Wednesday, September 10, 2014

Suckers for Strawmen?

There was a very strange op-ed in the Jerusalem Post yesterday.

It follows an analytical article last week, by Sam Sokol, entitled "New York circumcision controversy emblematic of longtime Orthodox ideological split." This article described the controversy surrounding metzitzah b'peh, the oral sucking of the circumcision wound. It also quoted my own blog post on the topic, in which I argued that the strenuous opposition to any form of regulation of the practice is rooted in a policy established by Chasam Sofer, that whenever there is a perceived threat to Judaism, even a minor custom is elevated to an inviolable principle.

Yesterday's op-ed in response, "A scientific perspective on ‘A New York circumcision controversy,’ was written by Dr. Daniel Berman, Professor Brenda Breuer, and Professor Awi Federgruen, the same trio that have been arguing in defense of metzitzah b'peh in several other forums. In their response, they write as follows:
...Sam Sokol wrote, on these pages, an article entitled: “Analysis: New York circumcision controversy emblematic of longtime Orthodox ideological split,” advancing two positions: (a) “Contemporary medical knowledge” supports the assertion of a causal link between MBP and HSV infections, as stated by the Centers for Disease Control and Prevention and “several prominent contemporary decisors of Jewish law (poskim)” – specifically Rabbi Tendler, described as a son-in-law of Rabbi Feinstein, and Rabbi Slifkin, otherwise known as the Zoo Rabbi; (b) MBP is practiced by a fringe segment of the ultra-Orthodox.
The authors proceed to argue that there is no causal link between MBP and HSV infections, and that MBP is not practiced by a "fringe segment of the ultra-Orthodox" but rather on 80% of Orthodox circumcisions in NYC.

Now, I am not qualified to take a position on whether MPB is significantly dangerous - I leave that to the experts. And indeed, I have never advanced a position on this. (Nor have I ever taken a public position on whether if there is a slight danger, this should be reason to abolish the practice.) So why do the authors claim that I did? It's very strange. Perhaps the reason for there doing so can be seen in their deciding to add that I am "otherwise known as the Zoo Rabbi" - maybe this is a cheap attempt to try to trivialize me?

Another misrepresentation is that the authors claim that Sokol's article advanced the position that MBP is practiced by a "fringe segment of the ultra-Orthodox," which they proceed to neatly refute. But Sokol said no such thing. In fact, he wrote that "more modern elements reject the ancient practice which in turn is embraced by the more conservative ultra-orthodox factions."

The authors further claim that it is "factually incorrect" to claim that MBP "opposes a rational (I think that they meant "rationalist" - NS) approach to Judaism." But they don't even get into any discussion regarding the fundamental reason for the practice given in the Gemara - that it is for health benefits - and whether the given reason has any basis in contemporary medicine. Is it because they don't have anything to say about this that they set up strawmen instead?

For the seminal study on this topic, see Shlomo Sprecher, "Mezizah be-PehTherapeutic Touch or Hippocratic Vestige?" See too the recent blogpost by the Rationalist Medical Halachist, "MBP - Dispelling Some Common Misconceptions." (If any qualified person wants to write a response to the scientific claims in the op-ed, I would be glad to post it.)

33 comments:

  1. I like this nasty aside from the article: "Rabbi Tendler, described as a son-in-law of Rabbi Feinstein".

    "Described as"? What the heck is that supposed to mean? Are they implying that people took a random rabbi off the street and said "he's almost like Rabbi Feinstein's son-in-law"?

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    1. Perhaps they mean to imply that he can't be described as anything else- never mind that he's a distinguished rosh yeshiva, a well known a talmid chacham, a professor of biology and medical ethics, and a prominent rav.

      Almost thirty years ago, R' Norman Lamm bemoaned the fact that roshei yeshiva of YU, when given kibbudim at a charedi wedding or, rachmana litzlan, speaking at a charedi funeral, are referred to as "son in law of such-and-such a gadol" or "rav of such-and-such a town in Europe" but never as "rosh yeshiva at Yeshivas Rabbeinu Yitzchak Elchanan." He didn't name names, but he probably was thinking of R' Tendler and R' David Lifshitz ("the Suvalker Rav").

