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CCAR RESPONSA

New American Reform Responsa

101. Anesthesia for a Berit Milah

QUESTION: At a recent berit milah the Jewish physician who performed the surgery asked me why it should not be possible to apply a local anesthetic superficially to the penis of the infant before the operation. This is routinely done before a cystoscopy or similar examination. (Rabbi Karl Richter, Sarasota FL)ANSWER: We must remember that the widespread use of anesthesia is rather recent. It is now utilized generally for minor surgery and even for routine dentistry. Although there was some early opposition to the use of anesthesia in circumcision as with all suggestions of change (N. Arik Imrei Yosher II #130). Later authorities indicated that there was no objection (Gedalia Felder Nahalat Tzevi p 57). A number of individuals have written on the subject and indicated that it is the operation itself which is important and not the reaction to it. In other words, the child or adult who is circumcised may be asleep or awake. Either way the operation is valid. He may feel pain or no pain. That too makes no difference although a midrash declared that Abraham gained merit because of the pain of circumcision which he bore stoically (Midrash Rabbah Gen 47.9). Furthermore, the mohel usually places a drop or two of wine on the lips of the child which may have a slight pain alleviating effect although this is not mentioned by any of the traditional authorities. We do not know whether an infant, eight days old, suffers more than slight discomfort due to the circumcision. I have seen a number of children virtually sleep through the whole operation. So it is not clear that anesthetic is necessary. If, however, the physician feels in a particular case that some kind of local anesthetic would be useful there would be no objection to using it.August 1989

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