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November 28, 2015 / 16 Kislev, 5776
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Posts Tagged ‘mohel’

Metzitza B’Peh – Knowledge is Power

Tuesday, September 23rd, 2014

It is a hot button issue that raises the hackles of the right. And it has been discussed to death. But the subject has come up again with a recent decision by a federal court criticizing the New York City Board of Health requirement of informed consent with respect to Metzitza B’Peh (MbP) – the over 3000 year old tradition of direct oral suction of the blood from the circumcision wound.

I understand the right wing argument against this requirement. But I still strongly disagree with them. To briefly restate the issue, the sages delineated the procedure for a Halachic circumcision (Bris Mila). The final step – Metziza (withdrawal of the blood) – is listed as the mandatory health requirement part of this procedure. Chazal required it in the belief that it was dangerous to the health of the child to leave that blood on the open circumcision wound. Although the Talmud never tells us how to do it, Metzitza has always been done B’Peh – by oral suction.

Over a century ago, when some babies died as a result of doing MbP, there were major Poskim who said it could be done in other, more sterile ways. There are Poskim today that say the same thing. On the other hand there are Poskim that disagree and say that MbP is an absolute requirement and that Metzitza must be done orally.

A few years ago there were some babies that died shortly after their Bris – having contracted the herpes virus. It was determined that the Mohel had a live herpes virus but at the time it was asymptomatic. The New York City Health Department concluded that the herpes virus was contracted by the baby via the direct oral suction of the circumcision wound by the Mohel. Long story short – as a result of that conclusion they issued a requirement that parents give their informed consent in writing if they wanted the Mohel to use MbP.

Then all hell broke loose. Those communities (mostly Chasidic) that believe that MbP is a Halachic requirement felt that the government was encroaching on their religious rights. They took legal action and were joined by Agudath Israel in filing a federal lawsuit claiming a violation of the separation clause of the first amendment. Furthermore fueling the debate is the fact that many non Chasidic Yeshiva type communities prefer MbP – considering it more Mehudar (an enhancment of the basic Halachic requirement).

The right wing has also characterized this as an attack on Bris Mila itself – seeing this intrusion into our religious practices a slippery slope towards a ban on Mila itself.

The New York board of health on the other hand saw this as a health issue. In a nod to the first amendment they did not ban MbP since a baby contracting herpes from an infected Mohel is a rare occurrence. But they do consider it dangerous enough to require a warning. This is why they require informed consent in writing by the parents of a child about to be circumcised by a Mohel using MbP.

This all made sense to me. But in an surprising decision, a federal court issued a sharp criticism of this rule as specifically targeting a religious community… and thus violating the constitutional amendment separating church from state.

Avi Shick has written an op-ed in the New York Daily News supporting that decision – asking New York Mayor, Bill de Blasio to rescind the requirement for informed consent. Avi is basically saying that the government should keep its nose out of our business. What about the health issue? He calls their argument about that weak. Among other things he says the following:

NY Newborn Contracts Herpes after Metzitzah B’Peh

Monday, February 3rd, 2014

A newborn in New York who underwent his ritual circumcision rite is undergoing treatment for neonatal genital herpes, according to the Forward, contracted after metzitzah b’peh, in which the ritual circumciser places his mouth directly on the child’s circumcision wound to revive the shocked blood stream.

The New York City Department of Health and Mental Hygiene issued a health alert about the baby’s case on Jan. 28. The baby was treated for the genital rash five days after his circumcision.

At least 11 boys contracted herpes between 2004 and 2011, according to New York City health officials. Two died from the disease and two others suffered brain damage.

In September 2013, the city’s Board of Health voted 9-0 to require mohels to obtain signed consent forms from parents; the Haredi Orthodox Jewish community opposes the forms. Several months earlier, the city had struck an agreement with city hospitals to distribute pamphlets about the ritual’s dangers to the mothers of newborns.

New York Mayor Bill de Blasio said shortly after taking office on Jan. 1 that he would leave the signed consent forms in place while looking for a more effective solution, according to the Forward. The Haredi Orthodox community had expected de Blasio to do away with the forms.

