's so simple... CA-MRSA exists, and raises the risks of all surgical procedures. It has reduced the frequency of elective procedures.

Informed consent now requires inclusion of infections risks, specifically MRSA, and Wiki should reflect practice.

It's easy to find research quotes (non DOC) citing general surgical MRSA risks. The risks/complications section should also review this relatively new risk.TipPt 04:53, 6 June 2006 (UTC)

Mediation Closed
The mediation appears to have resulted in very little. I still fundamentally thing the problem lies with a misunderstanding with Wikipedia's policies, and a misinterpretation of applying the policies correctly and POV editing. I'm sorry that we could not achieve more out of this mediation, but I have offered my advice and guidance above. I thank all of you for remaining relatively civil througout this mediation. --Wisd e n17 15:05, 6 June 2006 (UTC)


 * The above discussion is preserved as an archive. Please do not modify it. Subsequent comments should be made on the appropriate discussion page, such as the current discussion page. No further edits should be made to this page.