Jewish Journal (MA) - March 19, 1999

Local Mohel Speaks Out on Circumcision Debate

By Bette Wineblatt Keva
Jewish Journal Staff

Samuel Pessaroff, mohel and well-known cantor of Temple Ner Tamid of Peabody, said the latest debate over circumcision is irrelevant to Jews. "We don't have a choice of whether or not to circumcise. It's a commandment," he asserted.

The great debate has resurfaced regularly since at least 1971 when the American Academy of Pediatrics concluded that there was no absolute medical necessity for routine circumcision. In 1989, new research investigated the links between circumcision status and urinary tract infections and sexually transmitted diseases, especially AIDS. The academy concluded that there were slightly fewer cases of these diseases among circumcised males. This month, however, the academy reversed its 10-year-old policy, now stating that there are not enough health benefits of circumcision for it to recommend it as a routine procedure.

Pessaroff said Judaism "doesn't get involved with the debate over hygienics," and is only concerned with Jewish law. "There is no reason to do it for hygienics. It's like being kosher. Nowhere does it say in the Bible that it is healthy." Although Pessaroff has observed cases in which he believes removing an unusually tight or loose foreskin, for example, could eliminate problems in later life.

Jewish parents do have an option, and that regards their choice of some type of anesthesia. The most common is placing a drop or two of wine in the baby's mouth before and after the cutting has been completed. It is a necessary part of the ritual and has been known to produce a calming effect on the child.

But Pessaroff, who has performed hundreds of circumcisions, would not affirm or deny whether the baby actually experiences pain. The Jewish Theological Society, the umbrella organization for the Conservative movement, "leaves it up to the mohel if he wants to alleviate the pain." But the need for administering an anesthetic to the newborn, he insists, is "to placate the parents."

He said "all babies cry during and before the procedure. But it has to do with the fact that the baby is restrained, swabbed with cold alcohol, hasn't eaten for at least an hour. I'm not saying there is no pain, but the baby would cry with a circumcision or not. [People have observed] that the crying doesn't seem to change during the actual cutting. I don't necessarily agree with that, but if they want to believe that, it's an easier sell to parents."

While "nobody questioned the procedure 15 years ago," today more and more parents do, he said.

The fundamental principle of brit milah dating back to Abraham's covenant with God was once rarely questioned. According to a Scripps Howard News Service report last year, three decades ago, roughly 25 percent of men worldwide and more than 90 percent in the U.S. were circumcised, primarily for hygienic reasons. But when the American Academy of Pediatrics began investigating it in 1971, with some physicians agreeing that there is no medical reason for the procedure, the number of American males having circumcisions dropped to 60 percent.

Of all the reasons to forego the procedure, according to The Jewish Week this month, often the key factor is concern over the pain inflicted on the newborn. Rabbi Edgar Weinsberg of Temple Beth El said he has never seen a mother who has not turned away, unable to endure watching it.

Pessaroff emphasized that the procedure done by a doctor in a hospital is entirely different from that done by a mohel in a synagogue. They are like "night and day," he observed. The hospital procedure takes from 5 to 20 minutes; the circumcision given by Pessaroff generally takes 30 seconds.

In a hospital, the infant is "strapped down on a fiberglass board." In a synagogue, the child is held by his godfather while seated in a chair. In a hospital, the doctor may give a penal block or an injection. During the brit milah (the covenant of the cutting) only wine is administered, and perhaps a topical anesthetic, Emla cream, if the parents request it.

Pessaroff recoils when he considers the penal block which requires two injections into the penis. "I think it is negligent and is rather dangerous. I don't even recommend Tylenol." He insists that Judaism "doesn't advocate pain" during circumcision, and the majority in the Conservative movement agree to the use of an anesthetic.

According to The Jewish Week of March 5, Dr. David Branski, chief of pediatrics at Shaare Zedek Hospital in Jerusalem, commonly uses the Emla cream "although there are reports that it can cause swelling of the foreskin and may not be completely effective." Another pediatrician from the Upper East Side of New York, Dr. Barry Stein, said the "preferred method is a nerve block." He disagrees with the notion that the injections themselves are very painful.

Rabbi Edgar Weinsberg said "hospitals are notorious for being non-germ free institutions." He prefers that a child have the procedure done at home and with a mohel who "is more conscious of the procedures to safeguard the child." Calling it "the single oldest ritual, 3,700 years old, it is one of the most hallowed in Judaism."

Nearly a dozen anti-circumcision organizations have formed in the past ten years. In Boston, Dr. Ronald Goldman, executive director of the Circumcision Resource Center in Boston, has been on the forefront of the debate. He is the author of two books, including Questioning Circumcision: A Jewish Perspective. The National Organization of Circumcision Information Resource Centers (NOCIRC) of Michigan is another group.

According to a CNN report posted on the Internet, dated April 7, 1997, "some mohels are finding other ways of staying true to their faith, minus the cutting. Some have changed the ceremony to conform to the wishes of the parents, often just naming the baby. Dr. Goldman said feminist influences within Judaism have contributed to the falling rate of circumcision. The formation of bris/bat ceremonies, which create a Jewish covenant for baby girls by giving them a Hebrew name, has helped eliminate its patriarchal nature and represents the progressive nature of Judaism."

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