Wednesday, February 16, 2005

FREEDOM TO PRACTICE

By Rabbi Pinchos Lipschutz

In stark contrast to the despotic governments over the centuries under which the Jewish people lived, the United States affords our people and members of all religions, freedom to practice the precepts of their faith as they choose.

Throughout the Diaspora, when tyrants would legislate how the Halacha was to be followed, Jews who fought the falsification of the Torah did so at the risk of their lives.

By the grace of G-d, we live in a country where freedom of religion is one of the nation’s most cherished virtues. President Bush never tires of mentioning it, most recently in his state of the union address. There, he once again proclaimed the rights of all men to be free from unwarranted governmental intrusion into the private lives of its citizens.

Not everyone agrees. It seems as if a certain rabbi felt it was appropriate to bring the New York City Health Department into the delicate arena of religious practice.

The aforementioned rabbi has a problem with the practice of metzitzah b’peh as practiced by certain mohelim at the bris milah. Whether the act is an integral part of the bris is a centuries-old machlokes. Many authorities believe it is, while some are of the opinion that the extraction of the circumcision blood can be done in a different way.

Customs have evolved throughout the ages. In certain communities the mohel uses a tube and in others he uses his mouth to extract the blood.

That’s the way it has been for centuries. No authority of any stature has ever cast aspersions on either method. Even if there are differing halachic opinions, minhagim are sacred, and the custom of following a particular minhag has always been revered.

Either way a person wishes to perform the metzitzah, as long as he is following the minhag of either his rabbi or the custom in his family or community, it is fine.

But the rabbi in question isn’t happy with this time-honored approach. He wants everyone to follow his own interpretation of what is proper. He is deeply annoyed that others differ with his conclusion. “I am very disturbed that… the Mohelim don’t do what they’re told,” he complained to the JTA.

He has launched a campaign of vilification against mohelim employing metzitzah b’peh. He wrote an article together with scientists and doctors in the August issue of Pediatrics, claiming the reason seven infant boys in Eretz Yisroel and one in Toronto contracted the herpes virus was due to their being infected by mohalim who practiced metzizah b’peh.

There are killer mohalim on the loose and they are killing Jewish babies and must be stopped.

‘JUNK SCIENCE’

The article was characterized by people knowledgeable in medicine and Jewish law as “junk science” and “unimpressive.”

An indication of the shabby scholarship in the article is its unproven assertion that “the great majority of ritual circumcisions” are not performed with metzizah b’peh. The author goes on to wrongly assert that the only reason certain poskim condone this practice is because they “have felt threatened by criticism of the old religious customs and strongly resist any change in the traditional custom of oral metzitzah.”

The authors expose their bias by stating that the reason more cases of circumcised children are not known is because “We suspect, therefore, this entity is underreported for cultural reasons and that the studies described here are only the ‘tip of the iceberg’ of true incidence of the disease.”

They insinuate with absolutely no scientific proof that the incidence of children falling ill with the disease is much more prevalent but due to the backward insular behavior of religious Jews, they fail to report the illness or seek out for medical assistance. Of course no studies or proofs are cited to support this suspicion, which is patently false.

They further state that “The cultural process of replacing ancient customs by modern wound care has to be encouraged by a heightened awareness of this potentially life-threatening medical complication.”

The article concludes that, “Ritual Jewish circumcision that includes metzitzah [b’peh] carries a serious risk for transmission of HSV from mohels to neonates, which can be complicated by protracted or severe infection. Oral metzitzah after ritual circumcision may be hazardous to the neonate.”

The article’s conclusions collapse upon analysis. The fact that they came up with eight babies who contracted the herpes disease following circumcision over a six year period is strange. If the mohalim are so dangerous why are there so few cases?

The article states that the mothers of these eight babies all tested HSV negative, and therefore postulates that the mohalim were at fault. If the vast majority of adults carry antibodies to the disease, it seems as if the authors went cherry picking to find cases where the mothers tested negative so that they could arrive at their conclusion. Were a random selection made, it would seem apparent that at least some of the mothers of neonates with the herpes disease would test positive.

The numbers clearly discredit allegations that mohalim performing metzitzah were to blame.

