Wednesday, April 10, 2013

NEW STUDY: Ultra-Orthodox Mohels Don't Give Babies Herpes

The number of reported cases of babies contracting herpes following their circumcisions, where ultra-orthodox mohels practice the obscure tradition of using their mouths to suck a child's freshly circumcised penis to "cleanse the wound," (AKA "metzitzah b'peh") has been increasing. Just the other day two more such cases made the news, and it is alleged that New York City hospitals and the city’s Department of Health are suppressing disclosure of even more cases.

But mohels putting their mouths on the wounded penises of children is not a health risk, claims Jewish group Agudath Israel of America , who has been fighting tooth and nail to get a new law requiring mohels report the risks of their practice to parents repealed. (They have been, as of yet, unsuccessful.) The law is basically worthless, as there aren't any real penalties, and it holds no one responsible, but the group wants it repealed anyway.

Agudath wants the New York law repealed, and this time, they've got "scientific evidence" to "prove" their tradition doesn't put children in any danger.

Well, at least the danger of herpes transmission.

Agudath has issued a press release lauding a study which they hope will vindicate a practice of what would otherwise constitute as neonatal pedophilia in other cases.

I find it rather comical that a religious group wants to vindicate a tradition with "research" ("religious freedom," it seems, is in itself, insufficient) as if the outcome of any "study" determines whether or not an act is morally justified; the act of slicing the penis of a healthy, non-consenting newborn is already sufficiently morally repugnant.

What do the outcomes of any "study" matter to people of faith anyway? Would Agudath seriously stop practicing their ritual had their "study" produced unfavorable results? I highly doubt it. Ultra-orthodox mohels continue to practice the act in spite of new regulations as it is. The infected babies are the evidence.

But Agudath continues to try and make the case that although babies have contracted herpes, their cherished tradition has absolutely nothing to do with it, the evidence and other research be damned.

They've got the "scientific proof," which I'm sure was conducted neutrally, and dispassionately, without any particular political goal in mind.

(Yeah right.)

I've taken the liberty of taking some relevant excerpts in the latest press release and taking them apart, right here on this blog.

Adugath Israel of America Appeals to "Research"
Reads the title of the press release:

"Ivy League Study Casts Doubt on Claims that Jewish Tradition Leads to Herpes in Infants
Jewish leaders praise independent study by Penn Medicine that found little evidence to support the claim that circumcision ritual is infecting infants"

 It appears "casting doubt" was the sole purpose of the "study," which I have a hard time believing is "independent." I'm sure Agudath has absolutely nothing to do with it.

"In a study published in December last year, University of Pennsylvania's Center for Evidence-based Practice reviewed several studies linking circumcision with oral suction, a common ritual for many Orthodox Jews, and herpes simplex virus (HSV) type 1. Though four published studies since 2000 suggested that such a link does exist, Penn doctors found the evidence to be 'small and significantly limited.'"

What do they posit is the cause for male babies contracting herpes following the ritual?

Who are the "doctors," and have they been investigated for potential conflict of interest? (IE, are they ultra-orthodox Jews who engage in the traditional practice? Are they in any way tied to Agudath?)

I keep hearing the word "evidence-based" thrown around, but that seems to mean a practice is justified as long as you have some sort of "study" that says it's OK.

Shouldn't medical practice be "needs-based?"

And what, pray tell, does religious ritual have to do with medical practice?

Four studies have been published since 2000 suggesting a link between a person putting his mouth on the wounded penis of a neonate is a risk for herpes transmission, but this one sets them all straight.

It doesn't seem to help by suggesting a causal link of its own though.

"The study was cited in an appeal filed Monday in the U.S. Second Circuit Court of Appeals challenging a New York City Department of Health (DOH) regulation that seeks to place limits on the practice.
'We have been saying for years that the evidence attacking this religious practice is highly dubious, and now we have world class doctors agreeing with us,' said Rabbi Gedaliah Weinberger, chairman emeritus of the board of trustees of Agudath Israel of America, a party in the suit."

