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March 16, 2012 11:24 am

Circumcision Troubles

avatar by Jeremy Rosen

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Brit Mila Ceremony. Photo: wiki commons.

I have to my credit (or not) several blogs about circumcision in which I contrast my visceral antipathy towards harming a child with my loyalty to an ancient, resilient, and still relevant tradition. I also draw a distinction between a ritual that permanently removes an organ of pleasure and one which is simply superficial. And, at the risk of offending tattoo lovers, I find circumcised penises much more aesthetically attractive than uncircumcised ones, and indeed more than tattoos and body piercings. But I concede unreservedly that this is very subjective and no doubt culturally conditioned.

For over two thousand years it has been enshrined in Jewish law that where the health of a child is at risk one does not circumcise. All the commandments (except for blasphemy, murder, and adultery) are overruled immediately and without reservation where life is at stake. This is why we delay circumcisions until babies are declared medically healthy and why in the case of a child suffering from hemophilia the ceremony would be delayed indefinitely. There are plenty of other halachic precautions.

So how can one explain the sad death of yet another child because a Chasidic mohel passed on herpes when he put his mouth to the wound to draw blood?

The great and very conservative leader of European Orthodoxy, the Chatam Sofer (1762-1839) was asked to rule on the procedure of Metzitzah, mentioned in the Mishna. The mohel sucks the incision site to force a bloodflow through the cut. The Chatam Sofer writes that the original reason for Metzitzah was functional, to protect the health of the child. The flow of blood would disinfect, help healing, and dislodge any blockages caused by the circumcision itself. He argued that, given the health fears raised in his day, Metzitzah with a sponge was acceptable. Opponents of his ruling argued this was an exceptional ruling rather than a general one, and only in response to the threat of the authorities to ban circumcision altogether.

However, the default position of many ultra-Orthodox Jews, particularly Chasidim, is to perpetuate the custom, and thankfully the number of fatalities is minute. On the other hand, the more Modern Orthodox and more Lithuanian Rabbinical Council of America (RCA) recommend using the glass tube or pipette. In its paper on the subject, the RCA brings plenty of authorities, even from the strictest of Eastern European authorities, who either banned or discouraged the direct mouth method.

In Britain for many years, the late Dr. Bernard Homa, head of the Machzikei Hadass community of London, campaigned against Chasidic persistence in using Metzitzah by mouth.  He wrote several articles producing all the halachic evidence, culminating in a pamphlet entitled Metzitzah, published in the UK in 1960.

A few years ago a Chasidic mohel who used the oral method in New York was found to have infected three children with herpes, one of whom died. In response, New York authorities tried to prohibit him from performing Metzitzah b’peh. However, the mohel’s attorney argued that the New York Department of Health had not supplied conclusive medical evidence linking his client with the disease. In September 2005, the city withdrew the restraining order and turned the matter over to a rabbinical court. In May 2006, the Department of Health for New York State, issued a protocol for the performance of Metzitzah b’peh which purported to allow it to continue while still meeting the Department of Health’s responsibility to protect the public health.

Despite the furor at the time until after May 2007, when Fischer was linked to another case of neonatal herpes. At that time he was prohibited by the New York Department of Health from performing Metzitzah b’peh anywhere in the state. But it seems that both he and his community ignored the ruling. The Chasidic communities, being inherently conservative and opposed to outside interference, have refused concessions to modernity (except when their own lives and health are at stake).

Even so, they have been forced to acknowledge the risk and have encouraged the use of disinfectant and mouthwash. But most medical opinion doubts that this is enough. All this quite apart from the risk the mohel runs, himself, of contracting some blood-borne disease the child might have picked up from its parents. But, hey, if he wants to take the risk, no doubt he believes his Rebbe will protect him.

Once again, it is politics that is preventing anything being done. It seems to me axiomatic that if someone causes the avoidable death of anyone, whether through Herpes or AIDS or whatever, he or she should be prosecuted for manslaughter. Still, neither in Israel nor the USA will this happen. Why? Because in certain areas, the dominant Chasidic population can be commandeered by their Rebbes to vote en masse and en bloc. This is a serious factor in many closely fought political constituencies. No one wants to offend blocs of voters, if at all possible. In Europe, the inner-city Muslim vote similarly exercises a powerful influence to stall interference.

