The person who performs the mila, the mohel, is the topic of this week’s article. Should he be a registered certified mohel, or is a medical doctor preferable? Can a non-Jewish physician perform the bris? And what should be done in case of complications — is a non-Jewish urologist permitted to do the job? Can a non-observant Jew perform the bris, and what is there to do post-bris — if a non-observant doctor has already done it? Is a mitzva-intending mohel necessary, or is a health-conscientious doctor sufficient? And where should a bris take place – in an operating theater or religious establishment? Of this and more in the following article.
Bris Mila – Mohel or Doctor?
In this week’s parashah, we learn of the first mitzva in the Torah that is uniquely Jewish – the Bris Mila. The bris means “a covenant”, one sealed between G-d and His people. The bris is performed by the removal of the foreskin on the eighth day of a child’s life. This article will present the halachic approach to circumcision. Is it seen as a medical procedure requiring a doctor and surgical team to perform in the optimal manner, or should it preferably be done in shul and attended by a qualified mohel? This question becomes more pronounced when the child in question has a malformation or medical issue related to the circumcision area. Can any urological surgeon remove the foreskin or should he meet certain requirements before being chosen for the procedure?
In the following article, we will present the topic from the halachic, philosophic, professional and practical aspects.
The Kosher Mohel
What criteria define a qualified mohel – it is his level of mitzva observance? His religion? His credentials?
The Gemara (Menachos 42a) records a machlokes regarding the prospect of a non-Jew serving as mohel. According to Rabbi Meir, where there is no Jewish physician only an Aramean (gentile) and Samaritan (pseudo-Jews accused of idol worship), it is preferable that the Aramean circumcise the Jewish boys of the city and not the Samaritan. Rabbi Yehuda, however, says: It is preferable that the Samaritan circumcise the boys and the Aramean not. All agree that a circumcision performed by a gentile is valid.
Another braisa (Maseches Avoda Zara 27a) reads: “Rabbi Yehuda says: A Jew may circumcise a Samaritan but a Samaritan may not be allowed to circumcise a Jew because he circumcises him for the sake of Mount Gerizim. Rabbi Yosei said to him: And where do we find that the mitzva of circumcision Torah must be performed for the sake of fulfilling God’s will? Rather, a Samaritan may continue to circumcise Jews until his soul leaves his body”, i.e., until he dies due to his sin of Avoda Zara, and there is no room for concern.
According to Rabbi Yehuda and Rav’s approach, mila performed by a non-Jew is invalid and deduced from the passuk in Bereshis 17:9: “And you shall keep My covenant, you and your seed after you”. Only a person who has part in the covenant is permitted to circumcise others and allow them to enter the covenant. Rabbi Yochanan learns this from a different passuk: “Those born in the house and those purchased for money shall be circumcised, and My covenant shall be in your flesh as an everlasting covenant.” (Bereshis 17:13).
According to Rav and Rabbi Yehuda the bris may be performed only by people who carry the sign – the bris, while according to Rabbi Yochanan the point is the final product – being circumcised. The difference in the source has an interesting ramification – the possibility of a woman serving as a mohel. In Rav and Rabbi Yehuda’s opinion a woman who does not carry the sign cannot serve as a mohel. However, according to Rabbi Yochanan, a woman, who does not have a foreskin, is considered circumcised, and may serve as a kosher mohel.
The Rif (Shabbos, 56a) rules that halacha follows Rabbi Yochanan and a non-Jew is forbidden from performing the bris. If no Jewish male is available, a Jewish woman may perform it.
The Rambam and Shulchan Aruch
The Rambam (Hilchos Mila chapter 2:1) and Shulchan Aruch (Yore Deah 264:1) rule that preferably, the mohel should be a grown Jewish male who is fully obligated in mitzva performance. If no such individual is available, a slave, underage Jewish male, woman or even non-circumcised Jew may perform it. A non-Jew may not perform the bris even if there is nobody else available. In retrospect, if a non-Jew has already removed the foreskin, there is no need to repeat the process. The Rama, however adds (ibid) that if a non-Jew performed the bris, a hatafas dam is necessary (hatafas dam – creating a minimal bleed from the circumcision site), this time, by a Jew.