Moral and ethical questions are moot as long as you have some sort of "study," it seems. But this reasoning doesn't always work.

"'We have been saying for years that the evidence attacking this religious practice is highly dubious, and now we have world class doctors agreeing with us,' said Rabbi Gedaliah Weinberger, chairman emeritus of the board of trustees of Agudath Israel of America, a party in the suit."

 Argumentum ad verecundiam; we don the white coat of science, therefore we are correct.

"'Hard scientific evidence simply does not back up the alarmist efforts of the New York City Board of Health and others who are needlessly interfering with the fundamental constitutional rights of thousands of New Yorkers.'"


At least ONE study doesn't back it up, and it's "hardness" is questionable.

"In the Penn study, the center explains that the evidence base is substantially limited by several factors. First, the number of events - some that date back to the 1980s - is too small to establish a causal relationship."

The number of reported events is small.

But most importantly, is a large number of events needed to establish a causal relationship when the causal link is clear?

How many babies must die in order to prove that they will drown if you hold their heads underwater for too long? Or that putting a plastic bag over a child's head will result in asphixiation?

"Second, the way the cases were reported led to many questions about their validity."

We are not given an example.

"Third, important information about some of the cases is unknown, specifically the infection status of the mothers, which suggests that the disease could have been transmitted in other ways."

Here, the "researchers" are attempting to place the onus on the PARENTS, while absolving the mohels.

And what about the important information that is known?

For example, the fact that at least one mohel that engages in the practice of oral suction of a wounded child's penis, one  Yitzchok Fischer by name, tested positive for herpes? And that three other children that he circumcised contracted herpes? One of whom died?

"'This evidence has important limitations. The total number of cases is very small and was distributed across three countries and a fifteen year time frame. As with all case reports, they were identified and selected in a non-systematic manner and cannot be compared with a specific control group,' the Penn review said in reaction to one particular study."

Sure you can.

1.3 million gentile boys are circumcised yearly in this country.

How many contract herpes via their mother?

How many contract herpes, period?

"Last year, the DOH passed a regulation requiring rabbis, as a condition of performing MBP, to inform parents that the DOH advises that MBP 'should not be performed' because of its alleged risks, and to obtain the parents' signed consent. The regulation thus expressly seeks to deter New Yorkers from participating in this religious practice."

But, as indicated by two recent reported cases, the law is basically worthless; an attempt by the DOH to look busy while shirking responsibility.

"Several rabbis and Jewish groups later filed suit, arguing that the DOH regulation violates both the U.S. and the New York State constitutions. By forcing rabbis to communicate the DOH's subjective advice that MBP should not be performed, along with equally subjective views about unproven health risks, the DOH is imposing its own beliefs on others and violating the rights of the rabbis."

Nevermind the beliefs imposed on a healthy, non-consenting child by permanently disfiguring his penis.

"Moreover, the suit casts doubt on the DOH's contention that undisputed medical facts show that MBP poses a risk, a contention now further undermined by the independent Penn study."


At least Adugath hopes...

"The Department of Health would have the public believe there is an epidemic going on, which is not only untrue but irresponsible," said Dr. Brenda Breuer, PH.D., M.P.H., an expert witness in the case."

Straw-man argument; the Department of Health is not trying to convince the public that there is any kind of "epidemic," going on, but is trying to respond to the fact that many babies have been infected with herpes following traditional circumcisions that involved the practice of the oral suction of freshly circumcised babies by rabbis.

"This is a procedure the Jewish community has been performing for thousands of years without an issue, and that has not suddenly changed in the last ten years."

What has changed, however, is people's willingness to keep deaths due to circumcision secret.

And, no, while the practice of brit milah may have been around for millennia, the practice of oral suction of the fresh circumcision wound of a newborn, AKA "metzitzah b'peh" is actually a relatively recent practice. (A good reference on how the circumcision as practiced by Jews has evolved over time is "Marked in Your Flesh," by Jewish anthropologist Leonard Glick.)

