This week we shall continue our discussion of some of the questions that have emerged in modern times in regards to the Mitzvah of Milah. We will discuss the use of shields and clamps in the context of Brit Milah. We seek to shed light on an area of serious controversy.
The Plain Mogen, the Gomco Clamp, and the Bronstein Mogen
A few hundred years ago, a plain Mogen shield was introduced to enhance the safety of Brit Milah. The Pri Megadim (Orach Chaim, Eishel Avraham 75:8) endorses the use of this shield. Most Mohelim use at least this basic shield for Brit Milah to protect the baby from cutting more than necessary.
Approximately seventy years ago, the Gomco clamp was introduced and became a standard tool for physicians who perform circumcision, due to concern for danger due to excessive bleeding. Halachic authorities strongly opposed the use of the Gomco clamp. Rav Yosef Dov Soloveitchik (personal communication in 1984), Rav Moshe Feinstein (Teshuvot Igrot Moshe Yoreh Deah 2:119), Rav Yosef Eliyahu Henkin (Eidut Leyisrael p.144), Rav Yaakov Kaminetzsky (Emet Leyaakov p.361), Rav Zvi Pesach Frank (cited in Teshuvot Tzitz Eliezer 8:29) and Rav Eliezer Waldenberg (Teshuvot Tzitz Eliezer 8:29) strongly oppose the use of the Gomco clamp. Virtually no Orthodox Mohel uses a Gomco clamp for a Brit Milah.
One major criticism of Gomco clamp is that no blood is drawn during the removal of the foreskin. The Gomco clamp causes the blood to stop flowing to the foreskin, thus producing a bloodless circumcision. Rav Soloveitchik, Rav Moshe, and Rav Waldenberg mention that the drawing of blood is an indispensable component of the Brit Milah procedure. Rav Chaim Soloveitchik is cited as emphasizing this point vigorously (Chidushei Hagrach Al HaShas, Shabbat 135a). Rav Moshe seeks to demonstrate this assertion from Chazal's mentioning the act of drawing of blood in the Brachah recited at a Brit performed on a convert (Shabbat 137b). Another proof is that Hatafat Dam Brit (drawing of blood) is performed on a baby whose Brit was conducted improperly, such as a Brit performed before the eighth day or at night (Shach Y.D.262:2).
Another major criticism expressed by Poskim is that Halachah views the dead foreskin as detached from the body. Thus, the Mohel has not performed any cutting, which is certainly an indispensable component of the Milah procedure. Rav Frank and Rav Waldenberg express considerable concern for what they perceive as the excessive amount of pain inflicted on the baby when using the Gomco clamp.
A well known Mohel, Rav Zvi (Harry) Bronstein of blessed memory, introduced in the 1950's an upgraded version of the traditional Mogen. Rav Bronstein writes (in a pamphlet introducing his Mogen) that he seeks to satisfy the standards of both the medical establishment and Halachic authorities. At that time, many doctors advised against performing a Brit without a clamp and many parents heeded their advice. Mohelim were caught in a terrible dilemma: the Brit implements that the Rabbis permitted were forbidden by the doctors and what the doctors permitted the Rabbis forbade. Rav Bronstein developed his Mogen in an attempt to satisfy both Rabbis and doctors and thereby facilitate proper fulfillment of the Mitzva of Milah by the broader Jewish community. Rav Bronstein writes that Rav Eliezer Silver (one of the outstanding mid-twentieth century Torah luminaries of North America) gave his written approval to this procedure (printed in the Torah journal Hapardes, volume 30 number 1). In addition, some Mohelim prefer to use the Bronstein Mogen because of its considerable safety benefits.
There has been a mixed reaction among the Poskim to the Bronstein Mogen. Rav Yosef Dov Soloveitchik told me (in 1984) that the use of an implement is acceptable if blood is drawn. Rav Moshe Pirutinsky notes (Sefer Habrit p.179) that some blood is drawn if the Bronstein Mogen is placed immediately before the cutting and removed immediately afterwards.
Rav Moshe Feinstein (Teshuvot Igrot Moshe Yoreh Deah 3:98) rules that a Milah performed with the Bronstein Mogen is “certainly acceptable B’dieved (after the fact)” if blood is drawn during the cutting. Rav Shlomo Zalman Auerbach (cited in Nishmat Avraham 5:86-87) also rules that a Mogen clamp is acceptable B’dieved (after the fact) if blood is drawn. Rav Shaul Yisraeli (Teshuvot Bemareh Habazak 2:96) permits the use of the Bronstein Mogen in certain circumstances.
On the other hand, Rav Eliezer Waldenberg (Teshuvot Tzitz Eliezer 8:29, 10:38 and 20:52) emphatically rejects the use of the Bronstein Mogen. He rules that it is unacceptable even B’dieved and even if blood is drawn. He goes as far to say that it is better not to perform a Brit at all than to carry out a Brit using the Bronstein Mogen. Indeed, Dr. Ari Greenspan (a certified Mohel who lives in Israel) reports that the Israeli Chief Rabbinate strictly forbids the use of the Bronstein Mogen. Rav Pirutinsky similarly records that the American rabbinical organization called the Agudath Harabanim also issued a proclamation forbidding use of the Bronstein Mogen.
