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September 29, 2016 / 26 Elul, 5776
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Metzitzah B’Peh – Where We Are And Where We Need To Go

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Some have said that the Chasam Sofer’s p’sak has no relevance today, since they claim that it was only a hora’at sha’ah; a ruling under unusual circumstances that is applicable only for a given time and place. Even if so, perhaps we qualify for a hora’at sha’ah p’sak today, considering that infection with herpes type-1 virus today is at epidemic levels in adults and the consequences to an infant who contracts it is so great. Let those who claim that MBP is absolutely safe prove its safety and we can then reverse this temporary modification.

What do I recommend? I believe that the time has come to establish a formal medical committee that will consider the input and opinions of multiple national experts on pediatric infectious disease, virology and public health. There are plenty of such experts who can weigh in on this debate. This committee will issue a report and make a best-determination of probable fact, considering what is known today. It will also highlight legitimate differences of opinion where they exist. This report can be updated as further data emerges. Poskim can then use these finding of fact to make a determination of halacha.

I know there are many halachic issues. Amongst them: Is MBP a minhag or part of the actual bris? Is it only a medical recommendation by the Talmud that can be modified or discarded as medical knowledge changes? Does metzitzah need to be b’peh or is any other suction source or method of drawing away blood equivalent? Since I am not a rabbi, I am not qualified to rule. I merely seek a way to have fair representation of medical facts and judgment for those ruling on halachic matters.

I believe an organized approach will increase medical factual accuracy, and also result in increased confidence in the halachic process. Our children deserve nothing less than both of these outcomes.

Gary A. Gelbfish MD, FACS, is a vascular surgeon in private practice. He is a mohel certified by the Rabbinate of the State of Israel.

Dr. Gary A. Gelbfish

About the Author: Gary A. Gelbfish MD, FACS, is a vascular surgeon in private practice. He is a mohel certified by the Rabbinate of the State of Israel.

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