Let’s look further at the rabbi’s assumptions. He theorizes that since a majority of adults possess antibodies to the virus, in certain cases it is possible for adults to contaminate children. Though the virus affects adults in no way, it is fatal to infants whose immune systems are not yet fully developed. Mohalim who practice metzizah b’peh when performing a bris can thus infect infants, the rabbi-on-a-crusade maintains. Blame it on the mohalim.

There are several problems with this position, the most serious of which is that it is pure speculation. Not all the family members of the children were tested for herpes and neither were half of the mohalim. It is scientifically outrageous to suggest that the mohalim were the carriers of the disease until everyone else who came in contact with the babies is ruled out as a carrier. It could just have well have been transmitted by the mother, father, nurse or little brother. Additionally the authors admit in the study that “only four mohels were tested… the mouth cultures obtained from [the] mohels all were negative for HSV.”
To indict the mohalim is libelous and unfounded.
The article’s attempt at scientific analysis was so flawed as to be unworthy of being presented as serious research. In a truly scientific survey, the researcher would have used a control group and would have made comparative studies with other groups. He would have studied not only infants who had metzitzah, but would have examined an equal number of infants who did not, in order to isolate metzitzah as a disease-causing factor. Only then could his conclusions about the role of metzitzah in causing disease carry any weight.

No studies of this sort were cited by the rabbi or any of the other experts who signed their name to the article.

Interestingly, in Kiryas Joel, NY, a self-contained community where every male child undergoes metzitzah b’peh, there should be a rash of cases if to the rabbi’s theory is correct.

Yet, people there recall no cases of any infants carrying the disease after circumcision.
The facts themselves expose the fallaciousness of the charges of mohelim infecting infants. This is what is called “junk science;” it is generated by someone who will stoop to vilification and vindictive behavior in order to impose his viewpoint and to curtail the rights of others to do things differently.

MAKING GOOD ON HIS THREAT

Since writing the article in Pediatric, the rabbi publicly threatened a respected Monsey Mohel, Rav Yitzchok Fischer, that he would report him to the authorities if he did not halt his practice of metzitzah b’peh.

Rav Fischer, who is accredited by the Milah Initiation Society of England, has been practicing milah for 35 years. He is well known as a responsible, conscientious individual, who makes a point of staying abreast of the latest medical studies concerning Milah. He is acclaimed as an expert in his field and is regularly called upon when abnormalities are present in a circumcision case.

Rav Fischer has preformed thousands of brisos on infants, boys and men of all ages, in this country, as well as in Russia and Israel. It goes without saying that he has also been tested and found to be free of herpes or any other infectious disease.

The man is a renowned baal chesed, with a steady hand and smile, about whom there has never before been even a breath of impropriety. But the yeitzer horah works insidiously. He tries to get us to be mevazeh mitzvos and anashim chashuvim. Too often he is successful and we fall into his trap.

The crusading rabbi erred by picking on him. And the community erred by not rising to Rabbi Fischer’s defense.

I hear people whispering and saying they heard Rabbi Fischer didn’t check out and really is a carrier of the disease. Is there anything more revolting? Is there anything more disheartening than to see the koach of sheker overcome people’s better judgment? A prominent, highly esteemed mohel who has dedicated his life to ushering Jewish children into their covenant with G-d is now accused by someone on a wicked mission and people begin to vacillate. Suddenly, they aren’t sure. Could it be the rabbi is right and the Mohel is really at fault after all?

When the yeitzer hora saw he could not force a principled mohel to buckle, he sought out other pressure tactics. Articles were inserted into the general media, holding up the most esteemed members of Klal Yisroel and our most hallowed rituals to public mockery. When the laughter dies down, the public is left with the impression of Torah Jews as a backward people engaging in Neanderthal practices. They always knew those Orthodox Jews were a bit weird, but who thought they took it to such extremes?

The yeitzer hora is not satisfied with creating a Chilul Hashem only among the masses; he must also poison our own ranks. He must infect us with the asher korcha of Amalek—the weakening of conviction. Only then is he satisfied.

