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Saturday, December 12, 2015

The RCA on Metitza Be-Peh (MBP)

Metitza be-Peh (oral suction following circumcision, or MBP) is a practice followed by some Haredi Jews.  Here is a detailed history.

Below are three policy statements on MBP by the Rabbinical Council of America (RCA), from their website. Note the "evolution" of their position and draw your own conclusions.

Mar 1, 2005 -- The Rabbinical Council of America, the largest group of Orthodox rabbis in the world, has today issued a statement regarding Brit Milah (circumcision) and Metzitza (Oral Suction).

The statement reads as follows:
Bris Milah and Metzitza be'Peh
(Ritual Circumcision and Oral Suction)
A Policy Statement by the
Rabbinical Council of America

Tuesday, March 01, 2005

Bris Milah (ritual circumcision of Jewish males, performed on the 8th day after birth unless there are health contraindications) is a fundamental cornerstone of Jewish life and Biblical law. An important element of every Bris Milah is Metzitzah be'Peh, the extracting of blood from the wound and/or surrounding tissue using the mouth as the source of suction. This practice has been prevalent in all Jewish communities worldwide for thousands of years.

There has been a longstanding debate in the halachic responsa literature of the past several hundred years regarding the optimal way to fulfill the precept of suctioning. There are halachic authorities who mandate that only suction created via direct contact of the mouth to the wound adequately satisfies this requirement. Other halachic authorities, however, fully permit performing oral suctioning through a tube even as an ideal method of implementation of this precept.

A well-trained mohel, adhering to the scientific principles of sterile technique and antisepsis, essentially reduces the infectious risk of circumcision to the point where it is close to zero. Performing oral suction via a sterile tube does not pose any increased risk.

For those authorities who follow the view that suction via a sterile tube is completely permitted as a matter of Jewish law, this is clearly the optimal method to fulfill the requirement of Metzitzah be'Peh. In this manner, one absolutely fulfills the precept whilst placing the infant and mohel at no additional risk.

Based upon a careful study of the available halachic and scientific literature, as well as a review of sanctioned practice by numerous reliable Torah authorities past and present, it is the position of the RCA that the requirement of Metzitzah is fulfilled completely and unambiguously by the use of oral suctioning through a tube, as practiced by many mohelim in our communities. Therefore, according to this viewpoint, the use of such a tube is not only permissible, but is preferred (instead of direct oral contact) to eliminate any unintentional communication of infectious diseases. This protects both the mohel and the newly circumcised child.

An additional reason to encourage the use of a tube to fulfill the requirements of Metzitzah is that we not discourage less committed Jewish men and women from observing ritual circumcision (and possibly other Jewish rituals). Indeed, even some authorities who otherwise require Metzitzah be’Peh via direct oral contact, sanction a tube if that is the only way that the parents of a child would observe the mitzvah of Bris Milah.

In light of the above, the RCA urges its member rabbis, their congregants, synagogues and institutions, as well as the larger Jewish community, to encourage and where possible necessitate, that Metzitzah be’Peh be fulfilled via a tube.


Metzitza Be'Peh - Halachic Clarification
Regarding Metzitza Be'Peh, RCA Clarifies Halachic Background to Statement of March 1, 2005

(New York, NY) Jun 7, 2005 -- It is well known that there is a dispute among poskim regarding the obligation to engage in metzitza be’peh. Four major viewpoints exist, and we provide some sources for each below. More complete reviews are summarized in many sources, including Nishmat Avaraham, Vol. 2., Yoreh De'ah263:8 (p. 176) and 264:5 (pp. 182-183), and elsewhere.

The first view is that of Tiferet Yisrael (Commentary to Mishnah Shabbat 19:2), who regards metzitza as strictly a medical matter. The Talmud requires metzitza to avoid medical danger. Even though Tiferet Yisrael affirms that doctors in his day stated that this danger no longer exists (in keeping with the principle of nishtaneh ha’teva) and that, to the contrary, the act of metzitza itself might pose potential danger to the child, Tiferet Yisrael nonetheless advocated metzitza be’peh because he believed that doctors of his day agreed that it also provided a medical benefit to the child.

