Of rites and risks

Not long ago, a Jewish family in New York suffered a terrible tragedy, the death of one of their infant twin boys. The cause was determined to be an infection of herpes simplex type 1, the virus that causes cold sores - and for which, according to the National Institutes of Health, antibodies are present (indicating at least a one-time infection) in up to 90% of adults. The HSV-1 virus causes only discomfort in adults, but in a baby, with its undeveloped immune system, the infection can be more dangerous, even fatal on rare occasions. This case, sadly, was one of those rare occasions.

The tragedy, however, did not remain a private one. It became the focus of media reports around the world, because of the possibility, raised by New York City health authorities, that the infant may have contracted the virus from the ritual circumciser who performed his bris, or Jewish ritual circumcision. Since the circumciser, or mohel (plural: mohelim), applied oral suction to the wound, which is a part of the bris-procedure in many Jewish communities, the suspicion arose that the virus may have been present in the mohel, at least in a dormant stage, and may have thus passed on to the baby during the procedure.

The mohel in question, who is widely respected and experienced (he has reportedly performed over 12,000 circumcisions), is currently under order to refrain from the oral suctioning procedure and to undergo tests for the herpes virus. He is cooperating with health authorities.

Many Jewish ritual circumcisers, particularly in the haredi community, consider the time-honored - and, for most of Jewish history, universal - oral method to be an indispensable religious requirement. Others, though, address the Jewish religious law of applying suction to the wound (itself, interestingly, based on a health concern, the drawing of infectious agents away from the wound) by employing an intervening glass tube. Some use gauze compresses and dispense with the suction altogether.

And so calls have been issued to insist that all mohelim hew to those approaches.

Two doctors, for example, in a study in The Pediatrics Infectious Disease Journal urged that "public health officials and leaders of the Jewish community should act to modify the part of the circumcision ritual that involves direct oral contact with the blood... of neonates."

Rabbi Dr. Moshe Tendler, an Orthodox rabbi and biologist, is even more adamant. "I'm particularly disturbed," he told a reporter, "that once this information becomes available, the mohelim don't do what they're told," namely dispense with the oral suctioning procedure.

In a medical paper in Pediatrics, a group of medical doctors and researchers, including Rabbi Dr. Tendler, assert, without evidence or citation, that "the great majority of ritual circumcisions" are performed without oral suction. They further declare that Orthodox religious authorities who insist on the traditional method (a list that includes some of the most distinguished rabbinic leaders of recent decades) have done so only because they "have felt threatened by criticism of the old religious customs."

Scientists should certainly offer the results of their research. They are perfectly welcome, too, to take positions on medically related matters. But when they begin to wax derisive of rabbinic authorities, impugning their motivations and challenging their religious decisions, expertise threatens to morph into arrogance.

To be sure, were infections like the one that took the life of the New York infant to be proven likely, or even common, results of oral suctioning, medical authorities would have the right to do what was necessary to protect the public - and religious authorities would be no less concerned. Indeed, even in Talmudic times, when a risk was perceived by the deaths of a baby's brothers after their circumcisions (implying hemophilia), the newborn was not to be circumcised at all unless it became clear that he was healthy.

But the evidence of material risk as a result of traditional circumcision is far from persuasive. In fact, a number of pediatricians and pediatric urologists with scores of years of experience between them serving communities in which countless baby boys were circumcised in the traditional manner - have reported that they have never seen even one case of circumcision-related herpes infection in newborns.

So if there is a risk in the age-old method, it does not appear at present to be a great one. And while our first reaction might well be to righteously insist that "any risk is too great," we might pause to consider: Is there no risk at all to circumcision itself? Or to any of myriad activities that society happily sanctions without any pang of conscience - not only things like bungee-jumping and motorcycle riding (or SUV driving), but prosaic activities, too, like high school football, cosmetic surgery and crossing city streets?

And so the questions must be asked: Should religious practices be more subject than entertainment or vanity to governmental or societal coercion? Does that really square with our nation's commitment to religious freedom?

They shouldn't, of course, and it doesn't.