The cruelty of male circumcision

Today it is quite unthinkable to question the cruelty of female circumcision if you are a relatively informed person. However, to my own amazement, male circumcision (see picture) is still considered by many to be perfectly justified. It must evidently be so, considering how often this surgery is performed on young naive infants.

At one point in my life I actually became a little bit ambiguous as to whether circumcision might perhaps be justified. It was last year when, during my exchange year at UCSB, I attended some highly entertaining and informative lectures on Human Sexuality taught by two very charismatic (and married) professors John Baldwin and Janice Baldwin. You can read more about the Baldwins' view on circumcision here. I am not being ironic when I say that these were indeed great lectures, and that is perhaps why they almost convinced me that the costs and benefits associated with male circumcision more or less cancels out. As far as I can remember they referred to two positive consequences associated with male circumcision. One is the supposedly improved hygiene, which by the way is one of the most common justifications that people in favor of circumcision refers to. However, bad hygiene under the foreskin is only a problem for guys who never clean under the foreskin, so if we would simply remind guys that they need to remember to clean their more private regions this would not be a big problem. In any case I hardly think that this justifies circumcision….

The other favorable effect of male circumcision, the one that made me think that perhaps it was justified, is the reduced risk of being infected with the HIV virus. A few studies of this kind have been made and the effects superficially seem quite large. However, the studies which have shown this difference have been of poor quality, with poor control. Just as an example, in one large and frequently cited study, circumcised males were given advice on sexual behavior whereas those who had not been circumcised did not get this offer. Was the lower incidence of HIV among the circumcised due to the sexual advice or the circumcision? Studies with better control i.e. studies which try to rule out alternative explanations, have found smaller effects (see here for more information). I will not go as far as to say that circumcision does not give any improved protection at all, on the contrary, I believe that there is some truth in this. Nevertheless, it seems that the effects are significantly smaller than what the original studies suggested.

The fact that there seems to be no great benefits of circumcision is however not my main problem with it. Neither do I dislike it just because it is very much entangled with religion. I think it is a good example of how religious beliefs sometimes takes the upper hand over rational arguments, but it is not the main reason why I disprove of male circumcision. So what is the main reason? The reason is that the foreskin, which is removed during a circumcision, has a lot of very important functions. I think that this is hardly surprising because if the foreskin had been completely useless or even a burden to us, natural selection would probably have taken care of it long ago. The benefits of having a foreskin are many. To name a few, the foreskin is important because it gives protection to the glans penis, it reduces friction during intercourse, it gives important feedback to our brain about the "state" of the penis, it aids erection, and it regulates the timing of the ejaculation (people who have been circumcised often either ejaculate too early or too late). You can read about these as well as other function of the foreskin on this excellent page.

However, I think that the most important function of the foreskin, and hence also the most important reason why circumcision should not be allowed, is that it brings sexual pleasure to its owner. This of course also means that lack of foreskin will result in reduced pleasure. Sex, along with drink and food and neuroscience (that last one is probably rather personal), are things that make life worth living, and taking away the pleasure associated with sex just seems rather cruel to me. Now I am not saying that circumcised people do not feel any pleasure, I would not know, all I am saying is that there is good reason to believe that they feel less pleasure.

Summing up, besides just being a nasty and invasive surgical procedure which could well cause some kind of trauma in the infant, taking away the foreskin is associated with many other disadvantages. Even if the risk of contracting HIV would be slightly reduced, this hardly justifies circumcision.

The virtue of changing your mind

More and more I have wondered why it is seen as such a disgrace to change your mind about things. I have had many different discussions on different subjects online as well as in real life, and almost invariably people hold on to their ideas and beliefs as if their life depended on it. I will haste to admit that I am also guilty of this type of behavior. Even when my opponent has brought up a really good point that threatens my entire argument, it is tempting to go "well you are just an ashole", or something equally relevant... When I am courageous enough to say, "that is a good point, you are right" it often feels like I have lost my dignity, and I will walk away like a dog with the tail between its legs. I wonder why it is so hard to admit that you were wrong? Is there some evolutionary explanation of this?

