Jewish Groups Challenge Law on Circumcision Ritual

Jewish groups are challenging a new law requiring parental consent for a rare circumcision ritual linked to two infant deaths

During the ritual, called metzitzah b'peh, a mohel, who's trained in the practice, removes the foreskin and uses his mouth to clear the blood from the wound. At least 11 New York infants are thought to have contracted herpes from the practice, two of whom died and two of whom have irreversible brain damage, according to the New York City Department of Health and Mental Hygiene.

But in a lawsuit filed Thursday in Federal District Court in Manhattan, three rabbis and three organizations backing the ultraorthodox tradition argued the law violates their religious freedoms.

"The New York Constitution guarantees that '[t]he free exercise and enjoyment of religious profession and worship, without discrimination or preference, shall forever be allowed in this state to all humankind,'" they wrote in their complaint.

Most modern mohels use a sterile pipette to remove the blood after a bris. But metzitzah b'peh is still practiced among some ultra-Orthodox mohels, who insist the ancient ritual is safe.

"Not only is the Department of Health wrong about metzitzah b'peh, it is trying to enforce its erroneous opinions on the people of New York City," Hank Sheinkopf, a spokesman for the groups, said in a statement. "We believe the courts will stop this overzealous government overreach and keep them out of our speech and religion."

The Orthodox and ultra-Orthodox Jewish groups, which include the newly formed International Bris Association, the Central Rabbinical Congress of the United States and Canada and Agudath Israel of America, claim the law "contradicts the tenets of their faith and undermines a religious ritual that they believe to be mandated by Jewish law."

"The government cannot compel the transmission of messages that the speaker does not want to express -- especially when the speaker is operating in an area of heightened First Amendment protection, such as a religious ritual," they wrote in the complaint.

Some New York rabbis, however, support the new law requiring parental consent for metzitzah b'peh.

"This practice, which is not required by Jewish law, and emanates from older practices designed to prevent illnesses that precede current medical knowledge about disease, presents a serious health risk to babies and is inconsistent with the Jewish tradition's preeminent concern with human life and health," Rabbi Gerald Skolnik, president of the Manhattan-based Rabbinical Assembly, said in a statement.

"We are entirely committed to the practice of brit milah (ritual circumcision), an affirmation of our connection to God and Jewish people for more than 3,000 years, and we affirm its centrality to Jewish religious and communal life worldwide," Skolnik added. "It is crucial that the practice be conducted -- as it overwhelmingly is -- by methods which are safe and sanitary."

Infectious disease experts agree that safety should trump tradition.

"In the 21st century, not even a single case of such transmission should be permitted to occur," said Dr. William Schaffner, president of the National Foundation for Infectious Diseases and chairman of preventive medicine at Vanderbilt University Medical Center in Nashville. "The primacy of all religions is the safety of human beings, not their rituals."

The law doesn't ban the ritual, but instead requires mohels to inform parents of the infection risks. Since 2004, the New York City Department of Health has received "multiple complaints from parents who were not aware that direct oral suction was going to be performed as part of their sons' circumcisions," according to a public notice.

In an affidavit supporting the suit, Rabbi Levi Heber of the International Bris Association said mohels are trained to ensure they perform the procedure in accordance with Jewish law and without exposing the child to any harm.

"A mohel will absolutely not perform a bris if he is experiencing any cold sores," Heber wrote, adding that mohelim may also rinse their mouths with antiseptic and minimize the duration of oral contact with the wound. "In my experience, these precautions are more than sufficient to assure the safety of metzitzah b'peh, which is performed tens of thousands of times each year without incident."

But Schaffner called such precautions "totally inadequate."

"People can carry the herpes virus without ever experiencing or recognizing lesions in their mouths," he said. "They could then transmit the virus to the infant, even though they have no symptoms themselves."