CIRCUMCISION: Are Many Children In Special Ed Classes Becuase Of Metzitza B’Peh?

Writing for the JTA, Debra Nussbaum Cohen recaps the circumcision controversy generated by metzitza b’peh, the oral-to-genital sucking of  the open circumcision wound done by many haredim. The article is good, clear summary of events, and it has some extras that make it really stand out. The first is a quote from Rabbi Dr. Moshe Tendler of Yeshiva University:

"I’m convinced that many children have been
infected and not diagnosed, and years later they are in special
education in the schools and no one knows why," Tendler said.

On the other side, Rabbi David Niederman of the Satmar-controlled Central Rabbinical Congress tells a whopper and gets away unchallenged:

"There
have been seven cases, allegedly over a span of 15 years," he said. "In
Williamsburg alone we have close to 57,000 people. The overwhelming
majority is very young, so you’re talking about 120,000 brises of
metzitzah b’peh."

Agudath Israel estimates 2000 MBP circumcisions were done in the city last year. Less than 1/2 were done in Williamsburg. If 1000 MBP’s were done in Williamsburg every year for the past 15 years, then 15,000 MBPs were performed. Surely the number is much less than this, in part due to the smaller population in earlier years.

Another way to look at is as follows. 57,000 people. 1/3 are too old or are infertile. 1/3 are too young or single. 1/3 married and of the correct age. So, we have 19,000 potential people. 1/2 are men. That leaves us with 9,500. Women give birth on average about every three years (some more, some less). So 9,500 divided by 3 = 3167 births per year. 1/2 are  baby girls. That leaves 1584 boys to have  MBP. But some of these births take place in the Catskills, London, etc. , so you end up with about 1400 MBPs done in Williamsburg – and that is if Rabbi Niederman’s population figure is not inflated. Again, not factoring in smaller populations each year we go back, we end up with 21,000 MBPs over 15 years, 1/6 of the figure Rabbi Niederman claims.

Why is this exaggeration important? Because of what Rabbi Niederman said immediately after. The quote, now in context:

"There
have been seven cases, allegedly over a span of 15 years," he said. "In
Williamsburg alone we have close to 57,000 people. The overwhelming
majority is very young, so you’re talking about 120,000 brises of
metzitzah b’peh. You tell me, is it safer to give a flu shot or to do
metzitzah b’peh?"

Actually, the risk of serious injury or death from a flu shot is far less than from MBP, which by the most charitable statistic for Rabbi Niederman carries a 1 in 3000 chance of serious illness, maiming or death.

But none of this matters to the haredim:

"We are convinced that it’s not dangerous," [Rabbi Niederman] said.

Not surprising from a community led by a man who cannot do simple math. 

Controversy rages in New York over circumcision practice
By Debra Nussbaum Cohen

NEW YORK (JTA) – In the face of a religious
court’s failure to conclude its investigation of a mohel who
transmitted herpes to three babies, New York City’s health commissioner
recently issued an unprecedented public warning that a controversial
circumcision procedure is endangering the lives of Jewish infants.

"There
exists no reasonable doubt that ‘metzitzah b’peh’ can and has caused
neonatal herpes infection," Dr. Thomas Frieden wrote in December in "An
Open Letter to the Jewish Community" about a procedure routinely
practiced by mohels in some "haredi" – or ultra-Orthodox – sectors of
the Jewish community. "The Health Department recommends that infants
being circumcised not undergo metzitzah b’peh."

The letter – the
Health Department’s first official warning against the procedure –
follows an apparent breakdown in an agreement the department had with a
Jewish religious court in Williamsburg, Brooklyn.

In September,
the city withdrew a lawsuit against a mohel the department concluded
had transmitted the disease to three babies on whom he had performed
the procedure, including one who died as a result and one who suffered
brain damage. It also withdrew a court order barring him from
continuing to use the technique.

In exchange, Rabbi Yitzchok
Fischer agreed temporarily to stop performing metzitzah b’peh
voluntarily. And a Jewish religious court took up the case for final
resolution. But according to Frieden, the religious court, or Beit Din,
failed to meet the Dec. 1 deadline.

"They’ve since communicated
to us that it’s a complicated situation and they’re not sure when they
can come back," Frieden said. "So rather than let that continue
indefinitely, we felt it was important to make clear to the public our
own conclusion and position."
            

                   

                     

                   

                   

                     

                   

                  

Rabbi David Niederman, liaison for the Williamsburg Beit Din, said he was "shocked" at Frieden’s reaction to the delay.

"We
have set the date, and it might be a little bit later," he said.
"However, I believe that the lines of communication are open… We did
not break down the agreement."

The rabbinical court, he said, "is making a very thorough and broad investigation. They will not leave one stone unturned."

But
whatever the court’s ultimate conclusions about Rabbi Fischer, it will
not impact the practice of metzitzah b’peh in the haredi community,
said Niederman.

"We are convinced that it’s not dangerous," he said.