It is of course important to point out that it would also be a problem if people changed their mind too easily. Many of the ideas that are today seen as obvious, were ridiculed when first articulated (the earth revolves around the sun? I don't think so!). I don't know where to put the limit, but in general it seems that people are probably a little bit too slow in changing their mind.

I think that if people were better at changing their minds, we would have a better world. As a scientist the ideal-me should be able to change his mind if enough evidence against my belief is shown to me. This is by the way a difference between science and faith. In the latter you are not supposed to doubt, no matter what happens. I think that this inflexibility is probably the main problem with religion. Richard Dawkins in his documentary "the root of all evil" tells us about one of his professors who had been working on a theory for a decade or so when an American colleague came and showed him overwhelming evidence that the theory was wrong. The professor, unbelievably, admitted right there and then, in front of loads of people, that he had been wrong, Wow!

The reason I started to think about these issues was that someone very dear to me, after reading my post about homeopathy, said that I should be a bit more careful when I denounce ideas such as biodynamical foods. She said that these comments might come back to haunt me when I become a famous scientist. This is true indeed, but why should it be so hard to say that "that was my belief at the time, now I believe this and this". People should be allowed to change their mind. (of course, I should probably check my sources carefully before I throw out accusations). Knowing what we know today I think that the Iraq war was a bad idea, but back before the war I thought it was probably a good idea to get rid of Saddam and the WoMD that I thought were there.

This is what I am going to do. When I have written a certain number of posts on this blog I will review my posts, and then make a new post about which things I have changed my mind about, great idea is it not? I mean, it would be kind of remarkable if I got everything right the first time. So keep sending the good comments and tell me when you think I am wrong, you might just be able to change my rock-hard mind.

True cyborgs now a reality!

Muscular movements are controlled by the central nervous system. Right now my brain is actively planning the muscular contractions that will make my fingers exert a force on different buttons on my keyboard, ultimately resulting in the text that you are hopefully enjoying right now. How does this work? Well, there are many unsolved mysteries, but we have also learned quite a lot.
Two areas of the brain, the "supplementary motor area" (SMA) and the "premotor area" (PMA), seems to be involved in planning the exact series of muscle contractions that are required in order to do something such as writing this text. How do we know this? Put a person in an fMRI machine and ask them to imagine doing something, and wallah, SMA and PMA lights up (meaning that more blood is going to these areas, mening that more glucose gets there, meaning more activity in those cells)! In order to actually move you will also have to get your motor cortex involved. It is from this area that axons travel down into the spinal cord and elicits movements. If you stimulate the motor cortex electrically during a surgery (this is sometimes done to see how the body is mapped onto the motor cortex), then the corresponding muscles will contract, perhaps resulting in an arm or a leg flapping out. So when your SMA and PMA have planned the contractions they will communicate with the motor cortex which then sends signals down to the alpha motor neurons in your spinal cord which in turn will release acetylcholine onto the muscles causing them to contract. All this happens within a few milliseconds! (Of course other areas such as the basal ganglia and my own darling, the cerebellum are also involved in movements, this was merely a simplified account.)

Who cares?, where are the applications? Back in 1982 a guy named Georgopoulos measured the activity in the motor cortex of a monkey while it was performing some well defined motor tasks. Georgopoulos found that a certain movement would be associated with a particular pattern of activation in the motor cortex. Thus, merely by looking at the activation in the motor cortex he could predict that the monkey was trying to move say, its left index finger. This could be very useful for people suffering from paralysis. Theoretically it should be possible to measure motor cortex activity and from that see what movements the motor cortex is trying to do. Then, to help a paralysed patient what you need to do is to connect a robotic arm programmed to move in response to neuronal activity. This procedure is no longer science fiction, it is reality. In this article it is described how some surgeons used signals coming from the motor cortex to make a prosthetic arm move, in other words they made a true cyborg out of lucky Mitchell, 24.

Although I am pessimistic about the prospect of creating a brain that is as complex as our own I do think that in the future more and more applications like this one will appear.

Free will and determinism

Do we have free will, or are all our thoughts and actions a result of the physical forces in our universe?