We Jews are the first to cry foul. Why aren’t we all crying foul now? I am not suggesting a total ban. After all, we don’t ban sexual intercourse because one can pass on HIV. But I would like to prosecute any mohel who causes the death of a child through a practice that could have been avoided without infringing Jewish law. If one wants to be so holy, then one needs to take very serious precautions to avoid turning sanctity into tragedy.

The case against legislation is interference in religious affairs. But this is not a case of preventing a religious practice. It is not a ban on circumcision. It is merely closing one seemingly optional avenue of religious behavior when others are still open, even in the most diehard of communities.

Political correctness is a serious disease, all the more so when it really causes death. It can lead to the failure to stop terrorism by refusing to narrow down the field of suspects, and it can also put lives at stake by fearing or refusing to interfere with religious practice. If we cannot take the steps to stop it, we must at least enable the courts to.

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  • Emma

    I think that if a person wants to be circumcised later in life, then that is their personal decision. But forcing that procedure on a child for non-medical reasons just seems absolutely wrong to me.

    • jeremy rosen

      If you are worried about what damage parents can do to children, then I suggest you legislate for all the horrific damage that many untrained and immoral parents inflict psychologically and otherwise on their children . I will concede that damage is often caused by religions as well as good but most societies still believe in freedom of religious practice.

  • salvage

    Anyone who cuts their newborn based on a Bronze Age ritual to appease an insane god is an idiot.

    Of course it should be illegal but it’s stunning that there is a need for such a law.

    It’s to the Christian’s credit that when they were cobbling their version of this nonsense together they cut out the circumcision; a rare show of sense.

    • Steven

      Hey Salvage what are you an Atheist?

      • salvage

        Yes, I am sensible that way.

        • Steven

          Ok ; that explains your hatred for a religious practice which has been going on for over 3750 years!

          • salvage

            Uh… no, no it doesn’t but the whole needlessly cutting into a baby and on occasion killing one does.

            And well over 3,750 years? Wow! That’s a reason to do something isn’t it? It’s clear you’ve given the whole issue some deep thought.

            It’s a bizarre ritual done by weird people for their insane god delusion.

            And yes, I’m an atheist because I’m so full of hate! Grrr! Grrr! There is absolutely no sensible reason not to believe in magic.

  • jeremy rosen

    Then I can think of a whole raft of things we should ban that kill and put children at risk in far greater numbers…like driving cars!

    • salvage

      Ha! Ha! Yes! Driving a car is just like cutting a penis because some 6,000 years ago a sky god told some dessert nomads to do so!

      Reality, do you know it?

  • jeremy rosen

    I have to say thats more or less exactly how I thought I had framed the issue!

    • Steven

      Jeremy with all due respect if you see the “moronic” comments on your article the only sensible conclusion is that there is a real confusion amongst the commentators as to what exactly the issues are.

      The way I framed it all those comments are meaningless I urge all to read my comment and it will become mighty clear that the kids did not die becaouse of the Bris with Metzitza but rather due to criminal negligence of the Preformer of the Bris.

      So leave Bris with or without Metzitza alone and punish anyone who preforms it and has a contagious desease- simple.

  • jeremy rosen

    You are right, the analogy is not 100%, analogies rarely are. But to tweak it, parents are allowed to take decisions, sometimes matters of life and death, on behalf of their children and suffer the consequences ( or prosecution ) if they get it wrong.

    • Parents are allowed to make life-or-death decisions where the child’s life is already at risk and the outome of the decision is relatively minor compared to the risk. There is no other normal, healthy, functional, non-regrowing part of their child’s body that parents can decide to cut off. It is illegal to tattoo a child or to pierce his or her genitals (or to cut ANY part off her genitals, no matter how little or how surgically). Infant male circumcision is anomalous.

  • Steven

    The issue is not the Bris or the Metzisa but that the Mohel has Herpes. So the Mohel with Herpes is like a Blood donor who has AIDS and knowingly infects others.
    To me its clear that this debate is not framed properly and shows anti religious bias. There is a very simple solution to this problem, namely, any Mohel with Herpes should be prosecuted for premeditated murder if the child dies.
    Another suggestion is that All Mohalim test for infectious deseases regulary.
    I am concerned Jeremy that a person like yourself fail to have framed this issue properly.
    The Bris Mila is an integral part of our Heritage and can be safely preformed as in the past as long as those preforming it are healthy.