In
metzitzah b’peh, a mohel orally sucks blood from the site of the
genital cut he makes during the circumcision procedure. Not all haredi
groups mandate the practice, but several haredi sects insist that it is
required by Jewish law.

Rabbi David Zwiebel, executive vice
president of Agudath Israel of America, an Orthodox umbrella group,
estimates that metzitzah b’peh is performed more than 2,000 times a
year in New York City.

In his Open Letter, Frieden reviews seven
cases of herpes that have occurred locally, including two this year
that the letter discloses publicly for the first time. Health
Department investigators have concluded all were transmitted by mohels
performing metzitzah b’peh.

Frieden’s warning against the
procedure comes more than a year after a cluster of three neonatal
herpes cases were attributed to Fischer, and, according to New York’s
Jewish Week, a full five years after two senior pediatricians at Long
Island Jewish Medical Center, warned the city that metzitzah b’peh was
putting the lives of Jewish infants at risk.

Frieden issued his
statement in two parts: the Open Letter and a one-page fact sheet
titled "Before the Bris: How to Protect Your Infant Against Herpes
Virus Infection Caused by Metzitzah B’peh."

The fact sheet,
which is included on the Health Department’s Web site,
http://www.nyc.gov/html/doh/html/std/std-bris.shtml, states that "circumcision
has health benefits," but goes on to explain how herpes is contracted
from mohels who employ metzitzah b’peh and encourages parents to
"consider other options."

Zwiebel, of Agudath Israel, an
organization that represents haredi interests, said he would have
preferred the statement not be issued.

But at least "they have
been true to their commitment that they would not regulate the
procedure," he said of Health Department officials. "They haven’t
banned it and haven’t required some sort of informed consent, which was
an idea on the table at an earlier stage."

Zwiebel was concerned
that the department’s action could harm the haredi community’s public
image and serve as a "foundation on which other jurisdictions might
choose to regulate the practice, or even New York City might do that at
some future date."

Niederman stressed the huge number of metzitzah b’peh procedures performed with no apparent ill effects.

"There
have been seven cases, allegedly over a span of 15 years," he said. "In
Williamsburg alone we have close to 57,000 people. The overwhelming
majority is very young, so you’re talking about 120,000 brises of
metzitzah b’peh. You tell me, is it safer to give a flu shot or to do
metzitzah b’peh?"

Not all mohels agree.

Rabbi Yitzchok
Adler, spiritual leader of Beth David Synagogue, a modern Orthodox
congregation in West Hartford, who also performs many of the
community’s ritual circumcisions, notes, "It is the responsibility of a
mohel to review every step of the procedure with the baby’s parents so
that they are aware of what the child is about to endure. Since
‘metzitza’ is intended to draw blood away from the site of the wound,
and there are techniques other than oral suction which can accomplish
the same goal, I see no imperative to insist on ‘metzitza’."

What does Adler suggest for families who consider "metzitz" an important tradition?

"The
father should consider performing the custom himself. Remember, the
Torah commandment is for a father to circumcise his son. The mohel
stands in for the father to do what the father cannot. If the father
wants metzitza, the father can be shown how."

Ultimately, however, Adler is among what he calls "a growing chorus of rabbinic authorities who are discouraging metzitza."

"Just
as medical science has shown us how to make milah safer with modern
sterilization and innovative surgical instruments, similarly we should
welcome the professional wisdom regarding the control of infection. A
mohel who is modern in his technique is serving his community in a
fashion that enhances the observance of the mitzvah. It is never a sin
to play it safe."

Like Adler, Rabbi Moshe Tendler, a dean at
Yeshiva University’s rabbinic school and a professor of biology there,
as well as an expert in Jewish medical ethics with a doctorate in
microbiology, opposes metzitzah b’peh as halachically unnecessary and
medically dangerous.

"I’m convinced that many children have been
infected and not diagnosed, and years later they are in special
education in the schools and no one knows why," Tendler said.

Dr.
John Santelli, a pediatrician and chair of the department of population
and family health at Columbia University’s Mailman School of Public
Health, said, "It’s difficult when there’s a potential clash between
religious values and medical information, but it’s really important
that parents know, and for the commissioner to take the position that
this is a dangerous practice."

"The commissioner is now throwing
the ball back to the community and saying, ‘How are you going to
respond to this?’" Santelli said. "I hope we don’t have another
tragedy."

Judie Jacobson also contributed to this story.

                  

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1 Comment

Filed under Circumcision Controversy, Haredim, Modern Orthodoxy

One response to “CIRCUMCISION: Are Many Children In Special Ed Classes Becuase Of Metzitza B’Peh?

  1. Well. I am no fan of the actual practice of MBP (though I am cautiously supportive of the right to practice it). That said, you know how I feel about RMT’s suggestion, Shmarya. I think it’s an irresponsible and unproveable. What’s to account for the high number of girls in Special Ed? The high number of boys in Modern Orthodox schools that are in Special Ed? It was just a silly statement, and I wish I would stop seeing it repeated oevr and over.

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