Put Health Before Politics

Posted: June 10th, 2015 | Author: | Filed under: Ethics, Public Health | No Comments »

I’ve never had much respect for public health officials when it comes to infant circumcision. When they say adult or voluntary, they never mean it. It’s also seemed clear for a long while that they’re not much interested in health, either. The latest example is New York City Mayor Bill De Blasio’s approach to protecting infants from herpes transmitted during metzitzah b’peh. I’m ignoring for now the horrible optics of the new makeup of the New York City Board of Health. The actual proposal allegedly aimed at protecting the health of infant males:

The mayor’s proposal, which requires approval by the board and will be presented on Wednesday, is … would waive a requirement that parents sign a consent form before the ritual, which involves sucking blood from the incision on a baby’s penis.

Instead, the mayor’s plan would create an alternative system that would test a circumciser, or mohel, for herpes, although only after a baby is found to be infected. If the circumciser tests positive, penalties would be pursued if DNA tests can prove that the mohel and the baby were infected with the same strain.

We know infection happens with metzitzah b’peh. We know that herpes can have devastating effects on infants. That alone should be enough to demand a proactive rather than reactive approach to protecting the health of infants. The case for a potentially effective plan, not this proposal, is impossible to ignore when also remembering that infants have rights that the government and Board of Health are no less obligated to protect.

The consent rule, introduced under Mayor Bloomberg, was assailed by Orthodox leaders as an infringement of their religious rights. Mr. de Blasio pledged to rescind the rule, and his aides later said the consent forms had been difficult to enforce, saying that herpes infections linked to the practice actually rose in 2014.

“This approach hasn’t been working in the past, and we need a new approach to truly reduce the health risk for infants,” Mr. de Blasio’s press secretary, Karen Hinton, said in a statement on Tuesday. Ms. Hinton added that the mayor had an “obligation to ensure that the Board of Health is fully staffed with highly qualified health experts.”

Protecting the bodily integrity rights of all infants is a new approach to reduce the health risk for infants. We haven’t tried that yet. And trying that is the ethical approach.

I don’t pretend protecting the rights of all infants, the correct approach, will be easy. Even with the “consent” document Mayor Bloomberg implemented, infections increased. Protecting the rights of infants in law and in reality are separate issues. The former would not guarantee the latter. But public health officials, ostensibly entrusted to (ethically) protect the health of all members of society, must aim for effectiveness, not politics.



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