Interesting Conversation About Clamps

I received a phone call today from Rabbi Yaron Amit. He is an Israeli mohel who maintains a presence in South Florida, who has an organization that provides free bris services to Jews around the world. He told me they do 28 brisses a day.

He called because I wrote a blog post in response to an article which appeared in IsraPost a few years ago in his name. As it turns out, my response was more against the way the article was translated than against the points he made. My original post has been removed - at his request, and in respect of the clarification - but I would like to share the points he made in our conversation, along with my own commentary.

Rabbi Amit's main issue is that brisses done with a clamp are not kosher. He says there is never blood from such circumcisions and that even when there is blood in the procedure it is blood which emanates from handling an open incision, which is different blood than "dam milah" - the blood of circumcision. He also referred to realities that changed for people - which he witnessed - after their circumcisions-by-clamp were corrected, such as a change in parnasah, finding a mate, and general shift in life turning positive - what he refers to as "spiritual benefits" (my translation - we spoke in Hebrew).

He maintains that any bris done by such a method is unacceptable and needs hatafat dam bris. And that a mohel who uses such a device is unfit to be a mohel, and is unfit for anyone to hire as a mohel.

He shared with me stories of surgical corrections that needed to be done to brisses done through this method, as well as horror stories of amputations of the glans that he has witnessed on account of the use of clamps.

I agree with him on almost all points. I have long advised against the use of clamps:
* For halakhic reasons: Rabbinic approval is scant        Mistake #4
* For practical reasons: Danger        Arrogance (here I outline another practice, which the Rabbi agreed should not be done - "Freehand")
* In addition, in the "methods of circumcision" I have described here (for education purposes), I have made it clear that while there are some mohels who opt to use the clamp, this practice has been forbidden by many many great rabbis and poskim


The points in which we might disagree are:
I maintain that according to Rabbi Moshe Feinstein, if there is minimal blood at the time of circumcision, the bris is valid b'dieved, as long as there was blood. Rabbi Amit believes there is never blood when a clamp is used, and any blood is not "dam brit" as I explained above. Rabbi Feinstein also makes it clear that the clamp is not to be used (Iggerot Moshe Yoreh Deah 3:99).

I am not a fan of telling thousands of people that their bris is unkosher and needs a touch-up, even if it is "merely" Hatafat Dam. With this Rabbi Amit and I will have to agree to disagree.

CONCLUSION: FIND A MOHEL WHO DOES NOT USE A CLAMP (WHO DOES USE A SHIELD) IF YOU WANT THE SAFEST RESULTS, AND NO HALAKHIC COMPLICATIONS FROM THE BRIS MILAH PROCESS. ASTHETIC RESULTS - IN ALL CASES - ARE DETERMINED BY THE SKILL OF THE MOHEL, IRRESPECTIVE OF THE METHOD. ALL MOHELS ARE HUMAN. ALL HUMANS ARE IMPERFECT. EVERY MOHEL SHOULD DO HIS BEST, AND SHOULD TAKE EVERY NECESSARY PRECAUTION TO ASSURE THE BEST ASTHETIC RESULTS HE CAN.

Rabbi Howard Jachter has penned an article in which he talks about the clamp. I don't believe all the responsa he quotes are being portrayed accurately. I also don't understand what he means when he says "As long as the clamp is used properly." The clamp being used properly happens when the clamping arm is closed. This is what all the rabbis wrote against! The clamp being used "improperly" is when the clamping arm is not utilized. If one is not closing the clamp, why not just use the more traditional shield?

The deleted post (that inspired this one) concluded with these links.
He's YOUR baby, you have a right to choose whom you'll hire.
You have the responsibility to ask all the right questions to every mohel you interview before you settle on the one you want
And you also must take care to know what you are looking for to have the right kind of experience for your needs.  Always remember that the wrong attitude is not to ask.

REMEMBER - IMPORTANT REMINDERS (similar links), as well as THE MISTAKES YOU WANT TO AVOID

A Circumcision for Conversion

Here I explain my personal philosophy regarding my role as mohel for conversions and an alternative those looking for my services might want to consider. Here is my previous post on this subject - along with earlier links to related topics

I get calls and emails from people across the spectrum of Judaism: Orthodox Jews, Conservative Jews, Reform Jews, unaffiliated Jews, Jews by birth, Jews by choice, "Messianic Jews." I also get calls from those who identify themselves as "non-Jews."