LET’S CALL A BLOOD LIBEL BY ITS NAME

Why was there only one newspaper defending Rabbi Fischer? Why was there no organization standing up and calling a blood libel by its name?

The rabbi apparently followed through on his threat to Rabbi Fischer and massered on Rabbi Fischer to the NYC Health Dept, charging him with spreading disease. He cast the mohel as a menace to society who must be stopped before he kills more children.

Read the following reaction to the rabble-rousing news reports generated by the rabbi’s massering on the mohel, yes it is extreme, but it points to what the reports caused:

“San Diego, CA (PRWEB) February 9, 2005 — The recent death of a baby boy in New York City has prompted some Jewish groups to call for an end to the practice of male circumcision. City investigators believe the boy died after contracting herpes from an infected mohel who sucked the blood from the baby’s circumcision wound. Two other boys circumcised by the mohel have also contracted herpes, including the dead boy’s twin brother.

“What happened to this innocent Jewish baby in New York is especially tragic,” said Gillian Flato, Director of Jews Against Circumcision, an international organization of Jews who have re-examined the practice and have found it to be immoral. “I think this is a wake up call for the Jewish community. Are they willing to blindly follow tradition and jeopardize their sons’ lives?’”

The article goes on to report that “Attempts to protect boys from circumcision have now crossed into the legal realm as well. A federal bill proposal written by a San Diego group called MGMbill.org would protect boys from circumcision. Matthew Hess, the group’s president, said that Jewish support for the proposed bill will be critical to its success.”

REVISITING THE BITTER DEEDS OF THE MASKILIM

In the 1800’s our great-grandparents suffered greatly at the hands of Maskilim, who viewed themselves as the enlightened ones entrusted with the mission of ushering religious Jewry out of the caveman period and bringing them into the 19th century.

In their misguided zeal, they caused untold suffering and misery for religious Jews and caused many thousands to abandon their heritage for the lures of the secular world. Their primary tools in advancing their agenda were the press and the government.

They agitated relentlessly in the media and in government circles against rabbis, yeshivos, religious Jews and their practices. They had laws enacted that persecuted rabbonim and mechanchim who were not deemed sufficiently educated and acclimated into 19th century Russian society.

Those laws allowed the rabidly anti-semitic governments to intrude even further into the Jewish ghettos, all under the banner of “helping” the poor backward religious Jews leave the caves and join “civilized” society.

The havoc they wreaked drained the energies of the rabbonim, roshei yeshivos and askonim of the time who sought valiantly to stay one step ahead of the maskilim and their Czarist allies. It took world wars to finally put the masklilm out of business.

We ought to have absorbed the bitter lesson about the dangers to which unwarranted government intervention leads. We ought to have learned where mockery of religious practices in the public media will get us. Just weeks after a media frenzy over shechita, it is now milah that has been placed in the crosshairs.

Misunderstood mefarcheses became the battle cry for anti-shechita activists and animal rights crusaders. They manipulated the masses by stoking fear and outrage, and peddled their lies via the internet and the national print media.

There is nothing more precious than a Yiddishe neshama. There is nothing more shattering than the death of an infant. But the exploitation of tragedy in order to frighten G-d fearing people into re-thinking values that have been sacred to them for ages is more alarming than the danger of herpes infection.

Because the virus of slander is more deadly than the virus of disease.

Following the slandering of the time-honored ritual of metzitzah in the media, the Orange County Health department asked for a meeting with Kiryas Joel officials to discuss with them prevailing bris practices.

According to Gedalye Szegedin, administrator of the village of Kiryas Joel, “Kiryas Joel leaders made it clear to the Orange County Health Department that changing bris practice is non-negotiable and brisin will continue to be performed according to the mesorah handed down to us by our grandparents and great sages.”

Will we become like our Russian brethren in the past century who were forced under the communists to conduct the sacred bris in underground bunkers with sentries standing guard? In those dark days, Jews had to hide this holy ritual from government apparatchiks seeking to protect them from the “primitive” practices of Jewish clergy.

Are we about to revisit those day in our own country? Such a scenario may not be that far-fetched if we don’t raise our collective voices and set the record straight.