There are a number of objections raised against performing Milah with a Bronstein Mogen (see Rav Waldenberg’s aforementioned Teshuvah for a full presentation of the objections). One argument is that the Rambam (Hilchot Milah 2:2) and Shulchan Aruch (Y.D. 264:3) describe the Mohel performing the Periah process (removal of the second level of skin beneath the foreskin) with his fingernail. Moreover, the Shulchan Aruch describes Milah (removing the foreskin) and Periah as two discrete processes that can done by two different people on one child. A Mohel who uses the Bronstein Mogen accomplishes the Milah and Priah with one simultaneous cut. The Bronstein Mogen sets in place all of the skin that the Mohel will cut and the Mohel subsequently performs the Milah and Periah with one cut.
However, a responsum of Rav Hai Gaon (printed in Teshuvot Hageonim Shaarei Tzedek 3:5:6) endorses the practice of Mohelim in his country (Babylon) to simultaneously perform both Milah and Periah, even though the Mohel does not perform the Periah with his fingernail. Moreover, Rav Moshe Feinstein (Teshuvot Igrot Moshe Y.D. 1:155 and 3:98) permits simultaneous performance of Milah and Periah and endorses the authenticity of the Teshuvah attributed to Rav Hai Gaon. Shulchan Gavoah 264:27 (an important Sephardic authority) records the practice of Mohelim in Solonika (described by Rav Ovadia Yosef as a community filled with pious and learned Jews) to simultaneously perform Milah and Periah.
Many more Halachic authorities rule that Periah is acceptable even if the Mohel does not use his fingernail. Rav Chaim Ozer Grodzinsky (Teshuvot Achiezer 3:65:12) notes that since Periah is impossible to perform with a fingernail when performing a Brit on an adult, Periah performed on adult converts is accomplished with an instrument. Rav Chaim Ozer concludes that it is definitely acceptable to perform Periah with an instrument. Rav Ovadia Yosef (Teshuvot Yabia Omer 7 Y.D. 22), after citing numerous authorities to support his opinion, rules that Periah with an instrument is acceptable. The aforementioned Poskim, however, write that it is preferable to perform Periah with a fingernail as described in the Shulchan Aruch. Mohelim who use the Bronstein Mogen argue that the safety and societal benefits of the implement justify the performance of Periah in a Halachically acceptable, albeit less than ideal manner. Moreover, they argue that the practice of the Mohelim of Babylon and Solonika constitutes ample precedent to perform Milah and Periah simultaneously, without using a fingernail.
A second reservation that Poskim express is the reluctance to endorse a change in the traditional procedure for Brit Milah. Even though Rav Moshe Feinstein rules that a Milah performed with a Bronstein Mogen is acceptable, he declines to endorse its use. Rav Moshe explains that "one should Lechatchilah (initially) avoid anything new." Rav Donny Frank (Journal of Halachah and Contemporary Society number 36, Fall 1998, p.50), however, notes “innovations have been made over the centuries including the plain shield which is commonplace today." Indeed, Rav Shlomo Zalman Auerbach and Rav Yosef Shalom Eliashiv are cited (Nishmat Avraham 5:84) as ruling that a Mohel is "obligated" to use anesthetics if it medically sound to use them, even though it represents a departure from the traditional procedure. Similarly, one could argue that the safety afforded by the use of the Bronstein Mogen justifies the departure from the traditional procedure for Brit Milah.
Rav Yechezkel Landau (Teshuvot Nodah Beyehudah O.C. 2:18) presents guidelines for legitimate Halachic innovation. The Noda Beyehuda was asked whether a synagogue may be constructed in a shape other than the traditional rectangular form. Rav Landau responded that although Halachah has no specific requirements regarding the shape of a shul "it is best not to deviate from the venerated practices [of the Jewish People]." However, he writes, "If the reason [a departure from the traditional practice is desired] is that the proposed plan will allow for more available seating area, there is no reason why this plan should not be implemented." Rav Laudau asserts, though, that the change is inappropriate if the motivation to change the shape is to imitate the architectural style of the nobility.
Similarly, Rav Bronstein's motivation for introducing his Mogen was noble. He risked his life for decades to perform large numbers of Halachic circumcisions in the Soviet Union, despite government decrees (in accordance with Shabbat 130a). Rav Bronstein’s intention in developing his Mogen was to facilitate Milah for millions of Jews who would otherwise refuse a Halachic circumcision for their children. Moreover, the enhancement of the safety of Brit Milah might constitute a legitimate reason for change, just as the introduction of the plain shield was accepted as a legitimate change. Furthermore, Rav Bronstein wrote that he has not introduced anything new. Rather, he has merely modified the plain shield that Mohelim used in Europe for many generations.
Almost all Mohelim use at least a plain shield and virtually all Orthodox Mohelim do not use a Gomco clamp. Regarding the Bronstein Mogen, there is no universally accepted practice. Some Mohelim use it for every Brit they perform, some use it only for special circumstances and many refuse to use it under any circumstance.