While I am not picky about my clientele per se, I do try to distinguish between "circumcision services" and "bris services." While both obviously include a circumcision, the former is without a ceremony and without blessings. It is not meant to serve as a fulfillment of the Jewish "bris" and it is typically requested by those who are not Jewish.

The "bris services" are for Jewish babies, born of Jewish mothers, who are Jewish either through matrilineal descent - a line of Jewish mother after Jewish mother - or through a conversion I might have officiated over myself, were I in the business.

Due to the unfortunate reality of the manifold kinds of conversions out there, some of which do not demand very much from the converts in question, I try to shy away from them. Rarely do I perform circumcisions for the sake of conversion, and I have difficulty providing a "bris" for those mothers whose conversions I cannot personally qualify - simply because I do not have enough information about the process, the rabbi, the bet din, the method, etc.

A Thought on Metzitzah

According to the Talmud, there are a few steps that need to be followed when doing a bris properly. Incidentally, I am choosing not to "number" the steps, due to the variating ways people choose to read the Talmudic passage of the bottom of Shabbat 133a:

עושין כל צרכי מילה [בשבת] מוהלין ופורעין ומוצצין ונותנין עליה איספלנית וכמון
On the Sabbath, we do everything that needs to be done for the circumcision: Remove the foreskin, remove the membrane from the glans, draw out blood, put on a bandage and cumin.

The Talmud goes on to say that even if the cumin had not been properly prepared (crushed or ground) before the Sabbath, one could grind it with his teeth on the Sabbath, an act which would generally be forbidden on the Sabbath - but is permitted, presumably on account of the role the herb/spice would play in stopping the blood and healing the wound.

The differences in the reading open up a debate as to whether metzitzah, which I have defined as "drawing out blood" is considered to be: a. part of the steps of the process, or b. a suggested component that the Talmud records as the best known form of helping the wound heal.

If it is the former, then metzitzah must be done at every bris [how the blood is drawn is a topic of a different discussion, and of much debate, particularly in ultra-Orthodox and some Haredi/Hassidic circles]. If it is the latter, perhaps it need not be done,

Circumcisions versus Brisses - Circumcising Jews, Half-Jews, Non-Jews

As far as I can tell, citizens of the world who circumcise their sons do so for one or more of many possible reasons: as a medical procedure, as part of a religious ritual that is a right of passage, for cultural reasons, for asthetics, or because daddy is circumcised.

I have met doctors who perform circumcisions all the time, and some who do them every now and then. Each one has a method which works for them to achieve the desired result. (Doctors are wonderful people, and they usually specialize in a particular field. As such, I would be wary of doctors who do not do them regularly, simply from word of mouth from other doctors who've told me their colleagues ought to stick to what they know - but that is for a different discussion.)

Mohels find themselves in a unique circumstance. Most mohels (certainly Orthodox mohels) are not physicians, and yet they have what many would consider a medical expertise in a very limited field. Does this make them obligated, under a sort of Hippocratic Oath, to perform circumcisions whenever called upon to do so?

Firstly, mohels are also specialists and should never extend beyond their training. There is circumcision, which is more or less routine, and there are surgeries which require a reconstruction of the penis. A mohel who is untrained should not undertake such a procedure, particularly if the best setting for it is an operating room with general anesthesia.

Secondly, circumcision, particularly on a newborn, is not, objectively, a "necessary" procedure, and in most cases is not life-saving. As to-circumcise or not-to-circumcise is a choice made by parents, mohels are under no obligation to accept the job if they do not want to. (Religious law might require them to in the event there is no one else available, particularly for a bris which must take place on the eighth day -- though obviously if it does not work out on the eighth day, it can be done at the next opportunity, ideally as soon as possible.)

So we come to our question: May a mohel circumcise non-Jewish babies, or is he only allowed to do brisses (as opposed to routine circumcisions)?

Emotions Vs Intellect Vs God's Law (part II)

[Part I is here]

Rabbinic literature is loaded with discussions about the importance and greatness of Bris Milah. In many postings, I have alluded to the connection between Bris and Pesach (I will write about this some day). One of the most noticable connections is that Elijah the prophet makes an "appearance" at both.

