Adapted from a piece that originally appeared in Midstream magazine. Used with the author's permission.

Outside the Jewish world, circumcision is the subject of fierce controversy. Its proponents say the practice is safe and painless, and that it dramatically reduces the risk of medical problems ranging from urinary tract infections to AIDS. Its opponents, on the other hand, have called circumcision a painful mutilation of the body; an unnecessary medical risk, and a violation of the child's rights.

	More on Circumcision News: Reform Rabbis Confront Circumcision Doubts Which faiths perform the ritual? See our circumcision chart. The Cut That Almost Wasn't by Nancy Cahners "Why I Perform Circumcisions" by mohelet Dorothy F. Greenbaum Paul Got Christians Off the Hook by Thomas Lynch

Not surprisingly, many Jews find the arguments against circumcision exaggerated and inflammatory. Yet these arguments provide a useful springboard for Jewish inquiry into brit milah ("covenant of circumcision")--for all of them stem from Jewish principles. Concern about babies' pain echoes the Jewish prohibition against the causing of pain to living things. Opposition to bodily mutilation is based on the Torah's denunciation of such pagan practices as tattooing and cutting the flesh. Concern for medical risk, too, has roots in halakah (Jewish law). Any medical procedure that involves even the possibility of risk to life is halakically forbidden. And the idea of protecting children's rights brings to mind the Jewish principle that the poor and weak should be treated equally with the rich and mighty. If even the most inflammatory anti-circumcision arguments reflect ideas originating in Judaism, clearly we ought to address current concerns about the practice.

Risk Factors
The possibility of death and serious complications from circumcision appears to be relatively small. But the exact risk has not been established. In hospitals, circumcision death can occur from secondary causes such as liver failure, kidney failure, pneumonia, and blood poisoning; according to circumcision authority Edward Wallerstein, health professionals may fail to link these deaths to their original cause. It seems likely that nonfatal complications go unreported for similar reasons.

What about the risk of circumcision performed by mohels (ritual circumcisers)? No systematic data on deaths or serious complications from brit milah have ever been compiled. Of course, today's mohels provide much safer conditions than were available in Talmudic times, when brit milah deaths were common enough to warrant a law exempting a third infant son from circumcision if two of his brothers had already died from the rite.

Nonetheless, Jewish deaths from circumcision have been documented in modern times. For example, two infants are known to have died of brit milah in 1957, and another in 1978.

Many mohels and rabbis argue that circumcision deaths are so rare as to be a nonissue. Besides the fact that we don't know how rare they are, this perspective seems a strikingly un-Jewish one. Judaism affirms the sanctity of human life, embracing the idea that every life is of infinite value.

Accordingly, it would seem, every loss of life must be considered an infinite loss. Halakah also tells us that since danger to life takes precedence over all else, medically, hazardous medical procedures are strictly forbidden.

	More on Circumcision News: Reform Rabbis Confront Doubts Which faiths perform the ritual? See our circumcision chart. The Cut That Almost Wasn't by Nancy Cahners "Why I Perform Circumcisions" by mohelet Dorothy F. Greenbaum Paul Got Christians Off the Hook by Thomas Lynch

I Wouldn't Do It to My 5-Year-Old
As Jews and as Americans, we have been conditioned to think of circumcision of older children and adolescents (as is practiced in some other cultures) as deeply offensive. Most of us would find it impossible to subject an older child to unanesthetized circumcision for any reason other than absolute, life-and-death necessity.

It is often argued that the surgery is easier on infants that on older children or adults. Though infants' tissue seems to heal faster, current research suggests that early painful and traumatic experiences are far more difficult on infants than was previously imagined. Overall, we do not know whether surgery is easier on infants than on older children or adults. What we do know is that our bond with our infants is not as strong as our bond with our older children. Circumcision of infants is certainly easier on us than circumcision of older children. As Moses Maimonides, physician as well as rabbi in the 12th century, tell us when he advocates circumcision at eight days:

"...the parents of a child that is just born take lightly matters concerning it, for up to that time the imaginative form that compels the parents to love it is not yet consolidated. For this imaginative form increases through habitual contact and grows with the growth of the child...the love of the father and of the mother for the child when it has just been born is not like their love for it when it is one year old, and their love for it when it is one year old is not like their love for it when it is six years old."

