U.S. court revives challenge to New York City circumcision law

Unsurprisingly, the frequency of metzitzah b’peh is not exactly advertised outside of these communities, though it came under scrutiny in New York after a handful of infants — 17 since 2000 — contracted the herpes virus following the ritual. The baby is then bandaged. The purpose of the proposed amendment is to require informed consent from a parent or legal guardian when direct oral suction will be performed during his or her son’s circumcision. The statute in Smith prohibited the use of peyote both when it was used for secular purposes and when it was used as a religious sacrament. The article in Jewish Action, which is a summary of statements on medical topics made by the recently-deceased ultra-Orthodox leader R’ Yosef Sholom Elyashiv, declares that, “there is no conclusive scientific proof that a herpes infection would result from this procedure, unless the mohel had some sore or bruise in his mouth,” and that “Rav Elyashiv ruled that it is obligatory to continue the tradition of oral suction.” There is in fact no study suggesting that the ritual is any more or less likely to result in a herpes infection when the mohel has or is lacking a sore or bruise in his mouth; in fact, investigators for the New York City DOHMH have not been able to examine evidence approaching that level of detail, as they have been consistently denied in their requests to obtain even the identities of mohelim whose circumcisions have led to infection. At issue was the ritual metzitzah b’peh (MBP), in which a mohel who performs a circumcision uses oral suction to draw blood away from a wound on an infant’s penis. “If we discover that a previously accepted Jewish tradition is dangerous—or if we simply learn that there’s a more compassionate way to act, one that is more consistent with Jewish principles than the previous interpretation—it’s incumbent on us to modify or discontinue the tradition,” she says.

He said that several hospitals, including those serving the haredi Orthodox Jewish community, have agreed to distribute a brochure that describes the risk of contracting the herpes virus from the practice. The letter was addressed to Rabbi Yehudah Teichtal, who heads Chabad Lubavitch in Berlin and is one of several official rabbis in the city. Direct oral suctioning is considered the only acceptable way to draw blood away from the cut by some religious authorities. The regulation should be upheld so long as the court finds that it has a rational basis, the city argued. Health Department investigations of newborns with the herpes virus from 2000 to 2011 have shown that 11 infants contracted the herpes virus when mohels placed their mouths directly on the child’s circumcision wound to draw blood away from the circumcision cut, according to a statement from the department. Though it is not necessarily required by Jewish tradition, the practice of ‘metzitzah b’peh’—in which a mohel sucks the blood off and drips wine on an infant’s just circumcised penis—is still common in some Orthodox corners of Judaism. This procedure has been practiced for ages from the time of Avraham Avinu (our father Abraham) and Moshe Rabainu (Moses our teacher).

In September, the New York City Board of Health passed a regulation that people performing the ritual would be required to have written consent from the parents or the guardian in which they (parents/guardian) acknowledge that the Health Department advises against the rite. Male circumcision is the removal of the foreskin (prepuce), which is a fold of skin that covers and protects the tip of the penis. According to New York City health officials, the ritual practice infected 11 boys with neonatal herpes between 2004 and 2011, with fatal implications for two of them. Herpes can lead to brain damage or death. According to ABC News, one of the two babies stricken with herpes had a lesion develop on his scrotum seven days after the circumcision ritual. City health officials believe the practice was linked to at least 18 cases of infant herpes since 2000, though DNA testing to pinpoint the source of the infection was not done in all cases. Leas, MS, MA, a research analyst in the Center for Evidence-based Practice at the University of Pennsylvania Health System, identified six relevant studies for the systematic review.

A vote is expected in June. Shortly after a baby passed away in 2012 after contracting herpes, the New York City Board of Health started pushing for increased regulation on orally assisted circumcision, citing at least 11 cases where infants has contracted herpes from the ritual between 2004 and 2011. Section 556 of the Charter provides the Department with broad jurisdiction to regulate all matters affecting health in the City of New York. The practice is performed each year on an estimated 3,000 New York City babies, a fraction of the city’s Jewish population.

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