The second view is that metzitza is required and may be performed with any device – mouth or even sponge – that draws blood from the wound. (Chatam Sofer cited in Rav Pirutinsky's Sefer Habrit, pp. 216-217).

The third view is that metzitza be’peh is required, but the requirement of be’peh may be fulfilled through suction generated by the mouth through a tube. (Proclamations by Rabbi A. Hildesheimer and Rabbi S. R. Hirsch to their respective communities, and the latter's Responsa Shemesh Marpeh 55; Rabbi Tzvi Pesach Frank, Responsa Har Tzvi214; Rabbi A. Y. Hakohen Kook, Responsa Da'at Kohen 142; others cited in addendum to p. 222 at back of Sefer Habrit).

The final view is that metzitza be’peh actually requires suction from the mouth directly onto the site of the circumcision. (Responsa Binyan Tziyon 1:23-24; Responsa Maharam Schick Orach Chaim 152; Responsa Avnei Neizer 1:338).

The poskim consulted by the RCA (Rabbi Gedalia Dov Schwartz, Av Beit Din of the Beth Din of America and of the Chicago Rabbinical Council; Rabbi Hershel Schachter of RIETS/YU and the Union of Orthodox Congregations of America; and Rabbi Mordechai Willig of RIETS/YU and Segan Av Beit Din of the Beth Din of America) agree that the normative halacha undoubtedly permits the third view, and that it is proper for mohalim to conduct themselves in this way given the health issues involved in the fourth view. Rabbi Schachter even reports that Rav Yosef Dov Soloveitchik reports that his father, Rav Moshe Soloveitchik, would not permit a mohel to perform metzitza be’peh with direct oral contact, and that his grandfather, Rav Chaim Soloveitchik, instructed mohelim in Brisk not to do metzitza be’peh with direct oral contact. However, although Rav Yosef Dov Soloveitchik also generally prohibited metzitza be’peh with direct oral contact, he did not ban it by those who insisted upon it, and neither does the RCA advocate any such ban. Those who wish to follow their customs in accordance with the above-noted authorities are certainly entitled to do so, but the RCA is firmly of the opinion that in light of current realities and medical knowledge it is proper, and preferable, to use a tube.


The RCA, Calling for Safe Circumcision Practices, Disapproves of Unilateral Government Regulation

Sep 10, 2012 -- The Rabbinical Council of America (RCA), the largest group of Orthodox rabbis in the world, in light of the pending directive of the New York City's Health Department for parents to sign statements of informed consent prior to the performance of "metzitzah be-peh" (direct oral suction of the wound) as part of the traditional Bris Milah (circumcision), states:

Many Jewish legal authorities have ruled that direct oral suction is not an integral part of the circumcision ritual, and therefore advocate the use of a sterile tube to preclude any risk of infection. The RCA has gone on record as accepting the position of those authorities. Nevertheless, the RCA respects the convictions and sensitivities of those in the Orthodox Jewish community who disagree with this ruling and joins in their deep concern about government regulation of religious practices. The RCA urges these groups to voluntarily develop procedures to effectively prevent the unintended spread of infection.

The RCA supports the recent call of the Agudath Israel of America to New York Mayor Michael Bloomberg and the New York Health Department that, instead of unilaterally imposing regulations, they collaborate with Orthodox Jewish leadership to develop protocols to address health concerns.

Rabbi Shmuel Goldin, the RCA President, summarized his organization's position. "The act of circumcision is a precious and cherished ritual for the Jewish community, one which initiates our sons into the religious covenant. The RCA maintains that parents should use methods, in strict conformity with Jewish law, which enable them to hand down our religious legacy to a new generation safely and appropriately."