Pittsburgh Rabbi Denies Botching Circumcision

Wednesday, January 8th, 2014

Rabbi Mordechai Rosenberg, who was accused last week of botching a circumcision of an 8-day-old boy who was rushed to the hospital after his penis had accidentally been cut off, told a court that is not at fault.

The incident revived worldwide publicity at a time when anti-circumcision lobbies have succeeded in convincing some European officials to back the prohibition of non-medical circumcisions.

Rabbi Rosenberg admitted that the baby boy had been injured, but the lawsuit against him does not specify the wounds. The parents said through the lawsuit that they rushed the baby to a hospital for surgery and leech therapy that helps the body to accept reattached parts.

The suit charged Rabbi Rosenberg with causing a “catastrophic and life-changing injury.”

In his lawyers’ response to the lawsuit, the court was told, “Rabbi Rosenberg performed the Bris Milah in a careful and competent fashion, with the care and skill normally exercised by Mohels under the same or similar circumstances” and “denies that he is liable to plaintiff,” the Pittsburgh Tribune reported.

Judges Hear Appeal of NY Rule on Circumcision with Oral Suction

Tuesday, December 3rd, 2013

A federal court began hearing arguments on Tuesday by orthodox Jews appealing a  New York City rule that requires parents to agree to the rite of oral suction in circumcisions, The New York Daily News reported.

The city restricted the practice following 11 cases of herpes of boys who were circumcised with what in Hebrew is known as “metzitzah b’peh.” The practice is widely followed in Israel without controversy.

The orthodox Jewish groups are appealing a lower court decision supporting the law this past January

Council of Jews in Germany Awards Pastor Who Defends Circumcision

Thursday, November 21st, 2013

A German pastor who defended Jews’ rights to ritual circumcision will receive the highest award of the Central Council of Jews in Germany in ceremonies in Berlin Thursday evening.

The awarding of the Leo Baeck Prize will honor Nikolaus Schneider, 66, president of the council of the Evangelical Church in Germany – the country’s main Protestant body – for his support for Jewish life in Germany, his dedication to Israel and his “unconditional solidarity in the circumcision debate” that embroiled the country in 2012.

Schneider defended the right of Jewish circumcision during last year’s attempt by activists to bar ritual circumcision, helped by a May 2012 ruling that criminalized non-medical circumcision in Cologne.

Schneider decried the Cologne ruling as criminalization of an age-old religious practice and said that this “attack on Jewish identity” upset him “greatly, given history, and our German history with Jewry.”

Last December, Germany passed of a law affirming the right to religious circumcision of boys and setting medical standards to be met by mohels.

Council of Europe Chief Reassuring Rabbis on Circumcision

Wednesday, November 13th, 2013

The Council of Europe will not ban Jewish ritual circumcision of boys, its leader assured members of the Conference of European Rabbis.

Thorbjorn Jagland, the council’s secretary general, said Monday in Berlin that he wanted to make it “absolutely clear … that in no way does the Council of Europe want to ban the circumcision of boys. It is a very important part of Judaism and of Jewish life.”

He spoke during a news conference with rabbinical leaders as part of the conference’s annual convention.

Referring to a non-binding, anti-circumcision resolution passed last month by the council’s Parliamentary Assembly, Jagland said no European Union member country had actually banned the practice.

“We have an obligation to protect it” on behalf of freedom of religion, he added.

In recent years, ritual circumcision of boys and ritual slaughter of animals have come under attack in Europe, particularly by right-wing populist political movements.

Muslims, not Jews, are the main target of these attacks, said Conference of European Rabbis head Pinchas Goldschmidt, the chief rabbi of Moscow, in an address to nearly 250 member rabbis at a dinner at the Jewish Museum on Monday.

European Jewry is “the collateral damage in this anti-Muslim offensive,” he said.

Stephan Kramer, secretary general of the Central Council of Jews in Germany, told JTA he would like to know “what [Jagland] is doing, ‘tacheles,’ ” or ultimately, to protect religious freedom in Europe — and he offered to help.

Meanwhile, the Conference of European Rabbis is moving forward with its program to help European Jews find a mohel, or ritual circumciser, online.