Apparently, the Rambam and Shulchan Aruch’s (not the Rama) rulings are inconsistent. If a non-Jew’s bris is not kosher, why is hatafas dam not necessary post-circumcision? And if the gentile did it already, and, in retrospect, the child is considered circumcised — why postpone a bris just because there is no Jew available to serve as mohel?
This question can be answered in four ways:
1) Rabbi Yosef Karo in his sefer Beis Yosef explains that according to the Rambam a non-Jew’s circumcision is ineffective and the child is not considered circumcised. The bris, indeed, does not need to be performed again — there is no need to repeat the cutting of skin. However, hatafas dam is necessary but also sufficient. This is also Rabbenu Manoach’s opinion.
2) In Kesef Mishne, the Rambam is undecided if the halacha follows the majority of the Tanoim who agree that mila performed by a non-Jew is acceptable, or Rabbi Yehuda Hanasi. Therefore, l’chatchila, a bris should not be done by a non-Jew, even if on the eighth day there is no Jew available. Retrospectively, if the bris has already been done, there is no need to perform hatafas dam since according to the opinion of the majority of Tanoim the child is already considered circumcised.
3) The Sha’agas Arye (Chapter 54) raises a question on the Kesef Mishne’s explanation – if the child’s circumcised status is questionable, why not perform a hatafas dam to make it certain? Therefore, deduces the Sha’agas Arye, the Rambam’s opinion is that a bris performed by a non-Jew is invalid and irreparable by hatafas dam.
Similarly, the Minchas Chinuch writes (mitzva 2) that one who removed the foreskin before the eighth day has lost the mitzva, since he is no longer obligated to remove it, and it cannot be repaired by hatafas dam.
4) The Chasam Sofer (Yore Deah 132) explains that in this case the child is, indeed, circumcised and he needs no further circumcision. However, the child’s father has lost his opportunity for the mitzva of circumcising his son because only a grown Jewish male can serve as his emissary to fulfill the mitzva for the father.
The Beis Halevi (volume 2, chapter 47) clarifies this further: in his opinion, there are two mitzvos involved in the bris. One, cutting of the foreskin, and the second – the fact that the child is circumcised, is without a foreskin. Along the same lines, the Ketzos Hachoshen writes (382:2) that an underage Jew is permitted to circumcise only where there is no father, since a youngster (before bar mitzva) cannot be made an emissary, and in his action, he is effectively preventing the father from performing the mitzva.
Non-Jewish Circumcision – Summary
There are several opinions of the necessary steps one must take after a non-Jew’s performance of the bris:
According to the Taz (3) hatafas dam is unnecessary. According to the Rama and Shach it is.
The Sha’agas Arye and Chasam Sofer agree that hatafas dam is unnecessary and will not change anything. According to the Sha’agas Arye the child is impossible to circumcise and according to the Chasam Sofer the child is circumcised, but his father has forfeited his mitzva.
The Shiyarei Knesses Hagedola (Hagahos, Tur Yore Deah, chapter 264:4) writes that if a Jew stood next to the non-Jew when he performed the circumcision, the bris is kosher. But in the Har Tzvi’s opinion (Yore Dea 208) this is untrue, and it is invalid.
The Minchas Yitzchak (volume 3 chapter 101:7) records a case in which a necessary surgical procedure required the foreskin’s removal and no competent Jewish surgeon could perform the surgery. In this case, he required a Jewish mohel’s presence in the operating theater and his completion of the foreskin’s cutting mid-operation. This follows the opinions of the Beis Yaakov (104, quoted in the Pischei Teshuva Yore Deah 264:3) and the Or Someiach (Mila, chapter 2:1) that if a non-Jew began the cut but a Jew completed it, the bris is kosher.
An Unbelieving Jew
The Rambam writes that an uncircumcised Jew should not perform the bris, but if no one else is available to do so, he may. The Shulchan Aruch and Rama clarify who this uncircumcised Jew is – one whose brothers died as a result of their bris. The Shach explains that if he is not circumcised because he did not perform the mitzva, he is forbidden from circumcising others, even if no-one else is available. Similarly, the Rama explains that one who does not believe in the mitzva of the bris or is an idol-worshipper has the same status as a non-Jew.
