A win for Herpes

New York's decision to permit oral suction in circumcisions without informed parental consent is disappointing

The pressure from the Charedi world was immense. And New York Mayor Bill de Blasio seems to have succumbed to it. From the New York Times:

The city is seeking to waive a rule that requires parents to sign a consent form before the ritual, which involves the circumciser using his mouth to suck blood away from the incision on a boy’s penis. The ritual is common among some branches of Orthodox and ultra-Orthodox Judaism.


Administration officials on Tuesday announced a new policy that they described as a compromise between reducing health risks for infants and protecting the religious freedoms of those who cherish the ritual, known as metzitzah b’peh, or oral suction.


The policy, which must be approved by the city’s Board of Health, involves a series of medical tests when a baby is found to have herpes. A circumciser who is proved through a DNA match to have the same herpes strain as the baby’s would be banned for life from the practice.

Chasidim believe that Metzitza B’Peh (MbP) is an essential part of the circumcision ritual. As such they felt that even a warning to a parent of the possible hazards was an infraction of their constitutional right to practice their religion freely. Although the Supreme Court has ruled that freedom of religion does not extent to practices that are harmful, Chasidim maintain that the incidence of a child becoming infected with Herpes via MbP from a Mohel is yet to be proven. And in any case it is so rare, that health concerns are hardly a significant worry.

As I have stated in the past. There are a variety of poskim (adjudicators) on both the right and left, both past and present that have clearly ruled that Metzitza (drawing the blood out of the circumcision wound – a practice our sages required as a health measure) may be done by more sterile methods, like using a sterile pipette, or using gauze. The Mohel’s lips need not touch the baby’s open wound. So I would have no personal problem with abolishing the practice altogether. But I also respect that there are others who disagree… and say that without MbP, the circumcision is ritually invalid.

So for me the obvious and best compromise was the New York Board of Health’s requirement for informed and written consent by a parent before allowing MbP to take place. That – combined with the relative rarity of a child contracting an infection via MbP — sufficed in my mind as both protecting freedom of religion and at the same time making sure that a parent is aware that the medical profession has determined MbP to be  a serious risk to the child’s health.

I’m sorry to see this reversal of what I thought was a sound policy of compromise – even though it was probably observed by Chasidim and many Charedim more in the breach. But at least it was on the books. Parents deserve to know what the best medical minds in the country have to say on the matter. That they may not care is up to them.

Opponents of informed written consent claimed that even though MbP was not banned, the scare tactics of reading and signing a document that put MbP in such a bad light was in itself a violation of their religious rights.

I can’t really say I blame them. Who wants to see the government warning you that a religious practice you consider to be inviolable — is considered dangerous to one’s health?! Agudah Executive Vice President Rabbi Chaim Dovid Zweibel called this requirement profoundly offensive to his community

Nonetheless, the health of the child comes first. Way ahead of how offended someone feels about it.

When it comes to Sakana, danger to one’s health, there is no Halacha (aside from the three cardinal sins) that cannot be violated. Indeed they must be violated when it comes to health!

I suppose a recent test using DNA technology might have had something to do with de Blasio’s decision. It was determined in the case of one mohel strongly suspected to have transmitted a herpes virus to a child he circumcised (who subsequently died) that he was not the source. And to date, as far as I know there has been no direct link made between an infected mohel and a child that contracted herpes.

But that doesn’t mean it didn’t happen or can’t happen in the future. The Gemarah (Kesubos 23a) tells us: Lo Roinu Aino Rayah — Not seeing something  is not proof that it didn’t happen.

So I am disappointed in the mayor of New York. I would like to believe that he did this because of his sensitivity to his constituents’ religious rights, which was his stated reason. But I am a bit more cynical than that. He promised Hassidic voters during the election that he would get rid of the informed consent requirement if he were elected. They voted for him. So now, even though he personally believes that MbP is a dangerous procedure, he is keeping his promise. But it is a decision based on politics, not on good government.

I don’t see how anyone could say it isn’t dangerous to place a mouth on an eight-day-old baby’s open wound. Would anyone in his right mind approve of a surgeon sucking the blood out of an incision of that same infant undergoing surgery? Even if he rinsed out his mouth with Listerine?

I suppose that half a loaf is better than none as someone so wisely reminded me recently. So testing a mohel suspected of transmitting herpes to a baby he circumcised and banning him for life if he is proven to have had it is a plus. But that will not prevent a mohel that has never been tested from transmitting it.

Hopefully there has been so much public discussion about the dangers of MbP that most parents are now aware of it and will think twice about doing it. But for those who haven’t heard about it or those who have but don’t care, the danger still remains.

About the Author
My worldview is based on the philosophy of my teacher, Rabbi Aaron Soloveichik , and the writings of Rabbis Joseph B. Soloveitcihk , Norman Lamm, and Dr. Eliezer Berkovits from whom I developed an appreciation for philosophy. I attended Telshe Yeshiva and the Hebrew Theological College where I was ordained. I also attended Roosevelt University where I received my degree in Psychology.