One is a decision with wide community implications; the other concerns just one little boy. But in two different cases this week in two different states, the complicated and contentious legal and ethical issues around circumcision were once again raised – and the decisions once again sided with those in favor of the practice.
In New York City on Tuesday, Mayor Bill de Blasio's administration revealed plans to ease restrictions on a controversial circumcision ritual practiced by some Orthodox communities known as metzitzah b'peh, or oral suction. The ritual, in which the mohel sucks the blood from a circumcised infant's penis, came under tougher regulation during de Blasio's predecessor Mike Bloomberg's administration. As New York magazine reports, between 2000 and 2012, eleven babies reportedly contracted herpes – and two died – after undergoing the ritual. Since 2012, parents who wish to have the ritual performed have be required to sign consent forms, a policy that has been difficult to enforce. The Observer says that under the old rule, the city received exactly one consent form. And in the meantime, it provoked outrage, and a lawsuit, from religious leaders in the community.
Under the new policy, the consent forms will be done away with, but leaders will agree to contact health officials if a baby contracts herpes, and to ban any mohel found to have the same herpes strain as the baby from performing the rite ever again. In a statement, the mayor's office said that "While the de Blasio Administration continues to believe that MBP carries with it health risks, given the sacred nature of this ritual to the community, the administration is pursuing a policy centered around education of health risks by the health care community and respect for traditional practices by the religious community." On Tuesday, Rabbi David Zweibel said, "It is to Mayor de Blasio’s eternal credit that he recognized how profoundly offensive the regulation was to our community."
Meanwhile, a case out of Florida that's been brewing for almost four years took another turn this week. After parents Heather Hironimus and Dennis Nebus ended their relationship in 2011, they agreed in writing that Nebus "would be responsible for scheduling and paying for" the circumcision of their baby son Chase. But by the time Nebus was ready to carry out the procedure, Hironimus had experienced a strong change of heart, stating in court last year papers that it was "not medically necessary and she did not want to have the parties’ son undergo requisite general anesthesia for fear of death." A Palm Beach County Circuit Judge ruled in 2014 to allow for the procedure, but the family continued to fight over it after a higher court ordered a stay. In court filings, Nebus said that the procedure was "just the normal thing to do."
Then on Tuesday, supporters of Hironimus protested outside the office of Dr. Subhash Puranik, with signs reading "Don't cut Chase's penis" and "Genital integrity is a human right." One mother told reporters, "There are risks, including death, and that's not something we're willing to risk." Local news station WPTV says it is not known whether the boy eventually underwent the procedure or not.
Statistics on circumcision related mortality are hard to verify, but the most commonly cited one estimates roughly 117 annually, which puts it at "1.3% of male neonatal deaths." In guidelines issued in December, the U.S. Centers for Disease Control and Prevention did not recommend routine circumcision, but "emphasized that the benefits outweigh the risks, recommended the procedure be covered by insurance, and suggested that males of all ages who are not circumcised should receive counseling about its potential health benefits."
I don't have sons and I have no religious imperative regarding circumcision and I'm a lady, so I don't have a personal stake in the issue. But what strikes me as the most unfortunate aspect of the debate, on all sides, is how easy it is for adult willfulness to become a factor. It's not a compelling enough argument to do something, especially to an older child, because you claim it's "just normal." Conversely, it is unhelpful and unsupportive to men and boys who are circumcised to call them "mutilated." And whatever a family's choice, doing what's expected is never the same as doing what's best for any individual child.