This really was quite a busy day for the Board of Health: after a lengthy presentation about the controversial Soda Ban (which was passed), they turned their attention to the circumcision consent forms that have caused quite a stir among the Orthodox Jewish community. Though they referred to it as a "tricky issue," the board ultimately ruled that "parents need to be aware of the opinion of experts," and unanimously approved the forms. And of course, some rabbis were protesting outside the meeting, claiming this decision was Bloomberg's "blood libel."
"Metzitzah b’peh" is the practice of sucking the blood from a just snipped foreskin in traditional Jewish circumcisions. Most modern mohels use a sterile pipette to do so, but some Orthodox parents insist on the ancient tradition. The Board voted in favor of a mandatory written consent form being given to parents before a mohel performs direct oral suction of the infant's penis. Members acknowledged the delicateness of the "difficult legal situation"—despite there being a "very clear public necessity" to do something, they stressed the importance of respecting religious beliefs.
To that end, the board argued that there was a precedent for such intervention: in 1944, the US Supreme Court noted that "the right to practice religion freely does not include the right to expose the community or the child to communicable disease or the latter to ill-health or death." Their consent form neither prohibits ritual circumcision nor direct oral suction. This is the statement the form will include:
I understand that direct oral suction will be performed on my child and that the New York City Department of Health and Mental Hygiene advises parents that direct oral suction should not be performed because it exposes an infant to the risk of transmission of herpes simplex virus infection, which may result in brain damage or death.
As for possible enforcement of the law: among the penalties would be more education for the rabbis or mohels, a warning letter, or a monetary fine up to $2000. Many rabbis have already said they wouldn't heed the order—and that includes Rabbi Kalikstein, of Rockland County, who was protesting outside the meeting. He said death from the ritual was "almost unheard of." However, the CDC found a total of 11 baby Jewish boys in NYC were infected with herpes in the last decade. Kalikstein said:
Forcing parents to sign a form is against the fifth amendment. It's not right to make the public sign something against their will. It's not fair...if this were really a risk, why can't they require this for every time a person gets a shot?
Kalikstein doesn't believe Orthodox Rabbis and Mohels will follow the city's decree, saying "we are always careful about risk, we don't do circumcisions if a child is sick, we wait at least a week for them to get better before we do it. Even in medieval times, when people did not know anything about cleanliness, we washed our hands for thousands of years before we ate bread!"
When asked about the 11 children whom the CDC found were infected by herpes, Kalikstein argued: "They said they were infected, right? Now compare that to any other kind of risk, I'd say probably crossing the street is much more dangerous, more people die in car accidents than this. This is not even a statistic, it's so minute."
Some Board members believe this consent form isn't going far enough. Dr. Joel Forman in particular let his guard slip at one moment as he recalled seeing a child who had become ill because of the ritual: "I would argue for something a little stronger, because the evidence to me is overwhelming, this is a life-threatening disorder, having seen at least one case in our hospital in the last few years. It's crazy that we allow this to go on, I think. So I wish we could do something stronger."