Ny State and haredim have reached an agreement on metzitza b'peh, the dangerous oral sucking of the fresh circumcision wound by the mohel:
The new state guidelines require mohels, or anyone performing metzizah b'peh, to sanitize their hands like a surgeon, removing all jewelry, cleaning their nails under running water and washing their hands for up to six minutes with antimicrobial soap or an alcohol-based hand scrub.
The person performing metzizah b'peh also must clean his mouth with a sterile alcohol wipe and, no more than five minutes before it, rinse for at least 30 seconds with a mouthwash that contains 25 percent alcohol.
The circumcised area must be covered with antibiotic ointment and sterile gauze after the procedure.
In addition to the rabbinical policies, the state Health Department also added neonatal herpes to the list of diseases health care workers are required to report to state officials.
In adults, herpes is common -- almost 80 percent carry the oral form of the disease, according to the state Health Department. It is far less common, and potentially more dangerous, in children and babies.
If a baby who underwent metzizah b'peh does contract herpes, the mohel, the infant's parents and health care workers will be tested. If the mohel has the same viral strain as the baby, the mohel will be barred from conducting any future circumcision.
- No apparent provision for public oversight. If a mohel does not do what is required, who will know?
- Most reporting cited as "mandatory" is really voluntary, because there is no provision for public oversight (outside of what already exists in hospitals).
- No provision for dealing with the two mohels already linked to transmission, death and injury.
- Even if the agreement were better structured, washing the mouth with alcohol will not stop transmission completely.
As shown rather clearly in this article in Hakira by Dr. Shlomo Sprecher, MBP is not a part of the actual mitzva of circumcision, and it has been clearly linked to dozens of deaths and even more maiming in recent history.
No surgical procedure or practice would be allowed to continue under such conditions. While the idea of State involvement with religious practice is very worrying, the idea that an irresponsible religious group can endanger infants is even more so.
This agreement was reached because Satmar and other haredim vote in blocks. This rabbinically mandated practice, often enforced by promises of blessings for those who vote correctly and hellfire for those who do not (and the very real threat of violence and ostracism for those who refuse to go along) gives haredim a tremendous amount of political power that far outstrips their actual numbers. It also corrupts the electoral system and, because of the threats involved, is clearly illegal.
In closing, one must ask a question: Why did haredim not adopt the sanitary provisions of this agreement on their own last year? Why wait until now? The answer I believe is that haredim do not believe these procedures are necessary. They have done what is necessary to avoid a statewide ban on MBP and nothing more. This does not bode well for future haredi compliance.
UPDATE: In a comment elsewhere, Dr. Zachary Sholem Berger notes:
… I wonder about the precautions listed. They would probably help reduce bacterial infections, but what people are worrying about these days is neonatal herpes. Antibiotic ointment won't do much to counter that.
From the beginning, New York State took a much weaker line on this issue than New York City. God forbid, more babies will die and be maimed, all in the name of a procedure not biblically mandated, and in the name of political power. If you did not understand the danger of Jewish fundamentalism before this, you should understand it now.
UPDATE #2: Steven I. Weiss is reporting that Agudath Israel is not a party to this agreement and will not comment on it until it has a chance to study it. He also echoes many of the reservations I expressed above. A bad deal all around.