New York City's Board of Health voted Thursday to require parental consent for a form of circumcision that involves oral suction, a ritual practiced by some ultra-Orthodox Jews.
The board voted 9-0 to require that anyone performing the ritual obtain written consent from the infant's parent or guardian. The parents will have to sign a form acknowledging that the city Health Department advises against the practice because of risks of herpes and other infections.
The Health Department says there have been 11 confirmed cases of herpes simplex since 2004 in newborn boys after circumcisions that likely involved direct oral suction, and two of the infants died.
"The department is trying to be very careful here in its role in protecting the health of infants while also being respectful of religious traditions," Health Commissioner Dr. Thomas Farley said.
The procedure called "metzitzah b'peh" in Hebrew was once a widely practiced but has been abandoned by most Jews because of fears it could spread disease. During the ritual, the person performing the circumcision, called a mohel, cleans the wound by sucking blood from the cut and spitting it aside.
Doctors say the procedure puts the child at risk for herpes simplex type 1, a virus that most adults have and carry in their saliva.
That type of herpes is usually harmless to adults but can be deadly to newborns.
"The evidence, to me, is overwhelming," said Board of Health member Dr. Joel A. Forman. "This is a life-threatening disorder, having seen at least one case myself in our hospital in the past few years. It's crazy that we allow this to go on, I think, so I really wish we did something stronger."
But defenders of the tradition vowed to ignore the new rule.
"We're not going to sign papers admitting that we are child murderers," said Rabbi William Handler of Brooklyn, who passed out fliers opposing the regulation outside the meeting in Queens. "We follow the tradition going back 3,000 years. Any surgeon in a hospital would be proud to have a record like us."
Michael Tobman, a media consultant for Hasidic groups, said the Hasidic community was outraged by Thursday's vote.
"We believe this attempt to regulate a foundational religious practice based on the thinnest of contested medical evidence is plainly unconstitutional," Tobman said. "We'll be aggressively litigating this governmental overreach."
New York State Assemblyman Dov Hikind, whose district includes many religious Jews, said that the vote "has left the Orthodox community stunned and hurt."
"Orthodox Jews have historically made it clear that they will practice their religion as they always have, regardless of any government's attempt to interfere or degrade them," Hikind said in a statement issued jointly with state Senate candidate Simcha Felder.
Most reform and modern orthodox mohels clean circumcision wounds with sterile gauze or a sponge, or use a glass tube to suction away blood.