Roundup: Circumcision and HIV, Patient Care and Catholic Teaching

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Roundup: Circumcision and HIV, Patient Care and Catholic Teaching

Brady Swenson

Circumcision benefit doubted for gay men; Catholic hospital under fire for allowing abortion referrals and birth control prescriptions; Ohio top court mulls admission of medical files in Planned Parenthood case; U.S. Supreme Court refuses Missouri prison abortion rights case; Breast cancer vaccine within reach.

Circumcision Benefit for HIV Doubted for Gay Men

Circumcision, which has been shown to slow the
spread of the AIDS virus from women to men during sex by 50%, doesn’t
appear to provide a statistically significant protective effect for men having sex
with other men, U.S. researchers said today

The review is the most comprehensive analysis of the subject to date.
It encompasses data from 15 studies conducted in seven countries,
involving more than 53,000 men, most of whom were Caucasian and
approximately half of whom were circumcised. The authors concluded that
being circumcised reduced a man’s risk of acquiring H.I.V. by 14%. That
finding was statistically nonsignificant, but the authors say it should
be regarded as a launching point for future trials. "This study gives
us a more complete picture than we’ve ever had before," says Gregorio
Millett, the study’s lead author and a senior behavioral scientist at
the Centers for Disease Control and Prevention (CDC). "The next step is
to design better quality studies to see if there is an association we
aren’t detecting."

One such question, says Millett, is whether circumcision can reduce
infection rates among the subset of men who have only insertive sex
with other men, as opposed to those who have only receptive sex or
both. Millett’s review suggested that among the former group,
circumcision lowered H.I.V.-infection risk by 29%, a finding that also
showed statistical nonsignificance. But targeting that distinct
population in future studies may prove useful for distilling the
specific effect of circumcision — and perhaps for future public-health

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Catholic Hospital Under Fire for Allowing Abortion Referrals and Contraception Prescriptions

Catholic campaigners and some medical practitioners are criticizing a North London Catholic Hospital for its new ethics code that permits issuing referrals for abortion procedures and prescriptions for birth control.  Months of upheaval and debate over patient care and Catholic teaching at the 150 year-old institution have resulted in a compromise to provide patients who seek abortion care and contraception with a referral so they may obtain it elsewhere.  Some, however, do not see the new code as a compromise: 

Helen Watt, the director of the Linacre Centre, a traditionalist
bioethics facility that campaigns on life issues, said Catholic
teaching was "absolutely opposed" to all deliberate facilitation of
abortion and other "anti-life" procedures.

"A woman who is facing
a difficult pregnancy should be offered not abortion, but positive and
life-affirming support with having her baby. If it is wrong to perform
a procedure oneself, it is also wrong to refer for that procedure. A
Catholic hospital must make this unambiguously clear to everyone
working on the premises."

The code is backed by the hospital’s new chairman:

The hospital’s new chairman, Lord Guthrie of Craigiebank, a former army
chief of staff, welcomed the ethics code, saying "doctors and other
staff are presumed to be of goodwill and good conscience".

The new ethics code at the Catholic institution does retain restrictions on some procedures, however:

To clarify which activities were permissible, the hospital announced
last month that it would uphold its ban on sex changes and permanent
sterilization operations.


Ohio Supreme Court Mulls Planned Parenthood Files

The top court in Ohio is considering whether or not to permit patients’ medical files as evidence in trying charges brought against Planned Parenthood that claim the family planning organization failed to recognize and report potential sexual abuse. 

Ohio Supreme Court justices appeared skeptical Tuesday that an
abortion clinic’s medical records on other patients are relevant to a
lawsuit brought by parents of a 14-year-old girl who had an abortion
without their consent.

Lawyers for the girl’s family argued that
the information they seek is necessary to prove that Planned Parenthood
of Cincinnati had a pattern of violating Ohio’s parental consent law
and failing to report abuse. The unusual case pits a single plaintiff
against the privacy interests of a decade’s worth of patients.

The case involves a girl who was 14 at the time of her abortion in
2004, when the state’s parental consent law had not been completely
settled by the courts. She had been impregnated by her 21-year-old
youth soccer coach, John Haller.

The family’s lawsuit accuses the
Planned Parenthood clinic of failing to get parental consent, report
suspected abuse or to inform the girl of risks and alternatives. It
seeks unspecified damages.

Court records say the girl gave
Haller’s cell phone number as her father’s, and clinic officials
thought they had reached the father when they called inquiring about
parental consent. Haller was later convicted on seven counts of sexual

An appeals court ruled last year that records on other patients weren’t necessary for the family’s lawsuit.

Courts have traditionally been reluctant to permit private medical records as evidence in trial.  During a recent Kansas case in which medical records were subpoenaed by former Attorney General Phill Kline the state’s Supreme Court overturned the subpoena citing insufficient evidence showing the records were relevant to the case.  


U.S. Supreme Court Refuses Missouri Abortion Rights Appeal

Yesterday the Supreme Court refused to hear an appeal from the state of
Missouri regarding a woman’s right to abortion in prison:

The original case against the state, Crawford v. Roe, stemmed from a
2005 incident where Missouri prison officials denied a female inmate
transportation to an abortion facility. ACLU sued on behalf of the
inmate, "Jane Roe," who eventually received medical treatment.

In July 2006, the ACLU filed a class-action lawsuit on the behalf of
all female prisoners seeking abortions in Missouri. In the class-action
lawsuit, a Missouri District Court ruled that incarceration does not
deny women’s rights to an abortion. The Eighth Circuit US Court of
Appeals affirmed the lower court’s decision.

Reproductive Freedom Project attorney Diana Kasdan said in an ACLU press release
following the Circuit Court Decision, "Today’s decision is consistent
with rulings from across the country that women prisoners do not lose
their reproductive rights once they are incarcerated. Prison officials
must ensure that women have access to the full spectrum of
pregnancy-related care, including abortion."


Breast Cancer Vaccine Within Reach

The Guardian reports that "[e]nough is known about the causes of breast cancer to make a vaccine or prophylactic drug a real possibility."  Interestingly researchers have found that the more children a woman had and the longer she breastfed, the lower her risk was of later contracting breast cancer.

Women in developed countries where small families are the norm have six
times the breast cancer risk of those in rural parts of Asia with large

Professor Valerie Beral of Oxford University, who leads the Million
Women’s Study into the causes of the disease, told the Guardian the
study had put beyond doubt what had long been guessed – that many
breast cancers are caused by the absence of hormonal changes connected
with childbirth.

"But why aren’t we thinking of mimicking the effects of childbirth?"
she said. "We don’t know how this happens and nobody is doing research
on it. We should be looking at hormone production during late pregnancy
and lactation."

"The one hormone that has to do with breast changes doesn’t appear
until late pregnancy. It goes up exponentially. It produces the changes
in the breast that make for lactation," she said. "Why isn’t anyone
looking at it?" Whichever hormone or hormones are responsible, she
said, short-term exposure during late pregnancy and breast-feeding
provide life-long protection which is exactly what is required of a
vaccine or preventive drug.