Thursday, April 04, 2013

Another Baby (Almost) Bites the Dust

There has been yet another case of neonatal herpes reported in the media. From the Forward:
Another Jewish newborn — the second in three months — has contracted neonatal herpes due to a controversial oral suctioning technique employed during ritual circumcision, New York City’s Department of Health and Mental Hygiene has reported.
I frankly do not completely understand why even Satmar Chasidim continue using the procedure of Metzitza B’Peh (MbP)*. Even more perplexing is their opposition to a New York City Health Department requirement to sign a consent form before allowing that procedure to be performed on their newborn immediately after the Milah.

I am not going to go through the reasoning as to why this procedure is not Halachicly mandated. Been there and done that more than once. Suffice it to say that suctioning blood from the circumcision wound was understood by Chazal to be a requirement for medical purposes.

That it is mandated in the Gemarah makes it a Halachic requirement. But it does not make it part of the actual Milah. The Talmud also does not say how that suctioning should be done. Nowhere does it say that it must be done directly by mouth.

But Chasidim for reasons not completely clear to me say suctioning the blood by mouth is an essential part of the circumcision itself – without which the circumcision would be invalid. I suppose they base it on a mimetic tradition. This is how they saw their ‘fathers’ do it. And this is how it’s always been done. It therefore must be a requirement.

What about babies that have contracted herpes? They reject completely any evidence that is has been transmitted by a Herpes infected Mohel. How, they ask, could it be that a Torah requirement would cause a danger to a child? The truth is not what we see but what ‘God says it is’. (Or as I prefer to characterize it - what they THINK God says).The babies who have contracted it post circumcision could not have possibly gotten it from an infected Mohel no matter what the evidence shows.

What is even more perplexing is how common MbP is even among non Chasidim. And the fact that Agudah wastes poltical capital fighting even the requirement that a consent form be signed. Their response has been that this is a church/state issue. And that tampering in any way with any part of Milah is an attack against Milah itself.

What’s worse is that in their zeal to protect this procedure they have compared government concerns about the health of the baby to anti Bris campaigns of ancient Greece – where a Bris was outlawed so as to Helenize their Jewish subjects taking them completely out of the Torah’s orbit.

There are many Mohalim here in Chicago. Some do MbP and some do not – using a sterile pipette for suction instead. Those who do MbP are the most popular Mohalim among Charedim. Even those who are not Chasidim. It’s almost as if they did not know that MbP is an issue. Or don’t care.

How can a father not care what happens to his baby? How can he say that it’s probably going to be OK? True – it probably will since the incidence is of an infected Mohel transmitting the disease is very low. But why do they insist on these Moahlim? And why do these Mohalim insist on using MbP anyway? They are not Chasidic. And yet MbP is automatic with them. (Although my understanding is that some of them will not use if if asked not to... still - MbP is their default.)

Most people know that R’ Moshe Tendler is vehemently opposed to MbP. He has been publicly called a Hellenizer for his efforts by some members of the right. But according to the Forward so too is R’ Hershel Shachter. From the Forward:
In a public lecture last February in London, Schachter, who is a rosh yeshiva, or senior chief rabbinic authority, at Y.U.’s Rabbi Isaac Elchanan Theological Seminary, claimed that his daughter’s hospital treated three cases per year of Hasidic babies infected with herpes. The infections were “obvously because of metzitzah b’peh,” Schachter told his audience, citing his daughter r.
Schachter also cited his daughter as claiming that there are, in fact, about 15 such cases per year in the city, including the three cases or so she claimed per year at her own hospital. Schachter said his daughter explained that the hospitals do not report these cases because Hasidic clients would not return if they were made public. Schachter’s remarks were first posted March 14 on the website Failed Messiah and authenticated by the Forward.
What is not so well known is that as far back as 1972 the issue of Metzizah P’Peh was discussed by HaRav Moshe Pirutinsky in his “Sefer HaBris”. This monumental work includes  Haskamos (approbations) from  R’ Chaim Shmulevitz, R’ Yitzchak Hutner,  R’ Yitzchok HaLevi Ruderman,  R’ Mendel Zaks, R’ Modechai Gifter, R’ Shneur Kotler, R’ Nachum Perlow (Rabbi Yaakov Perlow’s father) and R’ Moshe Feinstein.
     
On pages 215-216 in his chapter on Metzitza, Rabbi Pirutinsky discusses the issue at length quoting many sources - both pro and con. But he concludes that if medical experts (the only ones qualified to do so) determine that there is a danger posed by a Mohel using the mouth for suctioning the circumcision wound - it should be performed by other legitimate methods. Ultimately Chazal required Metzitza for health reasons. If using the mouth is unhealthy for the child it ought not to be done that way.

*Grammatically - Metzitza B’Feh (MbF) is the correct Hebrew term and acronym. I choose to use Metzitza B'Peh (MbP) only because it is the more commonly used expression and acronym.