Sunday, November 15, 2015

Abraham looks down at the stars: The biblical sources of a midrash on Genesis 15:5

"ויוצא אתו החוצה ויאמר הבט נא השמימה וספר הכוכבים וגו׳" (בראשית טו:ה)

רש"י מפרש: "לפי פשוטו הוציאו מאהלו לחוץ לראות הכוכבים, ולפי מדרשו אמר לו צא מאצטגנינות שלך, שראית במזלות שאינך עתיד להעמיד בן, אברם אין לו בן, אבל אברהם יש לו בן. וכן שרי לא תלד, אבל שרה תלד, אני קורא לכם שם אחר וישתנה המזל. דבר אחר הוציאו מחללו של עולם והגביהו למעלה מן הכוכבים, וזהו לשון הבטה מלמעלה למטה.

מקור הדרשה האחרונה בב״ר (תיאודור-אלבק פרשה מד עמ׳ 432): "ר' יודה בר' סימון בשם ר' יוחנן אמר העלהו למעלה מכיפת הרקיע. הוא דאמר ליה 'הבט נא השמימה' - אין הבט אלא מלמעלה למטה."

ובניסוח מקביל בתנחומא (שופטים סימן יא) נמצא דיוק נוסף חשוב: "הבט נא השמימה - 'שא נא עיניך השמימה' אין כתיב כאן אלא 'הבט' - כאדם שהוא מביט מלמעלה למטה, וכן הוא אומר (תהלים יג) 'הביטה ענני ה' א-להי.'"

אולם במקרא מצינו שהפועל "הבט" אינו חד־משמעי או חד־כווני. ובצדק העיר הרא"ם על פירוש רש"י:

"ואינו רוצה לומר שכל הבטה היא מלמעלה למטה, שהרי מצינו (שמות לג, ח) 'והביטו אחרי משה', 'אל תבט אחריך' (יט, יז), 'הבט ימין וראה' (תהלים קמב, ה), אלא הכי פירושא: אין 'הבט' האמור פה אלא מלמעלה למטה, דומיא ד'אין עמידה אלא תפלה, ואין פגיעה אלא תפלה' (ברכות כו ב). וכן מה שכתב רש"י: 'וזהו לשון הבטה מלמעלה למטה' פירושו וזהו לשון הבטה האמורה פה מלמעלה למטה." (וע״ע ב"שפתי חכמים" שדחק בזה דוחק גדול).

אבל נראה לי שגם הרא"ם לא ירד לסוף דברי חז״ל המובאים ברש"י. והמהלך הנכון להבנתם נרמז בדברי התנחומא המובאים למעלה – "'שא נא עיניך השמימה' אין כתיב כאן אלא 'הבט' - כאדם שהוא מביט מלמעלה למטה."

כנראה שפסוקים ספציפיים מספר ישעיהו עמדו לנגד עיניהם של חז״ל כשדרשו "אין הבט אלא מלמעלה למטה":

1. "ועבר בה נקשה ורעב והיה כי ירעב והתקצף וקלל במלכו ובא-להיו ופנה למעלה: ואל ארץ יביט והנה צרה וחשכה מעוף צוקה ואפלה מנדח:" (ח:כא-כב)

2. "שאו לשמים עיניכם והביטו אל הארץ מתחת כי שמים כעשן נמלחו והארץ כבגד תבלה וישביה כמו כן ימותון וישועתי לעולם תהיה וצדקתי לא תחת:" (נא:ו) 

בפסוקים אלו נמצא ניגוד ברור בין ״פניה״ או ״נשיאת עינים״ לשמים ובין ״הבטה״ לארץ. ולכן פירשו חז״ל - על יסוד המלים "ויוצא אתו החוצה ויאמר הבט נא השמימה" - שאברהם ״הביט״ אל כוכבי השמים מלמעלה למטה כשהוא מוטל מחוץ ומעל כיפת הרקיע (celestial sphere), לפי דגם העולם של האסטרונומיה העתיקה. והרעיון מאחורי הדרשה הוא שאברהם וזרעו אינם כפופים להשפעות אסטרולוגיות - בלשון המדרש ורש״י על אתר, "צא מאצטגנינות שלך!"