The Beis Yaakov (104) was once asked regarding a child born during Gezeiros Tach veTat whose parents could not circumcise him. When the child grew up, he kept all he mitzvos but one – the bris. He seemed to be afraid to circumcise himself. With an interesting twist of events, this individual grew up and decided he wanted to serve as the local mohel. The Beis Yaakov answered that if the reason he didn’t circumcise himself was his fear of the pain — he is a mumar l’aralot – i.e. an apostate in relation with this mitzva, in which case he is not permitted to perform the bris. However, if his refusal to circumcise himself is stems from fear of death, although mistaken, he is not a mumar and is permitted to circumcise others, even according to the Rama.
Permitting a Non-Observant Jew
The Pri Chadash (Shut Mayim Chayim 3), Even HaOzer (Orech Chayim 189) and Rabbi Akiva Eiger (Yore Deah 264:1) question the Rama’s ruling prohibiting a non-observant Jew from circumcising. According to the Tosefos (Avoda Zara 27a) Rav and Rabbi Yochanan permit a non-observant Jew’s circumcision because he is included in the covenant – he is obligated to perform the bris, but doesn’t. Why did the Rama follow the Ba’al Ha’etur and Rabbenu Manoach as opposed to the Tosefos and forbid it?
The Gra settles the question, citing the source for the Rama’s ruling in the Toras Kohanim (beginning of Vayikra) regarding those whose sacrifices are invalid. Shevet Halevi (volume 5 chapter 146) notes that from a closer examination of the Or Zarua (which was not printed in the Achronim’s times) we see that although he agreed with the Tosefos that the bris was kosher even if performed by a mumar, he remained unsure if the mumar would perform the bris with the correct intention. Here, the Or Zarua viewed the mumar as worse than a non-Jew. In conclusion, he writes: if the non-Observant doctor is not a mumar l’hachis, it is possible to rule leniently and rely on him to intend the procedure for the mitzva.
Rabbi Akiva Eiger (Hagahos, Yore Deah, 1) concludes that the Rama is referring to an idol worshipping Jew. However, if no shomer Shabbos mohel is available on the eighth day of a baby’s life, a non-Shomer Shabbos Jew should perform it in order to refrain from postponing the bris.
The Chasam Sofer writes (Gitin 23b) that m’ikar hadin a non-Shabbos observant Jew is permitted to perform the bris and no hatafas dam is required, but a scrupulous Jew should refrain from it. If it was nevertheless necessary, one should make sure that a Shomer Shabbos Jew performs the metziza after the bris. This completion of the mitzva is the ultimate hatafas dam after the cutting of the mechalel Shabbos.
The Bnei Yissachar (Derech Pikudecha, mitzva 2, 19-20) opines that if a mechalel Shabbos performed the bris, the foreskin is considered to have fallen off on its own and a Shabbos observant Jew is required for hatafas dam. He warns that in this case, without hatafas dam the child will be left unnamed and unsigned with the King’s insignia. He adds that one should be careful not to honor a non-observant Jew as Sandek because Eliyahu Hanavi will not sit next to him — he will distance himself 4 amos from the non-observant Jew and the baby on his lap, and not assist him in the bris.
The Sefer HaBris writes (264:7) that he heard from Rabbi Mendel Zaks, the son-in-law of the Chofetz Chayim, that he overheard the Chofetz Chayim rule that a non-Shabbos observant Jew should not perform the bris even if it results in a postponed bris. The Chofetz Chayim, despite seeing Rabbi Akiva Eiger’s ruling that permits it, remined unyielding in his decision. This is also the Igros Moshe’s ruling (Yore Deah part 2: 78; 118).
Contemporary halacha is disputed how to proceed if a child was circumcised by a non-religious mohel. Igros Moshe (Yore Deah part 2:78) writes that hatafas dam should be done. But because the issue is debated between the Halachos Gedolos and Rabbenu Chananel (Tosefos Yevamos 46) no bracha should be recited.
