New York City health officials proposed on Tuesday that Orthodox Jewish parents be required to sign a consent waiver before they can take part in a circumcision ritual that is believed to have led to the deaths of at least two babies in the city over the past decade.
The proposal, introduced at a Board of Health meeting, represents an escalation of the city’s efforts to curtail the ancient Jewish procedure of metzitzah b’peh, in which an adult male, usually the circumciser, places his mouth directly on the wound created by the removal of the infant’s foreskin to suck away the blood.
Last week, the federal Centers for Disease Control and Prevention published a report based on city information that said that from 2000 to 2011, 11 newborn babies in New York contracted the herpes simplex virus after the ritual. Ten of those babies were hospitalized; two suffered brain damage, and two died.
Based on those findings, the city’s health department issued a statement last week strongly urging that direct oral-genital suction not be performed during circumcision. It also announced that a number of hospitals had agreed to distribute a pamphlet to parents considering at-home circumcision, warning them of the risks.
On Tuesday, Dr. Jay K. Varma, deputy commissioner for disease control for the health department, announced the city’s next step, proposing that the Board of Health, which approves public health policies, require all parents who want direct oral suction to be used to sign a consent form indicating that they are aware of the risk of infection.
The mohel, or ritual circumciser, would distribute the consent forms to parents before the circumcision and keep them on hand for at least a year. The precise warning language would be written by health officials, Dr. Varma said.
Oral suction is no longer a part of most Jewish circumcisions, but among the more than 250,000 ultra-Orthodox Jews in the New York area, the ritual remains commonplace. In its study, the C.D.C. estimated that roughly 3,600 newborn boys a year in New York had circumcisions that included the procedure. Those infants, the agency said, had more than triple the normal risk of contracting herpes.
Over the past decade, as stories of babies sickened after such circumcisions have come to light, ultra-Orthodox authorities have strongly defended the practice as a religious right. Some rabbis argue that there is not enough evidence to show that the procedure causes infection, while others say the practice is important enough that it should be continued anyway.
Avi Shafran, spokesman for Agudath Israel, an umbrella group for many ultra-Orthodox organizations, said on Tuesday that the group wanted to study the proposed regulation before commenting on it. In March, the organization’s executive vice president, Rabbi David Zwiebel, warned that regulating the practice could drive it underground, making it more risky.
In his presentation to the Board of Health, Dr. Varma said that two of the families whose babies got herpes after the ritual had told health authorities that they were unaware beforehand that it would be performed. He said distressed families had called, as recently as two weeks ago, saying they did not know their mohel would place his mouth on their infant’s wound, and wanting to know what could be done.
“Since we are regulating how part of a religious procedure is done, this will be heavily scrutinized by legal experts, and it may be challenged at some point,” he said. “But we feel we are on very firm legal ground, because there is a compelling interest on behalf of the city in protecting the health of infants.”
By SHARON OTTERMAN - NY Times
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