      Of course, one of Rav Soloveitchik's own talmidim has published three volumes of Torah of his rebbe while describing him on the title page only as "Av Beit Din of Boston."

      That was probably too much for the prominent charedi rosh yeshiva who, in a long eulogy for R' Soloveitchik, never once used his name, saying only "this man."

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    2. Rav Yosef Blau as well.

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  2. Another mistake was describing you as a "prominent contemporary decisor of Jewish law."

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    1. Actually, nobody described me that way. That was another straw man.

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    2. Um, what about: " “several prominent contemporary decisors of Jewish law (poskim)” – specifically Rabbi Tendler, described as a son-in-law of Rabbi Feinstein, and Rabbi Slifkin, otherwise known as the Zoo Rabbi."

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    3. That's a strawman. When Sokol wrote about "“several prominent contemporary decisors of Jewish law (poskim)” he was not referring to me. He quoted me later on a different point.

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    4. Right. I think "just saying"'s point was that they used a straw man by describing you as a prominent contemporary decisor of Jewish law. The trio did describe you as such in this sentence.

      But maybe it's not a straw man and they simply misunderstood Sokol's article? (And that would mean they have a great deal of ignorance about Judaism if they proceeded to describe you that way and think it's accurate). But it begs the question who are these 3 and why if they know little about Judaism and have little involvement in it, are they writing about this subjecct at all?

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  3. Wow, the comments to that Rationalist Medical piece you linked are depressing. A bunch of people- including an actual mohel- blabbering on and on about the "spiritual risk" to not getting direct MBP. Said mohel starts by acting all curious before finally declaring that he's not interested in debating the issue. God save us.

    Eery living thing- not just humans, but every living thing- has as its most basic instinct the protection of its young, part of the fundamental drive to reproduce. (The Torah itself, of course, indicates this by having it be the very first thing Hashem tells His creations.) There have been several times in human history where madness of a society has overridden this instinct, and it seems charedim are going through one such period now.

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  4. As for scientific rebuttal:
    > MBP has never been proven to be related to, let alone a cause of HSV in newborn infants
    That's a lie. The number of cases goes up every year.
    > A 2013 University of Pennsylvania study
    Which, if I recall correctly, was never released because of major flaws...
    > as with herpes, the arguments were confined to theoretical plausibilities.
    No, it's well established that herpes passes on skin to skin contact. If Dr Berman et al are disputing this then they need to have their medical degrees rescinded.

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  5. "A 2013 University of Pennsylvania study
    Which, if I recall correctly, was never released because of major flaws..."

    I read the article and did not find major flaws. It basically said that there isn't enough evidence to prove danger or safety. Agudath Israel of America, however, mischaracterized the study as saying that MBP is safe.

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    1. That seems to be the gist of ally the studies they cited. Not a convincing reason to continue MBP.

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    2. The final, published version of the study:
      http://jpids.oxfordjournals.org/content/early/2014/07/23/jpids.piu075.abstract

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  6. Such is the state of advocacy writing. It's not enough to let the facts speak for themselves, they must be crafted with a well chosen verb (e.g. NY Times articles on Israel referring to a Gazan "held captive" vs. taken in for questioning etc.) or adjective (e.g. purported expert - when you disagree with them).

    As they say ""If you have the facts on your side, pound the facts. If you have the law on your side, pound the law. If you have neither on your side, pound the table."