Shevet Halevi (part 5, 146) writes that although l’chatchila a mechael Shabbos should not be used as a mohel, retrospectively there is no room for stringencies and hatafas dam is unnecessary since according to most opinions the bris is valid. He quotes the Maharam Schick (Yore Deah 140): when most authorities do not require hatafas dam, it is forbidden, due to the prohibition of inflicting oneself unnecessary harm, and even more so — to another. At a regular bris, the mitzva offers its protection. But here, where most authorities agree it is unnecessary and not a mitzva, there is nothing to protect one from danger. This is deduced from the Chasam Sofer’s ruling that only a Shomer Shabbos should perform the metzitza – i.e. there was a Shomer Shabbos Jew present at the time of the bris who could perform the metzitza [the ultimate hatafas dam]. However, once the wound is healed, a new wound should not be inflicted.
Rabbi Moshe Sternbuch shlita (T’shuvos V’hanhagos, volume 1, 471) records a question he was once asked regarding thousands of babies from the Jewish community of Johannesburg who had been circumcised by a non-Shabbos observant doctor. The kehillah asked if those children required hatafas dam. He answered that mi’kar hadin, the bris is valid, especially since the mohel in question could be viewed as a tinok shenishba – an unintentional sinner who failed in his mitzva observance due to ignorance, not malicious intent. Therefore, hatafas dam is unnecessary. But one who wishes to be stringent will be blessed. Obviously, the community should have taken steps to ensure the mohel used by its members would be a G-d-fearing individual.
For hatafas dam some suggest using a blood lancet — a small medical implement used for capillary blood sampling which makes a very small puncture and causes minimal discomfort and danger.
The poskim are undecided if a bris requires full intention as seen from the Or Zarua’s ruling and quoted by the Rama (invalidating a bris performed by a mumar) — or not (as seen from the halacha that allows for an underage mohel).
The Minchas Chinuch (mitzva 2) is undecided on another point – if the mohel performed the mitzva explicitly for health reasons, i.e. with the sole intention that it serve for the child’s health, does the child need the additional hatafas dam?
The Keren Ora writes that the mitzva of mila is an active public display of the mitzva’s intention and fulfilled even without explicit verbal expression of intention. The K’sav V’hakabala (Bereshis 17:13) explains that when the bris is done publicly with other Jewish people actively participating [the Gemara writes that all those who are present are obligated to exclaim following the bris: “K’shem shenichnas le’bris – just as he entered the covenant, so too may he enter Torah, chuppa and good deeds”. This exclamation is the expression of their participation in the bris.] the mohel’s personal intention has no bearing on his action. Even if he circumcised with intention for Avoda Zara or for health reasons, his thoughts are inconsequential and the mitzva remains just that — a Jewish child entering the covenant with Hashem.
Furthermore, according to the Kovetz Shiurim (Kesuvos 249) and Zecher Yitzchak (Part 1 chapter 5) the final product is the objective. As such, any other intention is insignificant.
Health and Heaven
The Oznayim LaTorah (Bereshis 17:11) quotes the Midrash that explains that the foreskin is to the body as a wort. If removed – it heals. But if not, it is a sore to the body. According to this Midrash he explains the passuk “unemaltem es besar orlaschem — And you shall circumcise the flesh of your foreskin ” remove the numi [Aramaic: wort]. However, your intention should not be for health but to fulfill the Creator’s will. Then, it will be “…A sign of a covenant between Me and between you,” and healing will occur on its own.
Circumcision is recommended by health professionals and performed in many medical institutions throughout the world. But Jews perform it not for the health, but because it is G-d’s will. Interestingly, the British Royal house insists on a Jewish mohel for circumcision of all their males.
The Rama (Yore Deah 264:10) writes that a pious and righteous mohel and sandek are specifically recommended. The source for this is the Or Zarua (part 2, chapter 107:2-3): one should make an effort to find a righteous sandek and mohel so Eliyahu Hanavi will come and sit next to him during his bris as indicated in the midrash: “Let the pure come and treat the pure.”
The Aruch Hashulchan (Yore Deah 264:11) writes that the mohel and sandek’s preparation, purity of thought and intention are very important for the child and his spiritual life. They aid his ascent to holiness. Therefore, it is recommended for the mohel and sandek to be adorned in tefillin when performing the bris.
