Is Brit Milah Cruel and Unnecessary?

A debate about whether the time has come to reconsider the practice of circumcision

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Reprinted with permission from the Jerusalem Report (November 22, 1999).

Pain & Violence

Dear Dorothy Greenbaum, 

Of all the ancient customs still practiced, circumcision is the one we should be least proud of. I say this as a father who succumbed to communal pressure and had my son circumcised. He suffered not just a little, and despite the involvement of a doctor who applied topical anaesthetic. I then investigated the scientific record and was amazed to learn that a preponderance of experts worldwide consider circumcision medically unjustified, a painful, risky amputation of a functional body part.

Every year many infants are seriously injured in the course of ritual circumcisions. Babies' genitals have been permanently, severely damaged in the procedures performed by mohalim and doctors. Uncontrolled bleeding and infection are common; occasionally there are deaths. Is this a price worth paying for a badge of identity hidden under men's pants, a badge shared with Muslims and Aboriginals?  Few Jews would wish to resume animal sacrifices or polygamy, yet circumcision shares with these practices a tribal origin outside of Judaism, and fealty to it is distinctly in the realm of the irrational.

Thus the need for the emotional blackmail so many parents are subjected to; the myths of no pain and no risk; the hugely exaggerated claims of potential health benefits. Throughout Europe, health services abjure routine circumcisions because of the doctors' commitment to upholding the Hippocratic Oath not to do harm. Jewish parents should embrace that simple principle and take up welcoming ceremonies for our babies that are violence-free and egalitarian.

Victor Schonfeld

A Safe Practice

Dear Mr. Schonfeld:

It is with joy, pride, and honor that I perform brit milah. Your horror stories of serious complication and even death, although sad, are also freakish. In the U.S., where approximately 1.5 million newborns are circumcised annually, the rate of complications is 0.2 percent to 0.6 percent, most of them minor. The recent policy statement of the American Academy of Pediatrics clearly presents the evidence on the benefits of circumcision: protection against urinary tract infections, a much lower incidence of penile cancer, a decreased risk of HIV and other sexually transmitted diseases. The AAP statement also asserts the safety and efficacy of anesthesia. If your baby screamed and cried at his brit, blame the mohel, not the mitzvah!

Clearly, many young families have ambivalent feelings about this ritual, and they have a right to understand its meaning. Our covenant mandates us to work to repair the faults of an imperfect world--tikkun olam. This little piece of skin is symbolic of imperfection. It is a barrier between the baby and his faith, people, and future. We--the adults--at the brit are being tested to see if we will remove that obstacle. We are the ones being tested. But he is only a week old, he is not being tested.

The time has come to reform the pain but preserve the feeling of brit milah.

Dr. Dorothy Greenbaum

Dubious Benefits

Dear Dr. Greenbaum,

is circumcision cruel?

The young man who has to live with a lifelong disability due to a circumcision gone wrong will find no comfort in your assertion that his tragedy is "freakish" nor in your notion that the amputation done in adherence to religion and tribe was meant to "perfect" him. Your preferred statistics underestimate the real frequency of complications, but even they indicate that each year in the USA some thousands of newborn babies suffer complications.

You say, "reform the pain," but in a recent article for mohalim, you say you rely on an anaesthetic cream that cannot numb the deep tissues that cause the ba­by the most pain--a fact not mentioned on your website for parents. If circumcision is as beneficial as you claim, why not let young men choose it for themselves when they are old enough to give informed consent?

The claims of health benefits are contradicted by a variety of more recent research studies too numerous to mention here, but you do not refer to this data at all. You imply that theAAP advocates circumcision when in fact it has now reversed its position, as the recent policy clearly states: "Research studies suggest there may be some medical benefits ... but these data are insufficient to recommend routine neonatal circumcision." When you blind parents to the full picture, that's coercive and should be seen as such. And if the cutting of a baby boy's genitals is to be taken as the profoundly positive event you paint it as, then what's the message this transmits to Jewish women? Circumcision in this day and age is a perverse way of affirming Jewish identity.

Victor Schonfeld

A Part of the Covenant

Dear Mr. Schonfeld:

You distort the truth. Your "research studies too numerous to mention" were obviously not regarded as valid by the AAP, which hedged on recommending routine neonatal circumcision, in spite of its medical benefits, only because of cost issues. And you take my own statements regarding anesthesia out of context--I have great success using a combination of pain-control techniques.

If we wait for the child to be old enough to make his own decision about circumcision, we turn a one-minute, at-home, very safe procedure into one that requires a hospital stay, general anes­thesia, and much higher risk. In addition, circumcision done after infancy does not protect against cancer of the penis.

Circumcision is essential, but not the only part of the brit, the covenant. Standing with the baby in a ceremony that transcends time are Abraham and Sarah and our other ancestors, all who were at Sinai, up to and including us. At that ceremony you are connected to all the generations of your family that preceded you. I'm sorry your son's brit wasn't like that, but that is what it should have been. Since Sarai became Sarah, Jewish women have been part of the covenant. The reason Jewish men have to be circumcised into the covenant is to be worthy of a Jewish wife. We are born covenanted. If you don't see it this way, that is your prejudice.

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Dr. Dorothy Greenbaum

Dr. Dorothy Greenbaum is a Board certified Pediatrician, a Fellow of the American Academy of Pediatrics, and a certified Mohel.