Here is another connection, as quoted in the Chapters of Rabbi Eliezer (the same one I've quoted a few times recently - just a different section of his comments):

 פרקי דרבי אליעזר (היגר) - "חורב" פרק כח

בני יעקב מלו את בניהם ואת בני בניהם והנחילם לחק עולם עד שעמד פרעה הרשע וגזר גזירות קשות ומנע להם ברית מילה, וביום שיצאו ישראל ממצרים נמולו כל העם מקטון ועד גדול, שנ' כי מולים היו, והיו ישראל לוקחין דם ברית מילה ונותנין על משקוף בתיהם דם ברית מילה ודם פסח ונתמלא רחמים על ישראל, שנ' ואעבור עליך ואראך מתבוססת בדמיך, בדמך לא כתיב אלא בדמיך, בשני דמים דם ברית מילה ודם פסח, ואומר לך בדמיך חיי, ר' אליעזר אומ' וכי מה ראה הכתוב שני פעמים בדמיך חיי, אלא אמ' הב"ה בזכות דם ברית מילה ובזכות דם פסח נגאלו ממצרים ובזכות דם ברית מילה ובזכות דם פסח אתם עתידים להגאל בסוף מלכות רביעי

The children of Jacob circumcised their children and grandchildren and left them with this practice forever until the wicked Pharaoh rose and made harsh decrees, preventing them from doing Bris Milah (performing the covenantal circumcision). On the day they left Egypt the entire nation was circumcised, from young to old, as it says "Because they were circumcised when they left Egypt" (Joshua 5:5).

The Israelites took the blood of the circumcision and they put that blood and the blood of the Paschal lamb and put them both on the doorposts to become recipients of God's mercy on that fateful night, as it says " And I passed by you and saw you downtrodden with your bloods, and I said to you, 'With your bloods, live,' and I said to you, 'With your bloods, live.' (Ezekiel 16:6). It doesn't say "blood" in the singular, because it refers to two bloods which caused God to skip over the houses that night.

Rabbi Eliezer says, "Why does the verse say 'With your bloods, live' twice? Because the Holy One Blessed be He declared that in the merit of the blood of the covenant and in the merit of the blood of the lamb the Israelites were redeemed from Egypt, and in those same merits they will be redeemed again, at the end of the fourth exile."

3. A Covenant of Blood (count continues from previous posting)

In essence, then, we have a covenant created over blood.

Bris For Conversion

There are a few occasions that would warrant what is called in rabbinic terminology "Milah L'Shem Geirut" - מילה לשם גירות - circumcision for the sake of conversion.

1. When a Jewish couple adopts a non-Jewish baby and are committed to raising him according to their lifestyle.

2. When a couple converts to Judaism, and their children convert along with them. Any males who have not been circumcised - from father to adult children to babies - require such a circumcision.

What Makes a Jew

When I was studying to be a mohel in Israel, one kind of experience was repeated at many brisses.

As my teacher, Rabbi Mordechai Sasson, is a Sephardic mohel, most of the brisses he'd perform would be for Sephardic Jews, who have a rich cultural heritage which brings the entire family and community into every bris. (or should I say "brit"?)

Typically, after the ceremony was over and Rabbi Sasson was doing his post-op examination, some old-school grandmother or great-aunt would smilingly look upon the now circumcised baby and say עכשיו נהיית יהודי (akhshav nih'yayta yehudi) - "Now you have become a Jew."

Huh?

This concept may be true in other religions (e.g. before baptism, a Christian child is not a Christian), but in Judaism, one's Jewishness stems from one's birth mother. If the mother is a Jew, the child that emerges is a Jew. Consider girls, who are thankfully not circumcised. How are they to "become" Jews if circumcision is what makes a Jew?

Circumcision does not make a person a Jew.

While this blog is not the forum for discussing the rules surrounding conversion and the Reform practice of accepting people as Jews based on patrilineal descent, I am here to discuss the role of circumcision in all of these procedures.

Judaism manifests itself in Jews in two ways - nationally and religiously - and both are meant to be informed and enlightened by the totality of what we call "Torah" (not just the Five Books of Moses). According to Jewish law, the national element is given to a person at birth and can never be revoked (except in very extreme cases of apostasy). The religious component has always been a question of individual practice - there have always been Jews who were more observant of the law and the Torah's guidelines and Jews who were less observant of the law and the Torah's guidelines.

Religion

In the last few hundred years, there have been different movements in Judaism who defined new ways to experience the "religious" element of their Judaism (in no particular order): Hassidim (and all its branches and extremes), Maskilim, Reform (and all its branches and extremes), Conservative (and all its branches and extremes), Orthodox (and all its branches and extremes), Reconstructionist, BILU, New-wave, Humanist, Traditional, Cultural, non-affiliated (the list is surely not exhaustive).