It will be a bechiya ledoros if local health departments become the arbiters of halachic practice. It will be a bechiya ledoros if the NY Daily News and Don Imus are permitted to become the forums of halachic debate. It will be a bechiya ledoros if mesirah is tolerated as the method of arbiting Halacha.

It will be a bechiya ledoros if a person like Rabbi Fischer can be harassed and scapegoated and we don’t all rise as one to his defense.

8 Comments:

Blogger gad said...

After previously reading other articles on this subject I had begun to assume that the Mohel was at fault. I therefore appreciated this article's attempt to present the other side. However, after reading the article in Pediatrics I feel that your dismissal of its scientific accuracy is not totally fair. The assertions that you claim are made regarding the number of mohelim using the practice, or the reasoning of some orthodox Rabbis, may or may not show a personal bias but certainly have nothing to do with the scientific analysis of the topic. In regards to "cherry picking" to arrive at their conclusions - that's a bit of a stretch. I don't what there methodology was, but either these were all the cases that they could find, or even more importantly it would have proven nothing had they reported cases where the mothers were positive. You cite the fact that the mouth cultures for all of the mohelim tested were negative, but you ignore the fact that their blood tests were positive and that, according to the article, HSV-1 is secreted intermittently into the saliva. You also neglect the fact that the location of the infection is very significant. It is very sad that our enemies use this story to malign us. My first exposure to the incident was via an anti-semitic web site. But I would imagine that the Rabbi, whose name you admirably don't mention, is motivated by his understanding of what he feels to be a clear health risk. Since to him this is a case of a Pikuach Nefesh, he has no choice but to object. Should he have chosen another means? I don't know. Since you cite the example of Monroe, if he had gotten the support of Moetzes Gedolai HaTorah for example, would the Satmar Chassidim have paid any attention? Perhaps the entire issue should be turned around. If this is a Safek Pikuach Nefesh, and Metzizah is only a D'Rabbonon, how its continued use be justified??

2:48 PM  
Blogger TRW said...

But they're not arguing to stop metzitza b'peh-they're arguing to stop circumcision in all cases. And that IS a d'oraysa.
And with Pikuach Nefesh, if you remember Sh'mos, Moshe didn't mal his son because they were traveling and it would have been dangerous for the baby (ie pikuach nefesh). He was then almost swallowed by a "snake", until Tzipora malled (?) the baby.

6:58 PM  
Blogger Fruma Chaya said...

Oy I was so sick after I read about this whole thing and about the Chillul Hashem that those disgusting Hellenizers are committing against Rav Fischer -- a blessed and saintly man if there ever was one -- whose only crime is trying to carry out OUR LAWS as Hashem has commanded us to do it. But mark my words, the plan of those disgusting Hellenizers will backfire just as it did during the reign of Antiochus when the Hellenizers tried to put an end to the blessed and sacred ritual of bris millah. Those who try to tamper with our laws and with our rituals will suffer the consequences! And just like my brave, tough, strong, intensely proud Jewish ancestresses, I too would rather fight to the death before I would ever even dream of relinquishing this beatiful and joyous rite -- in its most purest form -- with metzitzah b'peh -- just as Hashem demands that we do it and just as Rav Fischer and other blessed mohelim continue and will ALWAYS continue to do it!

All right, so one baby died. But one swallow does not a summer make. I never heard of such a thing happening before. And just as you correctly say, who knows how it really got sick? Only Hashem knows for sure, and if it died, it died because Hashem wanted it to die and not because of any other reason.

5:07 AM  
Blogger kinsmancove said...

A thorough analysis of both metzitzah b'peh and the medical evidence puts this issue in more perspective. It can be found at the Toward Tradition websie: http://www.towardtradition.org/article_life_or_death.htm

9:57 AM  
Blogger der krimmer said...

