New York City could face mass resistance in the ultra-Orthodox community to proposed regulation of Jewish circumcision rites that involve the oral suctioning of blood from genital wounds, say advocates for that community.
The city’s Board of Health is set to vote on a proposal that would require parents to sign a consent form before their children are subjected to the controversial ritual, known as metzitzah b’peh. The form would warn that babies can contract a type of herpes sometimes fatal to small infants through the practice. The form will also warn that HSV-1, as this herpes type is known, can cause brain damage to infants infected by it who survive.
Ultra-Orthodox groups strongly oppose the proposed regulation and have banded together in a broad coalition to oppose its passage.
“Unless the city is ready to subpoena mohels or break the doors in of synagogues around the city, I don’t really think they understand what they’re trying to do,” said Michael Tobman, a political consultant who is working as spokesman for a coalition that includes Agudath Israel, the large umbrella group that advocates for ultra-Orthodox organizations, and various Hasidic sects. “This is a community absolutely committed to resisting this ill-considered effort, up to and including civil disobedience.”
Rabbi David Zwiebel, executive vice president of the Agudah, said he did not foresee the rabbinic leadership of his organization calling for outright civil disobedience against the consent forms. But he added: “Will there be compliance with the regulation? I’m not sure.”
Most Jews don’t practice metzitzah b’peh. Modern Orthodox and non-Orthodox religious authorities endorse the use of a sterile pipette, rather than the mohel’s mouth, to suction blood from the baby’s circumcision wound. But many ultra-Orthodox communities see the direct application of the mohel’s mouth to the eight-day-old infant’s wound to suck off his blood as a religiously required element of the ritual.
Direct contact between a mohel’s lips and an infant boy’s circumcision wounds has likely led to 11 New York City infants being infected with herpes between 2004 and 2011, according to the New York City Department of Health and Mental Hygiene. Two of those infants died. Health authorities also attribute two recent HSV-1 cases in New Jersey to infection via metzitzah b’peh. Both recovered after after 10 days’ treatment with intravenous anti-viral medication.
One of the two New York deaths attributed to metzitzah b’peh occurred in 2005, the other in 2011. It was the 2011 death that revived the metzitzah b’peh issue, which had been little discussed since 2006.
Advocates for the practice argue that those deaths are poorly documented, and that the rate of infections is low compared to the large number of times the practice is performed each year by ultra-Orthodox mohels for a community well-known for its high birthrate. Between 10 and 15 children have been admitted to hospitals in the United States, Israel and Canada with the disease over the last decade.
The new regulation would require “informed consent” from a parent before a circumcision ceremony that will include metzitzah b’peh. The city’s Board of Health will vote on whether to adopt the regulation on September 13.
Ultra-Orthodox leaders began mobilizing against the proposed regulation in June, shortly before a public hearing on the proposition. The depth of ultra-Orthodox opposition to the regulatory effort was evident when Zalman and Aron Teitelbaum, two famously feuding brothers who lead two warring factions of the large Satmar Hasidic sect, both attended a June 27 meeting to plan communal opposition to the proposal. The two were publicly photographed sitting near each other.
Hasidic leaders are cooperating directly with Agudath Israel, which represents mostly non-Hasidic Orthodox communities. The cooperation has taken the form of regular meetings, outreach within the community, and messaging outside the community.
“This is a public relations and a media effort to really drive home the point that the city’s efforts have been woefully inadequate in terms of record building and understanding the seriousness of what they’re suggesting,” Tobman said.
Rabbi David Niederman, leader of the United Jewish Organization of Williamsburg and a top Satmar official, said that the proposed consent forms that described the ritual as dangerous were offensive and amounted to an incursion the community’s right to practice its religion.
“What we’re saying is, allow us to conduct our religious activities the way we’ve been doing that,” Niederman said.
Zwiebel, the Agudah executive, said that the rabbinic leadership of his organization had advised during a conference call on August 9 that the group speak to health department officials before the September 13 vote. He said that he did not know what would happen if officials voted to approve the new consent requirements.
“There’s nothing about filing a consent form that is inherently in conflict with [Jewish law],” Zwiebel said. On the other hand, Zwiebel added, the notion that the metzitzah b’peh ritual is inherently dangerous is problematic for the Agudah’s rabbinic leadership, and the rabbis might not want their followers to sign a document saying that it is.
After the Agudah and other Orthodox groups filed letters opposing the regulation during the public comment period in July, New York City Mayor Michael Bloomberg reiterated his opposition to the ritual.
“There are certain practices that doctors say are not safe and we will not permit those practices to the extent that we can stop them,” Bloomberg said at a press conference. “You don’t have a right to put any child’s life in danger, and this clearly does.”
Bloomberg won’t run for mayor again in 2013, but the issue could play a role in the upcoming mayoral race. Malcolm Smith, a State Senator who is considering a Republican run for mayor, has already expressed his support for the practice.
“I don’t want to inject electoral politics for 2013 into this discussion, but it would be an act of incredible naïveté not to look at the numbers of these communities and how seriously they take this issue,” Tobman said.
Josh Nathan-Kazis is a staff writer for the Forward. He covers charities and politics, and writes investigations and longform.