Trollololol, BMJ

So, it is pretty funny that the British Medical Journal is trolling us.

 

Participants, setting, and design

To be eligible participants had to be part of a couple and willing to take part in the study. We carried out a parallel trial with one man and one woman in their own home. It was decided without consultation that the female participant would prefer to be right and the male, being somewhat passive, would prefer to be happy.

The male was informed of the intervention while the female participant was not (this form of pre-randomisation is known as the Zelen method2). The female participant was blind to the hypothesis being tested, other than being asked to record her quality of life.

Discussion

The results of this trial show that the availability of unbridled power adversely affects the quality of life of those on the receiving end.

Strengths and weaknesses

The study has some limitations. There was no trial registration, no ethics committee approval, no informed consent, no proper randomisation, no validated test instrument, and questionable statistical assessment. We used the eyeball technique for single patient trials which, as Sackett says, “more closely matches the way we think as clinicians.”3

Generalisability

Many people in the world live as couples, and we believe that it could be harmful for one partner to always have to agree with the other. However, more research is needed to see whether our results hold if it is the male who is always right.

 

It’s even funnier that the science correspondent of the Daily Telegraph, the Huffington Post and Medical Daily fell for it hook, line and sinker and, inevitably, Men’s Rights Activists are up in arms. 

Trollololol. Season’s Greetings, friends.

Just dropping by

Hi there.

Just a quick fly-by to say I’m doing some contract work at the moment, generally up to my eyeballs, and haven’t had time to blog.

If any regular readers are in London, you might like to know that I’m in Hackney on Thursday night, at the near-legendary BBC Question Time Watchalong  night. I’m doing an In conversation with… type thing alongside Laurie Penny and that’s about as much as I know, other than comedian Kate Smurthwaite is also doing a turn, and there will be beer. It should be light-hearted, friendly and fun. At least if I have my way. And then after 10.30 we all shout abuse at the big telly for an hour.

A few things round and about that have caught my eye of late. Of all the deserved tributes and moving commentary around the death of Nelson Mandela, I’m one of those bitter lefties of a certain age who cannot easily forgive those who were fiercely, furiously resisting sanctions, solidarity and other forms of activism to secure Mandela’s release and bring about an end to apartheid. When I was at university, our student union Conservative group campaigned for new members with Hang Nelson Mandela posters at the freshers’ fair.  Mark Steel captures my feelings pretty well.  

On my more familiar territory, this story about a father who still cannot see his daughter despite 82 court judgments in his favour is a pretty damning indictment of the failures of our family courts to impose any authority.

Finally, for those with an interest in the cutting and occasionally downright bleeding edge of feminist theory, I’m mulling over this post on intersectionality, which makes some really interesting points. I have the luxury (or privilege) of being able to consider it purely on an intellectual basis, I have no dog in the fight, but I do think it is a really good argument.

Any thoughts on these, or anything else?

What’s caught your eye of late, my friends?

Courts must not rule on circumcision, even in Israel

It is difficult to decide what is most shocking about the decisions made by Israeli Rabbinical courts last month. First there is the simple outrage that a mother could be fined for refusing to allow her son to be circumcised, with an additional 500 shekels (around £90) levied for every day she refuses to submit to the ruling. There is no secular law mandating circumcision in Israel, but the case arose as part of a divorce hearing, ruled upon by a religious tribunal, which also has the power to impose fines on plaintiffs.

The baby boy at the centre of the case did not have the traditional Jewish brit milah at eight days old, due to health concerns. By the time he was healthy, his mother had second thoughts. “I realized that I couldn’t do that to my son,” she was quoted as saying in Haaretz. “He’s perfect just as he is.”  Although the dispute between the issue of the circumcision is said not to be a factor in the divorce, establishing which parent has the authority to make such a decision has proved to be a point of bitter contention.

The district Rabbinical court of Sharon disagreed, ruling that “The Jewish people have always seen the circumcision as an act of repairing and completing the Creation.” Last week the High Rabbinical Court refused to overturn the original ruling. The woman now plans to appeal to the national supreme court.

Perhaps even more disturbing, the rabbis making the original judgement were quite clear that there was a political angle to their ruling. They noted a growing global trend against acceptance of infant circumcision, and were quite explicit that they were not going to tolerate a similar debate in Israel, stating:

“What will the world say if here too the matter of circumcision will be subject to the consideration of every person according to his perceptions? It is unthinkable that the matter of performing or failing to perform the circumcision will be taken away from Jewish scholars and be subject to the consideration of a civil court, when each one has his own opinions and worldview – this will not happen in Israel, God forbid.”

I hope what the world will say is that it unthinkable that such decisions might be ruled upon anywhere but in a civil court. In a state that so often proclaims its democratic credentials in contrast to its corrupt, totalitarian and theocratic neighbours, it is grotesque that theological interpretations should trump secular law.

Contrary to widespread perceptions, there is not uniform agreement on circumcision even among Jewish people. Both in Israel and around the world there is a small but growing movement of Jews who consider the practice anachronistic and barbaric.and who call for reform of the tradition. Without getting into Jewish theology, it is clearly essential to democracy and free civil society that people can explore and discuss such beliefs and live their lives in accordance with their own conscience, especially if their conscience is turning them away from harming others.

While the details of this case may be unique to Israel, in every country and culture where circumcision is practised, there will be families riven apart by the precise same argument – to cut or not to cut. Such disputes are likely to become more common as awareness grows of the risks of adverse consequences and complications, as religious devotion slides and appreciation of individual human rights to bodily integrity grows, and as claims for health benefits from routine ritual circumcision are increasingly shown to be arguable, if not downright spurious. Circumcision is a topic that divides opinions and divides communities so it is hardly surprising that it sometimes divides families.

Where such disputes arise, there can be only one humane judgement. When a child grows old enough to decide he would prefer to be circumcised – for whatever reason – he can make that choice. Once a foreskin is removed, it is gone forever.

Those who advocate the rights of parents to circumcise infants generally fall back on an argument of free choice and lifestyle. It is morally questionable, to say the least, that parents should have the right to irreparably mutilate a baby who is too young to dissent. The idea that a religious court should make such a decision, against the wishes of at least one parent, must be considered reprehensible.