Saturday 12 September 2015

In New York, a Win and a Loss on Health

The New York City Board of Health reached two important decisions on Wednesday, one decent and one that could have dreadful consequences for some infants.

The good news first. The board voted unanimously to require fast-food restaurants to post warning labels — a saltshaker in a black triangle — next to the sodium bombs on their menus. That is, dishes with more than 2,300 milligrams of sodium, which the federal government says should be the daily limit for most people. For people who are at greater risk of heart attack or stroke, are middle-aged or older, are African-American or have high blood pressure, that number falls to 1,500 milligrams.

These first-in-the-nation sodium labels fit neatly with the efforts of the city under Mayor Michael Bloomberg to fight obesity, secondhand smoke and trans fats. Mayor Bill de Blasio and his health commissioner, Dr. Mary Bassett, are right to advance that mission. It only makes sense to let people know if they’re blowing through their daily sodium limit with a single burger.

The department’s other decision was toabandon efforts to crack down on metzitzah b’peh, the ancient ritual of ultra-Orthodox Jews in which the circumciser, or mohel, sucks blood from a newly cut penis with his mouth. Public-health authorities, like the American Academy of Pediatrics, have long warned about the dangers of mohels infecting babies with the herpes virus, which can be deadly to infants.

The city Health Department has linked metzitzah b’peh to more than a dozen infant herpes cases, and two deaths, since 2000. The Bloomberg administration tried to discourage the practice by requiring mohels to have parents sign a consent form acknowledging the risks. But mohels, citing religious freedom, refused to use the form.

When Mr. de Blasio ran for office, he offered the politically powerful Orthodox community another approach. On Wednesday the Board of Health followed through: It voted to abandon consent forms in favor of education and friendly persuasion. It has a new brochure about the risks of metzitzah b’peh, to be given to pregnant women by clinics and hospitals. A small photo of herpes blisters helps parents recognize a symptom of infection.

The rabbis are exulting over a deal that doesn’t oblige them to do anything. No paperwork, no informed consent, no consequences. The administration is hoping that if a baby gets sick, the mohel will agree to be tested and, if there is a DNA match, stop doing circumcisions. It also argues that cracking down on mohels would drive the practice underground.

The decision to cave to the mohels is being spun by the administration as a win-win for everybody, but it seems to have closed its eyes to the newborn boys who will someday get sick.

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