NYC Board of Health passes regulation to require consent from parents before performing Jewish circumcision ritual known as metzitzah b’peh

The New York City Board of Health passed a regulation today that will require consent from parents before an infant can have a form of Jewish ritual circumcision, prevalent in parts of the ultra-Orthodox community, in which the circumciser uses his mouth to remove blood from the incision.

Photo/ DRosenbach via Wikimedia Commons

According to a NY Times report, the nine-member panel of doctors and public health professionals said that though the regulation had been challenged by some Orthodox Jewish religious authorities as an unconstitutional infringement of their religious freedom, the risk of disease from the ancient procedure was serious enough to warrant action.

The new regulation comes after a CDC report in June which described the risk neonatal herpes during the out-of-hospital Jewish circumcision ritual known as metzitzah b’peh.

In the CDC paper, health officials reported on 11 cases in New York City where newborn males contracted herpes after the ancient procedure.

The report describes the ultra-Orthodox Jewish practice by saying the circumciser (mohel) places his mouth directly on the newly circumcised penis and sucks blood away from the circumcision wound, also called direct orogenital suction.

The opposition to the orthodox procedure and the subsequent passing of this regulation has drawn ire from ultra-Orthodox Jews.

Rabbi William Handler, one of those protesting the city’s action said, “This process is being created without a shred of evidence.The city is lying, and slandering compassionate rabbis.”

However, city health officials say that mohels who fail to comply with the regulation could receive warning letters or fines.

Also supporting the NYC code are a group of bioethicists  from Baltimore. Bioethicists from the Johns Hopkins Berman Institute of Bioethics sent a letter today to Mayor Michael Bloomberg expressing their support for the circumcision amendment.

Dear Mayor Bloomberg:

With regard the proposed amendment to the NYC Health Code to require informed consent for orogenital contact as part of ritual circumcision, please note that the American Academy of Pediatrics’ Task Force on Circumcision has stated: “The Task Force advises against the practice of mouth-to-penis contact during circumcision, which is part of some religious practices, because it poses serious infectious risk to the child.”

Requiring informed consent for orogenital contact performed during ritual circumcision will help enable parents to make responsible choices to protect the well being of their infant children.

The ethical duty to protect the interests of vulnerable infants and to support parents in making informed and responsible choices cannot be overridden. Please support the amendment to the NYC Health Code.

The CDC reports the risk of an infant becoming infected with herpes simplex-1 or herpes simplex-2 who undergone direct orogenital suction is 3.4 times greater than an infant who did not go through the ritual procedure.