After having taken part in a discussion about consciousness on Furiku's blog I decided to learn a little bit more about the philosophy of the mind which discusses such things as the nature of the mind, consciousness, and free will versus determinism. The audio-course, which I warmly recommend, is from the teaching company (see my previous post about the the teaching company here), and it is called "philosophy of the mind". Teacher is John Searle (see picture) from the University of California, Berkeley.

My experience is that the question of free will versus determinism is a question that many people ask themselves occasionally. Are we free agents in the world or does everything, and I mean everything have a preceding cause. I cannot speak for anyone else of course, but for me it sure feels like I have free will. When I write these words I feel as if I am deciding to write these words, and I can even erase them again if I want to! On the other hand, dwelling further into this I can think of situations in which I have felt as if I had no free will, where I acted contrary to the way I wanted to act. One of my stepchildren exemplifies this point well. In the process of doing something violent to her younger sibling she sometimes says "I just could not control myself", which effectively eliminates the possibility of telling her that "that was wrong!".

I should state here what I believe; I believe that we live in a determined universe, that free will is an illusion (that we are determined to have), and I will now explain why.

We have physical laws which can, with some small exceptions, explain more or less everything that goes on around us. In most chemical and physical systems we can, if we know the current state of the molecules in the system, predict how the same system will look in the future. Our brain is a chemical/physical system (a very complex one), and therefore it should be theoretically possible to predict what our brain will look like in the future, and if we had more knowledge about the relation between the physical and mental state of the brain we would be able to predict exactly, the mental states and behaviors of the individual.

Some people will object to my view by saying that, if I don't have free will, then everything is determined and it doesn't matter what I do. I could go out and rape and kill people and that would have been inevitable. However, if the deterministic hypothesis is true, then you could obviously not decide to go out and kill and rape. If you did go out to kill and rape, it would be because of something, maybe these words (caused by processes in my brain) have had an influence of your brain which makes you go and do this, or maybe you have gotten a tumor in your amygdala, messing up your emotions. A similar objection that I sometimes hear is the following. "How can you (referring to me), believe in such a depressing thing?" Life is meaningless without free will! Of course the answer is the same, if the deterministic hypothesis is true I cannot decide to believe or not believe in free will, my beliefs were determined by the state of the universe when it began. Besides, I don't really feel sad when I think that I have no free will, rather, I think, I am a little bit amused by this thought.

Another objection is that research in quantum mechanics have shown that there is uncertainty in the universe. We cannot tell the exact location of the electron when it is orbiting the nucleus of the atom, hence free will. To me this argument sounds rather far fetched and desperate. There is no plausible reason to suggest that we would be able to control, through our mental activity, where the electron is located, and there is also no good reason (as I see it), why the location of an electron in the orbital cloud should give rise to different actions.

Summing up, I just cannot see anyway around the conclusion that there is no such thing as free will. It free will did exist it would be a big problem for science which rests on the assumption that every process in the universe have a cause. I would love to hear comments on this post, especially from people who do believe in free will...

New international guidelines for stem cell science

I have just had an interesting discussion with "anonymous" about the ethical issues associated with stem cell research. Yesterday I saw that an organisation called International Society for Stem Cell Research (ISSCR) have released a document in which they spell out some ethical guidelines. You can read about it here. ISSCR, controversially, states that they think it is okay to pay women to donate eggs. This has been largely prohibited before. Their argument is that the money in itself is only an issue if women start to ignore risks because of the gain.

“What you need to focus on is not the amount of money changing hands, but rather how the financial consideration is affecting the decision the woman goes through,” Daley says. “If it would make [the potential donor] trivialise any of the risks then it constitutes an undue inducement.”

A private reflection is that medical testing would come to a complete stop if money were not paid to subjects. Who would want to go to Astra and have something injected for fun? I have myself considered taking part in pharmacological studies because you get well paid and only expose yourself to low risks. I don´t think I would do it for free however. I do not really see the difference between the two examples. Of course it would be a problem if women ignored their own health and started to make a living out of donating eggs, however, it would also be a problem if they made a living from taking part in medical trials.

I think that rather than prohibiting payments, we should try and make sure, as far as possible, that women do not start to make a living out of donating eggs, hard as that may be. We should also keep in mind that stem cell research probably is our best hope when it comes to curing some of the worst diseases out there...