The New York City Board of Health was scheduled to vote this Thursday (two days after this issue went to press) on a measure requiring parents to sign a consent waiver before allowing a mohel to perform metzitzah b’peh, or oral suctioning, on their infants.
The proposal has created a firestorm in the Orthodox community. While some see the proposal as the first step toward an outright ban on metzitzah b’peh, others are simply leery of attempts by City Hall to legislate religious practices.
The proposed waiver reportedly is the result of a study published by the Centers for Disease Control and Prevention that found that since 2000, eleven newborns contracted the herpes simplex virus after the metzitzah b’peh was performed on them. Two of the infants cited in the report suffered brain damage while two others died.
In a statement released on June 6, the City of New York urged that the practice be discontinued entirely and city-owned hospitals began distributing a booklet advising parents about the potential health risks of metzitzah b’peh.
The booklet, titled “Before the Bris, How to Protect Your Baby Against Infection,” details a direct link between oral suctioning by a mohel infected with herpes and both infection and death associated with herpes simplex type one virus (HSV-1); it warns parents that there is no proof that any precautions taken by a mohel to prevent transmission of the disease can reduce the risk of infection and counsels parents to ask their mohel if he performs metzitzah b’peh.
Under the proposed regulations, mohels would be required to distribute consent forms to parents and to keep those waivers for a minimum of one year. The precise wording of the form, which would warn of the potential risks, would be drafted by health officials, not rabbis.
An earlier challenge to metzitzah b’peh on the state level was resolved in 2006 when the New York State Department of Health issued an official protocol for the practice of oral suctioning, developed in conjunction by a team of doctors and rabbis. New York State Commissioner of Health Dr. Antonia C. Novella praised the rabbis involved in the process for their cooperation, saying the meetings gave her a better understanding of the importance of metzitzah b’peh and that she was confident the newly developed protocols would respect tradition while still protecting the health of the public.
It is precisely the lack of rabbinical involvement in the proposed regulations that Rabbi Moshe Chaim Friedman of NYmohel.com finds unsettling.
“The problem with the way this is being done is that the city is not engaging in a dialogue with the people that this affects: the rabbonim, those involved in bris milah,” said Rabbi Friedman.
“What was done in 2006 was negotiated with a proper dialogue and was done in a mutually beneficial fashion. This isn’t being discussed with anyone. They are just ramming it down the collective throats of the Orthodox community. Our common goal is the safety of our children, so why mandate this instead of working with us?”
He said another concern was that “the controversy has scared away irreligious people from having a bris altogether, no question about it. They have been led to believe that the rabbi performing the ritual harms babies.”
“This isn’t about defending metzitzah b’peh,” he added. “This is about defending our right to freedom of religion.”
Rabbi Friedman said that regulating any part of bris milah is a dangerous precedent.
“I see this as the beginning of the end. Once they insert themselves into religious practices there is no limit to what they can mandate.”
“We need to protest this vociferously,” added one prominent Brooklyn posek, who asked that his name not be used.
“It is dangerous for the Jewish community to let this go by unchallenged. The moment they have a foot in the door to say anything about religious practice, we face the risk of serious problems.”
Rabbi Romi Cohn, a member of the American Board of Ritual Circumcision, a rabbinic board that has been regulating the practice of bris milah for over 50 years, called the proposed regulations a blood libel.
“Two children died in a twelve-year period,” said Rabbi Cohn. “Mayor Bloomberg says he wants to protect Jewish children from getting hurt? If he is really concerned about the welfare of children, perhaps he should look at New York City hospitals that are under the jurisdiction of the Department of Health. Significantly more children have died of staph infections they contracted at New York hospitals than have ever died as a result of a bris milah.
“How can an intelligent person come out with such ridiculous allegations? How many kids get hurt each year riding bicycles, or training for little league? Let Mayor Bloomberg make regulations where they are needed, not here where it is totally unnecessary.”
Rabbi Cohn noted members of the ABRC are trained both in the ritual and medicinal aspects of bris milah.
“What they are trying to regulate is something that we already are regulating,” said Rabbi Cohn. “The ABRC’s regulations are much stricter than those of the medical profession, and we are much more careful than any doctor performing a circumcision.”
At a public hearing held four weeks ago, Rabbi Cohn informed the Department of Health that he had performed more than 25,000 circumcisions in his lifetime and that fellow members of the ABRC had also performed a significant number of circumcisions, and not once in any of those cases had there been any incidence of infection in the circumcised babies, let alone any deaths.
“We believe in regulating circumcision,” said Rabbi Cohn. “But by religious authorities, not the government. By attempting to regulate metzitzah b’peh, they are infringing on our constitutional rights.”
Rabbi Cohn likened the Department of Health’s attempts to regulate circumcision to the attempts by Hellenists two thousand years ago to eradicate the practice.
“Chanukah is a celebration of how we prevailed against those who tried to prevent circumcision,” said Rabbi Cohn. “Once again, we are prepared to fight to the very end in order to protect our religious rights.”
A phone call to the mayor’s office was not returned. A Department of Health spokesperson, responding to the mohels’ statements, e-mailed The Jewish Press: “Since 2000, 11 babies have caught herpes from direct oral suction, and two of these babies died. The City’s highest obligation is to protect its children; therefore it is important that parents know the risks associated with the practice.”
Even some in the Orthodox community who are not necessarily in favor of metzitzah b’peh have voiced opposition to the city’s proposal.
The Rabbinical Council of America issued this statement on Monday: “Many Jewish legal authorities have ruled that direct oral suction is not an integral part of the circumcision ritual, and therefore advocate the use of a sterile tube to preclude any risk of infection. The RCA has gone on record as accepting the position of those authorities. Nevertheless, the RCA respects the convictions and sensitivities of those in the Orthodox Jewish community who disagree with this ruling and joins in their deep concern about government regulation of religious practices…
“The RCA supports the recent call of the Agudath Israel of America to New York Mayor Michael Bloomberg and the New York Health Department that, instead of unilaterally imposing regulations, they collaborate with Orthodox Jewish leadership to develop protocols to address health concerns.”
Rabbi David Niederman, executive directive of the United Jewish Organizations of Williamsburg, told ABC News that mohels will not agree to abide by the law should it pass. He argues that the data linking metzitzah b’peh and HSV-1 is flawed.
“This is the government forcing a rabbi practicing a religious ritual to tell his congregants it could hurt their child,” said Rabbi Niederman. “If, God forbid, there was a danger, we would be the first to stop the practice.”
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