Maimonides says that we must circumcise our sons as infants, lest we neglect to do so as we get to know them better and love them more deeply. He encourages us to call upon our natural indifference to our newborns--in effect, to do to a "stranger" what we could not do to one we know well.

But this thinking contradicts one of the most significant of all Jewish principles--the commandment to love the stranger. Rabbi Herbert S. Goldstein, professor of homiletics at Yeshiva University, writes that the early rabbis interpreted this commandment as an admonition "first of all not to pain or annoy him at all."

Facing the Dilemma
There are powerful Jewish reasons to fulfill the brit milah commandment. Jewish law requires it, and the thousands of years of tradition reinforce its significance as a primary emblem of Jewish identity. But there are also compelling Jewish reasons to question brit milah.

Current research confirms that infants are as sensitive to pain as adults. To exempt this evidence from our consciousness is to deem Judaism incapable of functioning in light of new information. The beauty of halakah is precisely its "capacity to recognize and to reckon with advances in empirical knowledge," in the words of Rabbi Robert Kirschner. As we have learned from the case of the cheresh (the deaf-mute, classified in Talmudic times with the mentally incompetent but treated by modern rabbis as an equal Jew in every respect), Judaism incorporates new insights into practice. We must confront the fact that brit milah is now known to cause our infants pain. And we must have faith that Judaism will withstand a reappraisal of the rite.

	More on Circumcision News: Reform Rabbis Confront Doubts Which faiths perform the ritual? See our circumcision chart. The Cut That Almost Wasn't by Nancy Cahners "Why I Perform Circumcisions" by mohelet Dorothy F. Greenbaum Paul Got Christians Off the Hook by Thomas Lynch

Since local anesthesia for circumcision is halakically permissible, its use for brit milah should be given serious consideration. The most effective form of anesthesia currently available, the dorsal penile nerve block, has been shown to reduce crying and distress during circumcision and afterward, and appears to be extremely safe. However, it consists of two injections of lidocaine at the base of the penis, and therefore in itself involves some pain. The medical establishment should be pressured to develop even better forms of local anesthesia for traditional brit milah. For example, electrical anesthesia, a nonintrusive technique being researched by the dental profession, should be explored.

Additionally, anecdotal evidence should no longer be tolerated as adequate proof of the ritual's safety. Brit milah certification boards should meticulously follow up on every ceremony and document all perfect circumcisions, as well as all complications. With this policy, we will set an example for the medical profession while fulfilling a Jewish responsibility.

We must also address the reality that Jewish parents are questioning circumcision more than ever before. Some find the pain and risks problematic, some question the point and the ethics of forcing an infant into a covenantal agreement, and some take issue with brit milah in light of their own lack of spiritual conviction about it. This reality is far from bleak; each of these concerns reflects a deep regard for Jewish values. Jews are questioning circumcision for Jewish reasons.

Some Jews have resolved their conflicts about circumcision by adopting a symbolic interpretation of brit--that is, by hold brit (covenant) ceremonies without the circumcision. Many would argue that this solution unfairly denies the infant his birthright. But beyond basic protection and love, it seems to me that the most important Jewish birthright is the parents' commitment to bring Judaism to life for themselves and their child. A symbolic interpretation of brit does not automatically deprive an infant of this birthright any more than a literal interpretation guarantees it. Indeed, I believe a heartfelt, carefully reasoned decision to observe brit symbolically may do more for the family--and for Judaism--than unthinking adherence to the ritual for its own sake.

	More on Circumcision News: Reform Rabbis Confront Doubts Which faiths perform the ritual? See our circumcision chart. The Cut That Almost Wasn't by Nancy Cahners "Why I Perform Circumcisions" by mohelet Dorothy F. Greenbaum Paul Got Christians Off the Hook by Thomas Lynch

Traditionalists argue that brit milah should not be questioned because, in the face of intermarriage and assimilation, we simply cannot afford to "water down" Judaism any further. My own experience does not bear this out. Through my inquiry, I have made more meaning out of my own Jewishness, and learned more of Judaism, than through any other means. If we present brit milah as a closed subject, it seems to me we miss a key opportunity to get Jews involved in Judaism. We force many parents either to do their questioning outside the realm of Judaism, or--worse yet--to worship ritual instead of God. Denying that conflicts exist does not strengthen Judaism. It makes Judaism brittle.

If it is our goal for Judaism to flourish, a fresh and honest reappraisal of brit milah will be a significant contribution. Let us approach this task with an open mind and a Jewish heart.