    KVCT

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  7. In a MBP case study, the CDC stated the following regarding the practice: "The preponderance of evidence pointed to acquisition during orogenital suction. First, in the cluster of three cases associated with mohel A, the twins were born by cesarean delivery, and the mother of the other HSV-infected neonate was HSV seronegative. Second, neonatal HSV-1 infection in males is uncommon, with a median of three cases each year in New York City, making it improbable that a single mohel would be associated with more than one case of male HSV-1 neonatal herpes in 2 years by chance alone. Although mohel A had no evidence of shedding HSV when tested, oral HSV shedding is intermittent and difficult to detect without repeated sampling. Third, the timing of symptom onset in all cases was consistent with acquisition during circumcision. Fourth, the location of herpes lesions on the neonates' genitals and related dermatomes is unusual and suggests infection was introduced at the genitals. Finally, all nine typed cases were HSV-1, which usually is transmitted orally." (See Neonatal Herpes Simplex Virus Infection Following Jewish Ritual Circumcisions that Included Direct Orogenital Suction — New York City, 2000–2011.) The CDC concludes that "The findings of this investigation and the previously published reports are consistent with a cause-and-effect relationship between Jewish ritual circumcision with direct orogenital suction and neonatal HSV-1 infection." (Id.) This finding by the CDC was endorsed by the International Journal of Infectious Disease in an article titled “Infections Associated With Religious Rituals.” Other organizations (that I know of) finding a causal connection include: 1) Israel's Association of Pediatricians; 2) The Infectious Disease Society of America; 3) American Sexually Transmitted Diseases Association; and 4) the NYC Department of Health and Hygiene.

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  8. Two renowned infectious disease specialists , Dr. Jonathan Zenilman and Dr. Lawrence Stanberry, published an article " The Dangers of Metzizah Bepeh A Response to Dr. Daniel Berman". They are "gedolim" in the field who practice at John Hopkins and Columbia. They accused Dr. Berman of "numerous inaccuracies and "erroneous conclusions".

    I have a PDF of the article, but I do not have the link. If anyone wants me to email them the PDF, email me at Benk2000@msn.com and I will email it.

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    1. http://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0CCYQFjAB&url=http%3A%2F%2Fwww.jhsph.edu%2Fdepartments%2Fpopulation-family-and-reproductive-health%2Fnews-and-events%2Fwednesday-seminars%2F2013-2014-presentations%2F09_18_13.pdf&ei=uu8QVL-oPMSoyATmloGYBg&usg=AFQjCNEGqruyRB0P7Uo-2SR4vp7nz7nRkw&sig2=9_-wsezoeRCVLAj45x3IPg&bvm=bv.74894050,d.aWw

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  9. ">The authors further claim that it is "factually incorrect" to claim that MBP "opposes a rational (I think that they meant "rationalist" - NS) approach to Judaism."<

    What's wrong with that? It's perfectly true - one can favor a rationalist approach to Judaism, and yet still use MBP. I'm a rationalist, and still I had MBP done, through a tube, to all my boys. In fact, nearly every orthodox rationalist Jew engages in practices that cannot strictly speaking be called rational (or rationalist.) I am large, I contain multitudes.

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    1. Yes, but you weren't risking your sons' life. I think metzitza is pointless but the mohel still did it, through a tube, and I had no problem with that. (When we asked him, he told us, perhaps not understanding where we were coming from at first, that if we wanted someone to do it with his mouth, we'd have to find another mohel.)

      I guess there can be levels of rationalism:

      Super-rational: No metzitza.

      Slightly less rational: Metziza, but not b'peh.

      Minimal rational: Metzitza b'peh with a tube.

      Bonkers: Metzitza directly with the mouth.

      Yes, it's a sad state of affairs where "rational" is defined as "at a minimum, not wanting to kill your kids," but we live in a mad world.

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    2. If I recall correctly, Rabbi Slifkin, at his most recent son's bris, asked the mohel to perform MBP with a pipette (or the mohel indicated that this was how he was going to perform the milah).

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  10. It's interesting to note that R. Osher Weiss, who is certainly an advocate of MBP, is far more candid about the risks it poses than the authors of this dishonest editorial:

    ג: מן הנתונים שהוצגו בפני למדתי שבחמש השנים תשס”ז – תשע”א דווחו בארץ ישראל חמשה מקרים של תינוקות שנדבקו במחלת ההרפס בעקבות ברית המילה. בכל המקרים הללו נעשה מציצה בפה. בתקופה זו לא דווח על בנות שנדבקו במחלה זו, על תינוקות שנדבקו לפני הברית, או על ילדים שלא קויים בהם מציצה בפה שנדבקו. עובדות אלה מחזקות את ההשערה שאכן נדבקו במחלה מן המוהל שהדביק אותם ע”י המציצה. אמנם באותם השנים נימולו בערך כארבעים אלף ילדים שבהם נעשה מציצה בפה. הרי שאחוז הילדים שנדבקו במחלה קטן ביותר. לדברי ד”ר שלזינגר שהוא רופא ירא שמים אין הדיווח מושלם ויש מקרים שלא מדווחים. אך אף לדבריו ניתן להניח שרוב המקרים מדווחים, וברור א”כ שמדובר באחוזים קטנים ביותר.