If the practice of placing one's mouth on the circumcision wounds of children isn't transmitting the herpes virus to them, then what is?

It seems vindicating what some view as a cherished tradition was more important than actually determining how exactly children are contracting herpes.

This "study" doesn't sound very scientific at all.

How are babies contracting herpes?

Aren't a mohel that tests positive for herpes, and the fact that the lesions appear around the child's genital area enough proof to conclude that the virus was transmitted via this practice?

Apparently not.

This doesn't seem to be a concern of the "researchers" or of Agudath.

Perhaps the practice of metzitzah b'peh hasn't changed in the last 10 years, but the act of keeping silent about these matters has. Just because people were failing to report these cases, does not mean that they weren't happening, it just means that 10 years ago, people were more willing to keep silent about these matters, and the times have changed.

We'll be hearing about how the practice of Metzitzah B'peh reduces the risk of cancer and HIV transmission next...

Related Articles:

Politically Correct Research: When Science, Morals and Political Agendas Collide

NEW YORK: Two More Herpes Babies, One With HIV
NEW YORK: Yet Another Herpes Baby

Rabbis Delay NYC's Metzitzah B'Peh Regulations - Meanwhile, in Israel...
New York: Oral Mohel Tests Positive for Herpes
Herpes Circumcision Babies: Another One? Geez!
Mohels Spreading Herpes: New York Looks the Other Way
Circumcision Indicted in Yet Another Death: Rabbis and Mohels are "Upset"


  1. Warren Jeffs leads a cult that rapes girls and young women, and he and his followers get arrested. Yet, these mohelim rape infant boys and no one cares in the slightest. Because let's not delude ourselves, forced oral sex (mouth to penis) is rape. The FBI rape definition supports this statement. That we allow this to happen without punishment of the law is atrocious and despicable. And don't get me started the mutilation that it entails first.

  2. perfect picture to go along with this story

  3. Do they ever mention where this "study" can be found. That would be illuminating. My guess is that they determine that you cannot establish air tight "causality" from a number or case reports. The big reason for this is that the numbers of boys who have gotten herpes from the mohel is small. It is hard to show "causality" with small numbers. But we reach conclusions with small numbers all the time. When someone is accused of murder we look at evidence to support that particular case. So for these infections we know mom was not infected (mothers with active genital herpes infections undergo Cesarean sections to keep the baby from being exposed to their mother's herpes lesions). The infecting strains are HSV type 1, which is more common in the mouth (genital herpes is usually HSV type 2, but there is some crossover). So the only way rational way, and the best explanation, for these infections to have occurred is from oral genital contact with an infected mohel. I suppose other explanations exists (such as alien abductions), but the known facts support these infections were transmitted during the circumcision.

    The logical fallacy used by these circumcision proponents is that it is impossible to prove the negative. While they say that this negative "study" fails to demonstrate that the link is strong enough to prove causality, the failure to find a link in a study does not mean the link does not exist. I have never personally met President Obama, but that does not mean that President Obama does not exist. My sampling of people of people is too small. I do know several people who have met President Obama, and one who went to law school with him, so this evidence is supportive of his existence. Also small studies, because of their size will miss things that are really there. The likelihood of a study finding an association if such an association truly exists, can be estimated. The larger the study, the more likely the association will be demonstrated. Also there is also a likelihood that associations will be found when no such association exists. For example, you can flip a coin and get heads six times in a row. This does not mean that coin is defective.

    I think they are being coy about the location of this "study" for fear that someone will actually read it.

    Finally, there were major concerns from the late 1800s early 1900s about religious circumcision resulting in infections with tuberculosis, syphilis, and diphtheria from oral genital contact. These are well established in the medical literature of the time. So the "no concerns" defense is pure sophistry.

  4. The link is to the webpage of University of Pennsylvania's Center for Evidence-based Practice:

    Where is this study published? If it is a consulting report, it's not worth the paper it is printed on. If Agudath Israel in any way paid for this study, that fact has to be disclosed on the report.