The Ot Shalom (264:6) writes that although one should look for a pious individual, if both are Yarei Shomayim, it is preferable to choose the more competent mohel as opposed to the more righteous one.
The bris mila is one area in which there is no margin for error and mohalim are required to perform at 100% perfection, all the time.
Rabbi Immanuel Jacobovitz (Harefuah V’Hayahadut, p. 239, footnote 14) points out that although most mohalim throughout Jewish History were not medical doctors, the number of accidents and fatalities over the generations was minimal, even before knowing about sterilization and infection, even though an open wound could easily endanger an eight-day old infant.
Rabbi Yonason Binyomin Goldberger notes in his sefer Bris Krusa Lasfasayim (Chapter 12) that mistakes in a bris are very rare, regardless of the professional performing it. Problems are usually easily resolved. Research has shown, surprisingly, that percentagewise, complications occurred more often when circumcision was performed by a medical doctor than when it was done by a qualified mohel.
This data can be explained in several ways: firstly, for a mohel, circumcision is his only profession. He spent years mastering it and is continuously learning and updating his knowledge in only one single field – the bris. For him, the bris is his life’s mission and he specializes only on that – how to minimize the baby’s discomfort [an important factor in halacha], raising his professional level and learning about every possible complication. He usually performs a number of brisim every day. A physician, though, does not usually perform as many circumcisions as a mohel, seeing it as a minor aspect of his medical practice and usually having minimal experience with urological surgery on infants.
Os Shalom (264:4) adds another aspect to this explanation: a non-observant doctor lacks the Siyata D’shmaya that a G-d fearing mohel has.
Another aspect in the professionalism required from a mohel is proficiency in all medical conditions that may endanger the baby, and when is the optimal time for a bris. These conditions, although noted in chazal, may be disregarded by the medical world. Rabbi Yaakov Kamitzky (Emes L’Ya’akov, Yore Deah 263) writes of a doctor in Kovno who circumcised a child with jaundice, contrary to halachic guidelines, while verbally mocking the Rambam who forbids it. Unfortunately, the baby died at his bris. Rabbi Yaakov Kaminetzki adds that in his opinion, circumcising a jaundiced baby involves an unlikely risk, however since the baby can be circumcised the following day when the jaundice recedes, chazal were careful of even an unlikely risk and instituted stringent safety precautions. In his opinion, the baby died as a punishment for having shown disrespect of the Rambam.
Tikunei Zohar (Tikun 24:70a) writes that the bris is equated with a korban and the Shechina is present at the time of the bris. The Rashba explains the reason the bris is customarily performed in shul: it is written in the passuk: “And the two of them made a covenant before the Lord” (Shmuel I 23:18) — there is no covenant other than the bris mila. Sefer Haminhagim writes that mila is the acronym of mal’ach yoshev lifnei ha’aron [an angel sits before the Ark]. In the writings of the Rishonim we find that traditionally, the bris was always performed in shul. Therefore, l’chatchila, when possible, it is preferable to carry out a bris in shul where it is most appropriate to serve a korban to Hashem.
A bris performed by a non-Jew is not kosher, for which according to the Rama and the Shach hatafas dam must be performed. According to the Taz, b’dieved, hatafas dam is unnecessary.
The Achronim are split over the status of a bris performed by a non-observant or non-believing Jew: the Igros Moshe rules that hatafas dam is necessary, while Shevet Halevi disagrees. According to Rav Moshe Sternbuch it is not mandatory, but if one wants to be stringent he will be blessed [especially today, when it involves only minimal discomfort and no danger].
Although there is room for leniency with regard to the kavanos required during the mitzva, it is proper to choose a mohel whose intention is for the mitzva and not for circumcision’s health benefits. This is especially important with a bris that takes place in a medical setting and not in a shul or other location where the intention of the mitzva is more obvious.
It is preferable to choose a G-d fearing person to serve as the mohel and sandek. This is for the child’s benefit and serves as heavenly protection so the bris will commence without complications.
From the professional aspect, a mohel is preferable to a doctor. He lives and breathes brisim and is continuously learning about the subject, much more than a medical doctor who sees circumcision as a trivial part of his practice.
A bris should preferably take place in a shul.