Most continue to circumcise their sons. Some do not.

National

On the national level, a Jew should ideally feel a sense of camaraderie with other Jews. (Yesterday was Yom HaShoah - I have long advocated that if Hitler did not distinguish between Jews, why should we treat other Jews in any manner other than respectfully?) Some people express this through their family name, through a "Jewish feeling," culturally, identifying with other Jews ('some of my best friends are Jews!'), identifying with the land of Israel, the State of Israel, the people of Israel, Yiddish theater, eating "Jewish food," etc.

Most continue to circumcise their sons. Some do not.

Bottom Line

According to all Jewish approaches, if a child is born to a direct maternal-line of Jews, the child is Jewish, regardless of levels of observance. (The questions arise when a conversion took place in that maternal line, as to what were the circumstances of the conversion.)

The circumcision the boys undergo puts a mark on the flesh that is the symbol of the covenant God made with Abraham in Genesis 17.

When a male non-Jew decides to go through the process of conversion, he may undergo circumcision (if he was not circumcised as a child) or an equivalent procedure significance-wise (if he is already circumcised), but the circumcision is not what makes him a Jew, though it is part of the process and his conversion would be incomplete without it.

Any person who converts undergoes a program of study, and is dutifully tested for sincerity and commitment to the Jewish faith, and subsequently immerses in a mikveh, under the auspices of a Bet Din to complete the conversion.

Hatafat Dam Brit

With the holiday of Pesach (Passover) approaching, it is appropriate to discuss the connections that bris shares with the holiday - and there are many.

One of them is the role of blood in the covenant.

The name of the holiday of Pesach comes from two sources: A. the Paschal lamb, the offering that was set aside for three days before being sacrificed and eaten by the Jewish people in Egypt, and B. the fact that God "passed over" the homes of the Hebrew slaves in Egypt on the night of the "Death of the First Born."

The Paschal Lamb is called the קרבן פסח - Korban Pesach, and the verb to "pass over" is פסח - Pasach - which is formulated slightly different in the name of the lamb and the holiday itself.

What caused God, or the destroying angel, or the death force to pass over the homes of the Hebrew slaves, the Israelites? If the edict against first borns was only against Egyptians, did the Israelites really need to do anything in order to be bypassed?

The answer to the first question is the blood of the lamb. The Israelites were instructed to put the blood of the lamb on the doorposts and mantle of their homes on the evening of the final plague to cause their houses to be skipped.

The second question is a trick question. Surely God knows the difference between the homes of those He is looking to punish and those He wishes to avoid. That is clear. But the Israelites needed to do something, to indicate they understood what was going on. They needed to show their faith in God, and in Egypt, on that night, their faith was demonstrated through following instructions.

Thus, in Egypt, the people were physically and symbolically saved through the merit of the blood of the Paschal lamb.

While the greater significance of blood is not the scope of this posting - there is much written about it in rabbinic teachings - the general significance of blood is that covenants are forged through it.

To our point - bloodless circumcisions, medical circumcisions and circumcisions pre-conversion

In the event that a baby is circumcised through a bloodless technique - which can be accomplished through the use of certain clamps - the bris is not considered to be "kosher." (This point is worthy of discussion, and I will return to it in a different posting) Of course, once the baby is circumcised, (hopefully) there is no more circumcision to be done.

Circumcisions done either not for the sake of a bris (ie by a doctor), before the eighth day of life, or by a non-Jewish officiant are all not considered to be "covenantal." In order to turn the "circ" into a "bris milah" a minor procedure involving the drawing of blood needs to take place under the proper auspices.

We draw a minimal amount of blood from the circumcision scar, typically using a medical lancet, the sterile pin used for blood tests. Once blood is drawn under the auspices of a bris ceremony, the circumcision is now considered to be a bris according to Jewish law.

(To bring an example from a different religion, and NOT TO COMPARE THE TWO RITUALS, you can pour as much water as you want onto a baby or a convert to Catholicism. But until the water comes in the form of baptism and is done by the right person in the right place, it is considered meaningless.)

The blood we are talking about is absolutely minimal. Most people who experience it as adults (converts, or those who discover they were circumcised in the hospital and want to make sure it is "corrected") feel the significance more than they feel the pin-prick that draws the blood.

Babies upon whom I have done this are usually smiling and cooing through the half second it takes.  Healing time is virtually nothing.