Lipshutz, enough is enough. Your'e a right-wing fanatic in bed with "the gedolim", and quite frankly, I've had enough! I want YOUR SON to undergo metzitzah b'peh, and let Fisher take a big sucking so that he can be afflicted with genital herpes. Try getting a reputable "shidduch" for your darling "bachur" then. IF METZITZAH B'PEH HAS CAUSED ONE INNOCENT CHILD TO CONTRACT HERPES- IT SHOULD BE DISCONTINUED AS THERE ARE OTHER METHODS TO ACCOMPLISH THIS GOAL. How dare you take on an undisputed gadol and scholar of the biological sciences, in order to promote your warped agenda?! As far as I see it, you weren't afraid of losing your loyal readership, so you felt no need to temper your remarks. Why don't you take on the fact that some of our "American Gedolim" are going senile, and their rhetoric is to be ignored. But I guess that'll hit to close to home. And to your languishing readership base.

3:41 PM  
Blogger The Perfect Ema said...

This article is really quite interesting. I think I will be shutting my Internet very soon for I would rather not know about all this lashon hara. I do believe that some mohelim specifically do not do the circumcision using the mouth b'davka because of health risks, and so I find it very difficult to believe that all yeshivisha rabbanim are saying that there is no basis to this study, unless, of course the study was not done correctly. But even if the study was not done correctly, IMHO, I would still think that we should investigate this possibility and if in fact it really does cause herpes (which happens to be a lot higher in the frum community then you would expect), then obviously the gedolim would have to deal with this situation.

However, gad writes that the blood results were in fact positive? Were the blood results positive for this R' Fisher too??? Or, the tests weren't done?

If in fact some of your scientific statements are not 100% accurate then it's difficult for me to trust what you say as accurate. Can you also write what the different rabbis said (state the rabbis names) so that I can form my own opinion. Thank you

2:49 PM  
Blogger EtzChaim said...

"And just as you correctly say, who knows how it really got sick? Only Hashem knows for sure, and if it died, it died because Hashem wanted it to die and not because of any other reason."

The above poster whose comments I have quoted before is wholly uncompassionate towards human life. The baby has a name and should not be called at it.

In addition, nobody in the Orthodox community is calling for an end to metzizah. But, many Rabbis are asking for the traditional method of metzizah to be re-evaluated in light of AIDS and other STD's. There is no requirement that suctioning be done "b'peh" even though traditionally metzizah was performed by mouth. What certain Rabbis in the Orthodox community are asking of mohelim is that they acknowledge the medical risks that metzizah b'peh may cause

It only takes one deviant in a community to pick up an STD (which might be undetectable for many moths)to start an epidemic. Obviously Hashem has protected us. But, it may be time to do our hishtadlus and evaluate current practice of metzizah (not bris milah) in light of the promiscuity that we know occurs, even in the Orthodox community, but none want to talk about.

4:52 PM  
Blogger ShekerBuster said...

For the record, HSV-1, Herpes Simplex Virus -1, which is what the issue is dealing with, is something which 90% of the general population is infected with. The mohel most likely WAS infected with it, and there is NOTHING WRONG WITH THAT! That is NOT the herpes that is a STD, rather HSV-1 is the cause of "cold sores" aka "fever blisters" etc. 90% of us are exposed to it as children via saliva in school from other kids, and the virus will lie dormant in your nerve ganglion, perfectly supressed by the immune system, until you get a minor cold, or flu, stress, or one of the many things that could lower your immune system. Then the infection can come out, which is why the lesions HSV-1 produces are called "fever blisters or cold sores" because they often occur after someone has a fever, or a cold. People are making the mistake and saying that it can't possibly be true that Rav Fischer has HSV-1, when the fact of the matter is, it CAN be true, and there is no shame or problem with that. As long as one behaves responsibly. Now, to quote "Oral and Facial Pathology, by Dr. Neville" one of the authorative texts written on oral infectious diseases: HSV-1 is generally seen only above the waist, but in rare cases, it can be transmitted to below the waist, in a pattern similar to HSV-2 (genital herpes, which ch"v is not the infection that Rav Fischer is accused of, contrary to popular belief on the internet). The fact that HSV-1 is so rarely transmitted to the genital area, explains why the Pediatrics study was only involving 8 cases, and why Kiryat Joel, NY, can have no occurences. The fact is, that it is rare, but IT DOES HAPPEN. And that is the issue with which the whole matter is revolving around. Does that constitute a sakana?

11:36 PM  

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