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Monday, March 02, 2015

De Blasio’s wise circumcision reform: In praise of a move that's being unfairly attacked 

The de Blasio administration's announcement that it has resolved a lawsuit challenging New York City's first-in-the-nation regulation of circumcision has generated substantial commentary — much of it accusing the mayor of putting politics ahead of public health.

The reality is that Mayor de Blasio was right to move past the prior administration's problematic and ineffective efforts to require consent forms when circumcision is performed with metzitzah b'peh, the oral suction of blood from the circumcision wound.

The mayor's critics tend to ignore not only the pending lawsuit but also that a federal appeals court has vacated a lower-court decision upholding the regulations, expressing deep skepticism about their purpose and effect. Given the risk that the regulations would be invalidated, it was prudent for the mayor to negotiate a resolution.

Those who question the virtues of compromise should consider the city's soda ban. However well intentioned, it was struck down by the courts. By acting before a final court decision in this case, de Blasio was able to preserve key public health benefits.

The new approach is also likely to be far more effective than the one it is replacing. Insisting that mohels provide parents with consent forms drafted by the city was both legally suspect and practically ineffective.

Requiring a ritual circumciser to repeat the government's view about circumcision was antithetical to the First Amendment. And conscripting unwilling participants to deliver a message they don't believe to parents in the moments before circumcision was not an effective method of communicating public health concerns.

The de Blasio administration will replace a consent form with an outreach and education campaign aimed at the medical community, especially obstetricians and pediatricians who service observant and Hasidic families.

A message communicated by a willing doctor in a medical setting is far more likely to make an impact on a parent's thinking than a legal document that is forced upon them at an inopportune time by an unwilling messenger.

The city's new protocol is also more science-friendly than the regime it replaces. Some of the medical experts the city relied upon in the litigation have expressed disappointment about the new plan. But those same experts were never able to say anything more than that it is "biologically plausible" for infants to become infected with herpes via circumcision.

What the de Blasio administration has extracted from those who questioned any connection between circumcision and infection is a commitment to have mohels and families of infected infants fully cooperate in comprehensive testing, including DNA testing that can conclusively determine whether the newborn's virus was transmitted by the mohel.

That in turn will permit the community and the city to ban any mohel found to have transmitted the herpes virus.

This plan also aligns the city with the rest of the state. New York State's 57 other counties previously endorsed a similar protocol. With the city on board it is now likely to become the practice statewide.

A final benefit of de Blasio's approach — and this cannot be overstated — is the important example he set of a liberal Democrat working constructively with religious communities. For too long, the relationship between progressives and religious communities has been one of mutual distrust.

De Blasio's action, like Gov. Cuomo's recent announcement that he is creating a new Office of Faith-Based Community Development Services, signals to Democrats nationwide that they must engage with faith communities. The country will benefit if other elected officials follow their lead.

Cynics may chalk up the administration's plan to politics. They would be wrong to overlook prudence, principle and public health, all of which strongly support the city's action.


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