Tuesday, December 14, 2004

Mohels - Often Unregulated


At 3:06 PM, Blogger jewishwhistleblower said...

Are standards lacking for Mohels? There seem to be more protections and supervision for animals that are slaughtered
( www.failedmessiah.typepad.com the new schita website) than children who are circumcised.

If there is a Rabbinical authority in your jurisdiction, check that your mohel is approved. Further, check references, ask questions. Find out what method he will be using and his experience in that method.


Opinion: Regulate circumcision
August 16, 2000
The Jerusalem Post

As if parents of newborns didn't have enough to be nervous about, think about this: mohalim (ritual circumcisers) are not required to have a license. Israel has never had a circumcision law - so anybody can buy a scalpel, cotton wool, alcohol, and a prayer shawl, print up business cards for distribution in obstetrics departments, and perform the invasive ritual.

Fortunately, in recent years there have been no reports of baby boys dying from a brit mila, but there have been cases of long-term injury. Even Shas MK Nissim Ze'ev, an occasional mohel, bandaged too tightly the penis of a baby he circumcised several years ago and failed to check him on time, causing gangrene and permanent harm.

This week, Ha'emek Hospital in Afula reported that, a month ago, a newborn baby's penis was accidentally amputated below the corona by the ritual circumciser and reattached by surgeons using delicate microsurgery. The good news was that the baby recovered and will be able to function normally.

The hospital reported the highly unusual incident to the Health Ministry, but Ha'emek still doesn't know the identity of the mohel, as the family refused to give his name and have not yet filed a complaint. Brenner said that it was possible the family would complain to the police or sue the mohel for damages now that the child had recovered, "or maybe they received payment from the circumciser to keep quiet about the incident." It isn't known whether the mohel has a license or not.

Rabbi Yosef Weisberg, the Religious Affairs and Health ministries' joint national supervisor of mohalim, said, "If asked, our committee will investigate. Such a thing is extremely rare, but I have heard of one or two other cases here over the year. Any mohel who did such a thing must have been blind, drunk, or pushed while performing the brit mila." He said he also knows of circumcisers who have no insurance, and there are no figures on how many of the several hundred practicing mohalim in the country are unlicensed.

Weisberg blamed the lack of a circumcision law on "pressure on Knesset members from representatives of American Conservative, Reform, and female circumcisers who are afraid they'll be left out." Health Ministry officials say they, too, would like such a law to accredit and supervise mohalim, but that they never succeeded in getting it through. There are regulations about acupuncture, which allow a non-MD practitioner to perform this complementary medicine technique only if under supervision of a licensed medical doctor, but nothing about circumcisers, who perform more a invasive procedure.

The lack of standards affects not only Jews, but also Moslems (who have their sons circumcised when they enter adolescence), and many Christians (the males in Britain's royal family have reportedly all been circumcised by mohalim).

Weisberg knows even of a case of an Israeli baby who was infected with genital herpes by a mohel with oral herpes during the ritual. Standards and supervision are also needed to prevent the transmission, either way, of blood-borne diseases such as AIDS and hepatitis C. There are also aging circumcisers whose hands shake and who suffer from vision problems; no one tells them when to retire.

The growing opposition among secular Jews to the state- sanctioned rabbinate from controlling life's major events - such as marriage, divorce, and funerals - has affected the most pervasively observed Jewish ritual of all: circumcision. Weisberg reported with concern and disapproval that many young parents in the Dan Region now ask secular MDs to perform a circumcision on their children using local anesthesia (forbidden by Halacha) in the hospital. There is no ritual, no prayers, and no audience. A day or two later, the couple invite their friends to a hall and hold a "party." But such MDs may be considerably less experienced in performing circumcision than veteran mohalim who have performed thousands of them.

It's high time for the Health and Religious Affairs ministries, as well as relevant voluntary and professional organizations, to sit down and formulate a government- sponsored bill for passage by the Knesset that would protect the babies and the interests of their parents, as well as that of qualified circumcisers.

At 3:30 PM, Blogger jewishwhistleblower said...

Israel's Mohels Cut Up Competition: Knesset Calls For Stricter Circumcision Standards
by Michael Arnold
Forward (NY)
July 10, 1998

JERUSALEM -- Here's a tip: if you're having your son circumcised in Israel, make sure you check the credentials of the mohel.

A Knesset committee is examining ways to increase supervision of mohelim following complaints about unregistered circumcisers roaming maternity wards handing out business cards. Only mohelim who have been certified by an inter-ministerial committee are allowed to search for business in hospital corridors, but not all institutions make an effort to enforce the regulations.