Vienna Rabbi Shlomo Hofmeister told JTA that the Conference of European Rabbis’ Union of Mohelim in Europe will go online within days. Orthodox mohels who meet stringent medical requirements will be listed and parents will be able to contact them through the site. Mohels may not charge a fee for performing a brit milah, but may ask parents for compensation for travel and lodging, Hofmeister said.

The website, whose address has not yet been announced, will also provide legal advice to mohels.

See also: Council of Europe Says Ritual Circumcision Won’t Be Banned.

In Defense of Parental Consent for ‘Metzitzah B’peh’

Wednesday, October 16th, 2013

Imagine the following commonplace scenario: The parents of a newborn Jewish boy are looking for a mohel to perform a bris on their son, but do not know any personally. They ask around and receive a recommendation from a friend. They call the mohel, who agrees to perform the circumcision. On the appointed day, the mohel appears, performs the circumcision, and the parents make a donation to a charity of the mohel’s choice in lieu of payment.

Now imagine this: A week later, the child begins to develop lesions (sores or blisters) at the site of the circumcision. An investigation reveals the mohel performed the procedure known as metzitzah b’peh (MBP), direct oral suction of the incision. This practice is the subject of intense halachic dispute. Some hold it is an essential requirement of Jewish circumcision; others, that it is permitted but not required; and still others, such as Rav Chaim Soloveitchik (the Brisker Rav) and his son Rav Moshe Soloveitchik, that it is forbidden because of the risk of disease transmission. The parents, however, like the fourth son at the Seder, did not know to ask, because they, like many Jewish parents, had never heard of MBP. The lesions spread. Soon after, in the worst case scenario, the child dies.

The question: Should the mohel have explained the MBP procedure and told the parents he would be performing it as part of the bris, giving them the opportunity to choose not to have it done, whether for halachic or medical reasons?

Last year, after receiving complaints from parents that MBP had been performed as part of their child’s bris without their knowledge and consent, and after confirming eleven cases of herpes simplex virus (HSV) acquired by infants in New York City from MBP in recent years resulting in two deaths and two cases of permanent brain damage, the city passed a parental consent regulation to ensure that parents are the ones making the informed decision about whether MBP is performed on their child.

Agudah and groups affiliated with segments of Chabad and Satmar, as well as some individual mohelim, brought a federal lawsuit to challenge the regulation. The regulation at issue does not, in any way, limit the permissibility of MBP. The law only requires that, prior to the circumcision, the parent or legal guardian has to give written informed consent, which must include notice that “direct oral suction exposes the infant to the risk of transmission of herpes simplex virus infection and other infectious diseases.”

In this way, not only does it not infringe on the religious liberties of mohelim, it actually protects the religious liberties of parents by ensuring that they make the decision whether MBP – a religious act – is performed on their child.

As a matter of constitutional law, medical ethics and common sense, it is the parents – the individuals ultimately responsible for their child’s well-being – who must make fully informed decisions regarding their child’s healthcare and religious upbringing. As the U.S. Supreme Court has recognized, a parent’s rights in the care, custody, and control of his or her children is “perhaps the oldest of the fundamental liberty interests.”

I’m the lawyer representing major national medical organizations in the case. My clients include the American Academy of Pediatrics, the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society, and the Sexually Transmitted Diseases Society of America. My clients felt compelled to get involved in the case because they are gravely concerned about the public health and public policy implications if the challenged regulation is blocked.

In many ways, I’m an unlikely advocate for the defense of the metzitzah b’peh regulation. I’m a constitutional litigator and Orthodox Jew who is a lot more accustomed to suing New York City than defending it. I’ve been involved in cases against the mayor, the City Council, the Department of Buildings, the NYPD, the Taxi & Limousine Commission, and other city and state agencies and officers.

And I’m a lot more accustomed to bringing religious liberties cases than defending them. Among other cases, I’ve represented dozens of members of Congress at the U.S. Supreme Court in the Zivotofsky passport case and my shul in Teaneck in an ongoing religious liberties lawsuit against the local zoning board under the First Amendment.

Printed from: http://www.jewishpress.com/indepth/opinions/in-defense-of-parental-consent-for-metzitzah-bpeh/2013/10/16/

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