Manitoba Jewish community pans physicians college proposal on circumcisions

The regulator for Manitoba’s physicians promises it will respect religious and human rights, after a proposed change triggered concern in the local Jewish community about its ability to continue the traditional rite of circumcising infant boys.

A draft of a new standard of practice from the College of Physicians and Surgeons of Manitoba, as currently written, would mean Manitoba doctors would only be allowed to perform the traditional Jewish brit milah in the confines of a medical facility or doctor’s office. 

That’s an inappropriate restriction on a number of fronts, critics of the college’s proposal say. 

The rite is something best done in a private home or synagogue as it introduces the baby to the faith community, Rabbi Anibal Mass of Congregation Shaarey Zedek told CBC News on Friday. 

Mass was one of five Manitoba Rabbis who co-signed a letter of feedback to the physicians’ college regarding the draft standard. The letter, obtained by CBC, outlines their frustration and opposition to it on a number of grounds, including the lack of evidence of risk. 

“There is no evidence to support that brit milah is not safe,” it reads. 

‘Why now? What’s the problem?’

The rite of circumcision on the eighth day of a male child’s life is a bedrock Jewish practice that those of the faith consider to be not a medical procedure, but a religious one that’s part of a broader and vital community ceremony. 

The college says its proposed practice standard is being developed to minimize risks around a range of specific office-based medical procedures, with male circumcision among many outlined in the draft.

But its potential infringement on the activities of physician mohels (the Hebrew title for the person who performs the circumcision) has prompted a vocal flurry of worry from local Jewish faith leaders, legal experts and the advocacy group B’nai Brith Canada. 

“Why now? What’s the problem?” read the letter co-signed by the Manitoba rabbis.

“Jews have been doing this for decades with trained doctors. In fact our Jewish community in Winnipeg is fortunate to have Jewish doctors who have taken special training in this procedure and the accompanying rituals and blessings, and have been performing this task outside of their offices and in non-hospital settings for years.”

Mohel Manachem Fleischmann, left, holds a baby after a circumcision ceremony at a synagogue in Berlin in a 2013 file photo. Winnipeg’s Rabbi Anibal Mass says he knows of two mohels in the city, both of whom are physicians. (Markus Schreiber/The Associated Press)

Mass told CBC he’s aware of two mohels in Winnipeg. Both are physicians and would therefore be bound by the college’s proposal. The practice standard would have no impact on a mohel who is not a doctor as they wouldn’t be under the regulator’s purview. 

That in itself is an issue which could create greater risks, University of Manitoba law professor Bryan Schwartz told the physicians’ college in a lengthy written submission he shared with CBC on Friday.  

“Denying the ability of physician mohels to conduct a home brit milah may mean the most experienced and medically expert individual is not available to a family,” Schwartz said. 

Additionally, having to take a newborn to a health facility could expose them to an adverse environment, he said. 

“Given the potential impact on the viability of Jewish families to maintain their faith and way of life, the college is required by overriding human rights law to consider the specifics of the brit milah and calibrate carefully any limitations that might affect how it is performed,” Schwartz said. 

College promises amendment

The College of Physicians and Surgeons of Manitoba provided lengthy responses to questions posed by CBC. It said the proposed standard was developed by a working group established last year, and it was circulated publicly for the purpose of consultation and generating feedback. 

“While its focus was on prevailing standards of care in the profession, the working group was informed by various complaints CPSM has received over time,” registrar and CEO Dr. Anna Ziomek said. 

“Common issues raised relate to communication, informed consent, conflicts of interest, infection or other complications,” she said. 

Ziomek said the college recognizes there are issues with the draft standard and will take steps to address them. 

“We recognize as currently written, it would implicate a practising member of CPSM performing a male circumcision outside of an appropriate medical facility,” Ziomek said.

“That was not the intention when drafting the standard. At a minimum, the working group will consider adding an exemption in the standard for male circumcision performed in a religious ceremony or tradition.”

Understanding how people might interpret the standard was the point of drafting and seeking public feedback on it, said Ziomek. 

“We want to assure the public that the standard will not infringe on any human or religious rights and freedoms whatsoever.”

Schwartz noted the provincial government has recognized the brit milah as distinctive in its health regulations.

He suggested the college incorporate the language used in the regulations to define an exemption in its finalized practice standard. 

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