  • Jessica S.

    Yet another circumcision victim dies… enough is enough, circumcisions on minors against their will should not be allowed in this day and age.

    We need to protect children and adopt new religious ways of honoring God without putting our children at risk!

  • So it’s not OK for an old man to suck a baby’s penis for a second, but it’s OK to cut (the best) part off lifelong? Have a look at the context in which it was reportedly instituted, Gen 17. Not only was Abraham to circumcise himself and his sons, but also his slaves and every male living in the household. The Mexican live-in gardener might have something to say about that nowadays.

    You refer to your “loyalty to an ancient, resilient, and still relevant tradition.” Ancient and resiilent certainy, but to what is cutting parts off babies’ penises relevant?

    “I also draw a distinction between a ritual that permanently removes an organ of pleasure and one which is simply superficial.” Well, circumcision does the first, as Philo of Alexandria, Maimonides and many others universally agreed, whether they thought that was good thing or not, until circumcision became widespread and the contrary view could become widesspread among men who have no idea what they are missing.

    “For over two thousand years it has been enshrined in Jewish law that where the health of a child is at risk one does not circumcise.” It is time to acknowledge that circumcision itself puts the health of the child at risk. A Richmond VA pediatrician had to repair 1600 circumcisions by other doctors in three years, suggesting a complication rate of 13%.

    • jeremy rosen

      I dont expect you to understand my own existential experiences and commitments. The debate over circumcision, pro and con, rages on and I am not at all persuaded by the so called scientific evidence that under normal conditions circumcision does any harm any more than cutting ones finger. But I am not evangelical and don’t expect to convince you. Quoting Abrahan is irrelevant. No one in my religion has suggested imposing circumcision on outsiders for thousands of years.
      Accidents and errors happen all the time in the most scientific and medically up to date of conditions. People die under anaesthetics but I have yet to see an argument for banning them.


      • “No one in my religion has suggested imposing circumcision on outsiders for thousands of years.” No, only on newborn babies before they have any chance to have a say in the matter. I don’t expect you to understand their own existential experiences and commitments once they are adult either, but more and more are saying that they resent it very much – some to the point of leaving Judaism because of it. Cutting part of one’s finger OFF certainly does do harm, especially a highly innervated part.

        People die under anaesthetics mainly because we don’t put people under anaesthetics unless they are sick enough to warrant it, and/or they have signed no end of informed consent papers – for themselves, not someone else.

  • Tom Tobin

    A baby was killed in New York through Metzitzah b’peh in New York in 2005, and two other babies infected with herpes for life. The same year, 8 babies were infected in Israel, and one suffered brain damage.
    New York’s Health Department currently notes that “there is no proven way to reduce the risk of metzitzah b’peh” and that, while “a mohel may use oral rinses or sip wine” before performing the ritual, “there is no evidence that these actions reduce the spread of herpes.”
    It is the responsibility of the state, to protect these children, who are too young to protect themselves.
    It’s not a religious issue, when it is killing the children, or infecting them with an incurable disease. It is a child protection issue.
    If the state cannot ensure that the practice can be done safely, the practice cannot be allowed.
    New York filed a legal complaint to compel Rabbi Yitzchok Fischer to stop, after the 2005 death. He refused. If he was involved, the charge against him should be murder.
    In any event, the city of New York needs to be held accountable. They put nothing in place after the 2005 death, to protect future Jewish children, resulting in the 2011 death. When the city cares more about its image, or fears a backlash so much that they are in effect paralyzed, they themselves are endangering the life of the child. The law needs to be corrected, and the city needs to be held accountable. No more innocent deaths to a practice which has become life-threatening.

  • jeremy rosen

    Every tradition has a range of very weird customs. No religion or culture survives detached scrutiny unscathed. We in the Modern West dont consider it at all weird for male doctors to peer up womens’ vaginas. Others think its scandalous..

    • I suspect that women’s health statistics in those countries will reflect that fact.

    • salvage

      yes, and they too would be considered by any sensible person to be ignoramuses who let their insane superstitions interfere with health.

  • So it’s okay for a mohel to suck a baby’s penis? No one has any sort of an issue with that?