The result of this laxity is that nearly half of the working circumcisers in Israel are uncertified, according to the chairman of the plastic surgery department at Assaf Harofeh Hospital, Dr. Moshe Westreich, who is also a member of the 10-man certification committee representing the Ministries of Health and Religious Affairs and the chief rabbinate.

Complaints of maladroit circumcisers may be few, but a Knesset committee is acting with foresight to head off a potential problem.

"The field is wide open and it's a mess," said the chairman of the Knesset's Public Complaints Committee, Rafi Elul. "Anyone can become a mohel after training for as little as a few weeks. Some parents teach their children how to do it. There is today no law determining what is required to become a mohel and there is no need to present a license before carrying out a circumcision."

Israel currently has only three circumcision inspectors, who evaluate the skills of mohel candidates -- those who seek certification, that is -- before recommending them to the interministerial committee. The committee flunks about half of the candidates, many of whom are young yeshiva graduates with little grasp of medical procedures or biological sciences, Dr. Westreich said.

Rabbi Yosef Weisberg, head of mohel supervision in Israel and the author of three books on the intricacies of circumcision, says the supervision system is excellent. The three inspectors are charged with carrying out random checks at the 25,000 to 35,000 circumcisions performed in Israel each year, a task which critics say is far beyond their capabilities. In fact, only a handful of circumcisions are subject to spot checks each year. Still, Dr. Westreich says he has seen relatively few egregious errors over the years. The errors include cases where mohelim have removed additional parts or where portions of the organ turn necrotic after the operation and fall off.

"What we really need to make the system work better is more supervision," Dr. Westreich said. "Once someone gets his license, he practices for five years and we don't know what he's doing. We need sort of a circumcision police force."

Into the breach, Mr. Elul said, have waded wildcat mohelim as young as 16 or, on the other end of the spectrum, too old to control the trembling of their hands. Though certified circumcisers must appear before the interministerial committee every five years, Mr. Elul and others talk of forcing mohelim to retire at age 70. They also hope to add another 12 "expert" mohelim, who must have 10 years of experience in the field and do it as a full-time job rather than a hobby, to the current pool of 25. The experts supervise the training of certification candidates in Jewish law and in medical procedures such as sterilization and blood-clotting.

Opposition from the religious parties appears likely to foil the chances of anchoring any reforms in legislation. The minister of education, Yitzhak Levy of the National Religious Party, proposed a bill four years ago to tighten the certification and oversight of mohelim, which passed a preliminary reading but was killed in committee by opposition from the fervently Orthodox. Rabbi Levy now has been convinced to oppose his own ideas.

The problem, apparently, is fear that legislation in Israel would work to the disadvantage of Jewish communities overseas. Foreign governments might cite the Israeli example as freedom to legislate on the issue and pass laws restricting the procedure to doctors only.

"A brit milah has to be done by someone who considers that he's doing it for the sake of a mitzvah," Dr. Westreich explained. "If a person says he's not religious and he doesn't believe in anything, then it can't be considered a mitzvah."

Parallel to the certification debate are disputes over use of local anesthetic -- which Dr. Westreich favors only for operations on adults, such as the thousands of immigrants from the former Soviet Union who are not legally Jewish when they arrive -- and the "crushing clamp" which kills the foreskin by cutting off circulation but which is not allowed halachically.

At the same time, a small anti-circumcision movement is forming in Israel among parents who charge that brit milah amounts to genital mutilation of infants and worry that it will limit their sons' sexual pleasure later. Still, societal pressure to conform, as well as the high level of respect even among secular Israelis for the mark of Abraham's covenant with God, would seem to ensure that pro-foreskin forces won't find too many adherents here.

Another factor is economic. Doctors are squeezing traditional mohelim out of the market, despite the fact that the 1,500 shekel ($410) sum they charge is about thrice what mohelim receive. Standardizing the certification procedure might build public confidence in the mohelim and help protect their slice of the market. It also might help prevent the unholy alliance Dr. Westreich fears could form among destitute mohelim and unemployed Russian doctors who could conspire to offer cut-rate circumcisions that cut corners.

"I don't think it's going to be long before a mohel charges 500 shekels and then hires [an unemployed] doctor to come along and give an injection for 500," offering a combination of tradition and medical expertise for less than a regular doctor takes, Dr. Westreich said. "I'm afraid we're going to get all kinds of people whose ethics aren't the highest."

The Knesset will discuss the issue again this month with an eye to improving the system and getting the government to pay for more supervision.

"Right now the budget is zero. I think it should be more than that," Dr. Westreich said. "Certainly if the mohelim know there's someone looking over their shoulder they're going to be more careful."

At 5:10 AM, Anonymous Anonymous said...

Soneh Isroel

At 8:19 AM, Blogger jewishwhistleblower said...

>Soneh Isroel

Quite the contrary, I'm an Ohev Israel.


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