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Wednesday, June 27, 2012

MRI Studies: The Brain Permanently Altered From Infant Circumcision



by Dr. Paul D. Tinari Ph.D.
October 26, 2009
Two of my physics professors at Queen's University (Dr. Stewart & Dr. McKee) were the original developers of Positron Emission Tomography (PET) for medical applications. They and a number of other Queen's physicists also worked on improving the accuracy of fMRI for observing metabolic activity within the human body.

As a graduate student working in the Dept. of Epidemiology, I was approached by a group of nurses who were attempting to organize a protest against male infant circumcision in Kinston General Hospital. They said that their observations indicated that babies undergoing the procedure were subjected to significant and inhumane levels of pain that subsequently adversely affected their behaviours. They said that they needed some scientific support for their position. It was my idea to use fMRI and/or PET scanning to directly observe the effects of circumcision on the infant brain.

The operator of the MRI machine in the hospital was a friend of mine and he agreed to allow us to use the machine for research after normal operational hours. We also found a nurse who was under intense pressure by her husband to have her newborn son circumcised and she was willing to have her son to be the subject of the study. Her goal was to provide scientific information that would eventually be used to ban male infant circumcision. Since no permission of the ethics committee was required to perform any routine male infant circumcision, we did not feel it was necessary to seek any permission to carry out this study.

We tightly strapped an infant to a traditional plastic "circumrestraint" using Velcro restraints. We also completely immobilized the infant's head using standard surgical tape. The entire apparatus was then introduced into the MRI chamber. Since no metal objects could be used because of the high magnetic fields, the doctor who performed the surgery used a plastic bell ("Plastibell") with a sterilized obsidian bade to cut the foreskin. No anaesthetic was used.

The baby was kept in the machine for several minutes to generate baseline data of the normal metabolic activity in the brain. This was used to compare to the data gathered during and after the surgery. Analysis of the MRI data indicated that the surgery subjected the infant to significant trauma. The greatest changes occurred in the limbic system concentrating in the amygdala and in the frontal and temporal lobes.

A neurologist who saw the results to postulated that the data indicated that circumcision affected most intensely the portions of the victim's brain associated with reasoning, perception and emotions. Follow up tests on the infant one day, one week and one month after the surgery indicated that the child's brain never returned to its baseline configuration. In other words, the evidence generated by this research indicated that the brain of the circumcised infant was permanently changed by the surgery.

Our problems began when we attempted to publish our findings in the open medical literature. All of the participants in the research including myself were called before the hospital discipline committee and were severely reprimanded. We were told that while male circumcision was legal under all circumstances in Canada, any attempt to study the adverse effects of circumcision was strictly prohibited by the ethical regulations. Not only could we not publish the results of our research, but we also had to destroy all of our results. If we refused to comply, we were all threatened with immediate dismissal and legal action.

I would encourage anyone with access to fMRI and /or PET scanning machines to repeat our research as described above, confirm our results, and then publish the results in the open literature.

Dr. Paul D. Tinari, Ph.D.
Director,
Pacific Institute for Advanced Study
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Circumcision Study Ends Early Due to Infant Trauma

This study is an old one (1997) but we still find that the majority of baby boys circumcised in the United States go under the knife for surgery without anesthesia. Unfortunately, even when it is used, we are not able to eliminate the pain from the anesthesia injection (babies are at a significantly heightened level of sensitivity following birth) and even our best dorsal block injections do not numb below the perineal nerve, where the frenulum is torn back over the glans and is cut. It is no surprise that most babies scream wildly to escape the cutting, must be restrained to counter their physical attempts at escape, or they lapse into a semi-comatose state to survive the trauma.


ATLANTA (CNN) A new study found circumcision so traumatic that doctors ended the study early rather than subject any more babies to the operation without anesthesia.

The researchers discovered that for those circumcised without anesthesia there was not only severe pain, but also an increased risk of choking and difficulty breathing.

The necessity of circumcision is the subject of increasing debate, but the traditional reasons for the operations have always been prevention.

Approximately 96% of babies in the United States and Canada receive no anesthesia if and when they are circumcised, according to a report from the University of Alberta in Edmonton. [As of 2009, 32% of newborn boys born in the United States and 9% of newborn boys born in Canada undergo circumcision surgery.]

One of the reasons anesthesia is not used, the study found, is the belief that infants feel little or no pain from the procedure. It has been argued by some that injecting anesthesia can be as painful as circumcision itself, and that infants don't remember the procedure, anyway. Other physicians state that the infants do, certainly, feel the pain of genital cutting, but that it takes longer to use anesthesia, and wait for it to take effect, than it does to just do the clamping and cutting and complete the surgery.

There are, however, those who find the 'no pain' or 'no memory' reasoning difficult to believe, and Dr. Aurthur Gumer is one of them.

"To say that the baby doesn't remember it is not an adequate excuse to me," he said. "Babies experience other painful procedures to a greater degree than adults do, and we worry about that, and we do give them anesthetics for those procedures."

The Edmonton researchers, whose study was published in this week's Journal of the American Medical Association, studied the heart rates and crying patterns of babies during different stages of circumcision. Some babies were given an anesthetic, and others were not.

Rabbi Ariel Asa has performed hundreds of circumcisions. When families request it, he says he puts an anesthetic on the skin, in an effort to reduce some of the pain. But he admits it is not very effective, and there are frequent complications.

"Due to the fact that moyels (those who perform the cutting blessing in the Jewish community) do it very quickly and the pain that the baby experiences is minimal. I don't think that the overall benefits are gained [from anesthesia]," he says.

But researchers found that while topical anesthetics may help initially, they are woefully inadequate during prepuce tearing, separation and amputation.

They concluded that if circumcision must be performed, it should be preceded by an injected anesthetic that is given time to take effect.

In fact, they found the results so compelling that they took the unusual step of stopping the study before it was scheduled to end rather than subjecting any more babies to circumcision without anesthesia.
http://www.drmomma.org/2009/10/circumcision-study-ends-early-due-to.html

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