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    1. Given that Milah itself is not without risks, this is path is at least consistent. The problem is that anyone that actually reads the relevant Gemara will conclude that one should not be taking any health risks for MBP. It's really amazing how far people much more knowledgeable than me can go with something that is completely misaligned with the only real reading of the halacha.

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    2. שו"ת אגרות משה יורה דעה חלק א סימן רכג

      ומה שנזכר בדברי כתר"ה חתוך פריעה ומציצה שהם ג' מעשים שאין אחד בלא חברו כלום כמצות ד' מינים. חושב אני שהוא רק פליטת הקולמוס שפשוט שמציצה אינו עכוב בהמצוה דהוא רק משום רפואה. ואולי כוונת כתר"ה להטפת דם ברית שהוא ודאי חלק מהמצוה. אבל לדינא מסופקני אם הוא עכוב כשיעשה חתוך ופריעה ולא יצא דם שיותר משמע שאינו שוב בדין ערל אף שהוא ג"כ עיקר בהמצוה. אבל אולי יצטרך אח"כ גם להטפת דם וצ"ע. ידידו, משה פיינשטיין

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    3. David Ohsie.

      It's because in much of "orthodox" Judaism, the bottom line is that Zohar, kitvei Ari and subsequent kabbalistic works are more authoritative than the writings of Hazal. It's not just a few isolated problems here and there, it's a systematic subversion of the entire meaning and essence of the Torah, which the rest of us, sinfully, try to ignore as much as possible except when it manifests itself in something so obviously terrible.

      Stop wondering about what is really quite obvious, accept it and then fight it. The next time one of us ventures to criticise baking keys in halla or whatever, don't tick us off for being so vulgar, because trivial as these issues may seem to you, they are all manifestations of one thing, which is not trivial at all,

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    4. Gavriel M, I disagree. Kaballah is used here by people who have never and would never bother reading a Zohar because it helps in circling the wagons.

      Another way of saying this: Kaballah, where invoked for ill, is a usually symptom and not a problem.

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    5. Gavriel M, I disagree. Kaballah is used here by people who have never and would never bother reading a Zohar because it helps in circling the wagons.

      Another way of saying this: Kaballah, where invoked for ill, is a usually symptom and not a problem.

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  11. This was never really about MBP per se. The reason it has become almost a "yehareg v'al ya'avor" issue is that it's perceived as threatening Charedi authority itself. How so?

    1) By appearing to prove that Charedim and Gedolim can be "wrong", thus undermining the narrative that we and our mesorah always know better. That is the crux of our faith after all - we possess The Truth.

    2) By allowing "goyim" to dictate what we should and shouldn't be doing in our most sacred rituals.

    Always having to be "right" and "no one can tell us what to do" have the outward appearance of "strong" religious positions but ultimately reveal a deep insecurity.

    I lay the fault at the feet of Charedi rabbanim for not immediately stepping up and banning the practice, citing pikuach nefesh reasons. If they'd done that, then the Charedi world could have "owned" the issue, and the threat to their authority (at least here) would have been neutralized. But they didn't, and here we are.

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  12. You mean like the Hatam Sofer owned the issue back in 1845?

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  13. That sort of immediate Hareidi response?

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  14. Thanks for the link again to my post about MBP, I just wrote my response to this latest outburst of the MBP trio on my blog here: http://rationalistmedicalhalacha.blogspot.com/2014/09/mbp-again-scientific-perspective.html I hope you and all of our fellow rationalists enjoy it.

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  15. Well, R. Slifkin, kol hakavod for being patronized and dismissed along with this generation's top expert in halacha and bioethics! Truly august company. Identifying R. Moshe Dovid Tendler as "the son-in-law of R. Feinstein" is like referring to President Obama as "a graduate of a high school in Hawaii". Crazy people. Organized religion really does lead to unthinking nonsensical dogma. Shame Judaism can't be the world's first major "disorganized religion."

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