An ancient circumcision ritual is at the center of a present-day legal battle in New York.

The New York City Department of Health wants to require parental consent for a controversial circumcision practice, which it says can spread the herpes virus. But several Jewish organizations are suing to block the new rule, which they say violates their freedom of religion.

Jewish law requires that all baby boys be circumcised on the eighth day of life. Orthodox Jews sometimes follow with a ritual known as metzitzah b'peh. Immediately after the boy is circumcised, the man who performs the ritual — known as a mohel — takes a mouthful of wine. Then he places his mouth around the base of the boy's penis and uses suction to clean the wound.

Metzitzah b'peh is supposed to prevent infection. And when it's done correctly, proponents say, that's exactly what it does.

"I did, I think, over 35,000 circumcisions," says A. Romi Cohn, a mohel from the Borough Park section of Brooklyn. "Never had one incident where a baby got an infection. Never, never, never."

Cohn is also the chairman of the American Board of Ritual Circumcision. He says mohels who are properly trained and certified are not a threat to the health of the baby. "Our regulation is very strict about protecting human lives," says Cohn. "If there's any slight possibility — I'm not saying 50 percent, even 1 percent — that that baby gonna get hurt, we not allowed to perform that circumcision."

Requiring Consent For A 'Risky' Procedure

Most circumcisions in New York probably do not involve metzitzah b'peh. Still, the city's Health Department says it has linked the practice to nearly a dozen recent cases of the herpes virus in young boys.

"Of the 11 cases that we have absolutely confirmed to be herpes infection that was transmitted in this way, we know that two babies have died," says Jay Varma, the deputy commissioner for disease control. "Those are deaths we would have liked to have avoided."

So the department is taking steps to reduce what it sees as a risky behavior. "We are not banning the procedure," says Varma. "We're not regulating circumcisions. We're merely mandating that people who undergo a procedure that is risky be aware of those risks before it occurs."

Earlier this year, the department passed a law requiring mohels to get parental consent before performing metzitzah b'peh and give parents literature that explains the city's concerns. But that regulation goes too far for a group of rabbis and religious organizations, who sued to block the law.

The plaintiffs declined to comment for this story. But lawyer Avi Schick — who is not part of the case — wrote about his objections in an editorial in the New York Daily News. "Government shouldn't be telling religious officials the message to deliver," Schick says. "If the city has safety concerns, the way to address them is not by drafting religious figures and making them their foot soldiers in its war against this practice."

A Rule On Hold

To most observers, and even to many Jews, the practice may seem like an obsolete ritual that's not worth defending. But the lawsuit doesn't surprise Samuel Heilman, a professor of sociology at the City University of New York who studies Orthodox Jewish communities.

"Whenever it seems that the modern world is inserting itself into matters of ritual," Heilman says, "there are certain elements in the Jewish world that say, 'No. We will stand guard over what is genuinely appropriate in ritual, and not the modern world.' "

And those elements seem unlikely to bend to the will of City Hall. Mohel Cohn may speak for many Orthodox Jews who say they will not obey the new regulation. "The mayor is the mayor of the city of New York," says Cohn. "But we have a mayor; he's the mayor of the universe. We gonna follow his instructions."

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