Bris Missed: May Milah Be Delayed for a Surgical Procedure?

Adapted from the writings of Dayan Yitzhak Grossman

August 22, 2024

Business Insider reports:

An Australian hockey player made the shock move to have part of his finger amputated so that he could compete at the Paris 2024 Olympics.

Matthew Dawson, 30, broke the ring finger of his right hand in the lead-up to the international sporting event, which begins on Friday. Speaking to Business Insider on Friday, Dawson recounted the injury, saying another player’s stick struck his hand during an inter-squad training match a couple of weeks ago. “There was plenty of emotions running through my head, thinking, ‘That could be it, the Olympics are over,’” he said. After his injury, one option would have been surgery to put a wire in his finger, which would have impacted his ability to compete in the Olympics. Dawson said a plastic surgeon advised him that it could involve four to six months of recovery, and there was no guarantee he would regain full function of his finger. Instead, the hockey player opted to have the top of the finger amputated, which only required about 10 days of recovery, enabling him to play in Australia’s first Olympic hockey match on Saturday…

Dawson told BI that it was so important to compete because it may be his last Olympics. He also now has a son, which factored into his decision. He said he wants his son to know how much dedication is required to compete. And hopefully, he added, “I get to show him the gold medal at the end of these two weeks.”[1]

(Dawson did not medal at the Olympics.)

The incident brings to mind the words of R’ Nechunyah ben Hakanah:

I thank You, Hashem, my G-d, that You have established my portion with those who dwell in the study hall, and you have not established my portion with idlers. For I arise early and they arise early: I arise early for words of Torah, and they arise early for idle words. I toil and they toil: I toil and receive reward, and they toil and do not receive reward. I run and they run: I run to the life of the World to Come, and they run to the pit of destruction.[2]

Dawson’s dilemma, however, is reminiscent of a fascinating halachic question that arose a century ago.

An infant was born with a deformed leg. A physician declared that he could straighten the leg with a plaster cast,[3] but this would have to be done immediately, while the leg bones were still soft and pliant. If the cast was applied immediately, it would be impossible to circumcise the baby on the eighth day (because the treatment would “weaken” him), and the bris milah would have to be delayed. But if the cast were applied after the eighth day, it would be difficult or impossible to straighten the leg.

R’ Tzvi Yechezkel Michelson, the rav of Plonsk, Poland, consulted at least three great halachic authorities of the era about the permissibility of applying the cast immediately and postponing the bris.[4] All three—R’ Avraham Borenstein of Sochachov (the Avnei Neizer),[5] R’ Malkiel Tzvi Tannenbaum of Lomza (the Divrei Malkiel),[6] and R’ Yehudah Leib Tsirelson[7]—allowed it, but they arrived at this conclusion based upon a variety of different considerations:

Cost

The halacha is that one is not required to expend hon rav (a great fortune) in order to fulfill a mitzvah, even a mitzvah overess (one which will soon become impossible to fulfill).[8] Rav Borenstein infers from this that a fortiori, one is not obligated to condemn a child to permanent deformity in order to fulfill the mitzvah of milah in the proper time.

Rav Tannenbaum, however, rejects this argument out of hand, asserting that because the halacha is that Shabbos may not be violated even for sakanas eiver (to save a limb),[9] the mitzvah of bris milah may certainly not be postponed to prevent deformity, which does not even constitute sakanas eiver. (This argument is quite baffling, because the halacha clearly distinguishes between a mitzvas asei (positive commandment) like bris milah, for which one is not required to spend a great fortune,[10] and a mitzvas lo sa’aseh (negative commandment) like Shabbos, which one must lose everything he has to avoid violating.[11])

Preemption

Despite rejecting the rationale of Rav Borenstein, Rav Tannenbaum permits the procedure for an entirely different reason: Because the mitzvah of milah does not apply until the eighth day, the treatment may be performed sooner, even though this will inevitably result in the postponement of the bris.

Rav Tzirelson builds upon this basic point that the procedure is being performed before the eighth day, i.e., before the mitzvah of milah takes effect, by adding two further considerations:

Curing the child’s deformity fulfills the mitzvah of hashavas gufo (restoring someone’s body), which the Gemara declares to be a form of the mitzvah of hashavas aveidah (returning lost property).[12] So one may certainly commence the treatment before the mitzvah of milah takes effect, and once we have begun the treatment, we apply the principle that ha’oseik bemitzvah patur min hamitzvah (one who is involved in one mitzvah is exempt from another), even where the second mitzvah is greater than the first.[13] (Rav Borenstein makes a similar point, although he notes that his earlier rationale would allow the procedure even on the eighth day, whereas this latter one would only allow it earlier.)
One who declines to save a person from the loss of a limb violates two lavin: “you shall not hide yourself”[14] (a lav against failing to return lost property) and “you shall not stand aside while your fellow’s blood is shed”[15] (a lav against allowing someone to come to harm). Because these lavin take effect before the mitzvah of bris milah does, the principle that asei docheh lo sa’aseh (a positive mitzvah overrides a negative one) does not apply.

Human dignity

The Gemara teaches: “Great is human dignity (kavod habriyos), as it overrides a prohibition in the Torah.”[16] Rav Tzirelson asserts that if the child’s deformity is not corrected and remains with him for life, “there is no greater disgrace than this,” both in terms of the inherent condition of the deformity as well as its implications for the child’s eventual status within Klal Yisrael: If he is a kohein, he will be disqualified from entering the Bais Hamikdash, performing the avodah there, and (under certain circumstances) bestowing birkas kohanim. If he is a yisrael, he will be disqualified from serving on the Sanhedrin, and even today, he will be disqualified from serving as a dayan in cases of get or chalitzah, and according to the minhag, even from serving as a witness to a get. (Rav Tzirelson also offers an additional basis for considering the deformity a matter of kavod habriyos.) Accordingly, the need to correct the deformity overrides the mitzvah to perform the bris milah on the proper date.

[1]Joshua Nelken-Zitser. An injured hockey player chose to amputate part of his finger so he could compete at the Paris Olympics. Business Insider. https://www.businessinsider.com/injured-hockey-player-amputates-finger-to-compete-at-paris-olympics-2024-7.

[2]Brachos 28b.

[3]The precise nature of the deformity in question and the proposed method of treatment are not entirely clear. The Ponseti method for the treatment of congenital clubfoot involves plaster casting, but the procedure was apparently not developed until the 1950s.

[4]Rav Tannenbaum and Rav Tsirelson identify their correspondent as Rav Michelson; Rav Borenstein does not name his correspondent, but it was presumably also Rav Michelson.

[5]Shu”t Avnei Neizer Y.D. siman 321.

[6]Shu”t Divrei Malkiel cheilek 5 siman 148.

[7]Atzei Halevanon siman 61.

[8]Rama to Shulchan Aruch O.C. 656:1.

[9]Shulchan Aruch ibid. 328:17.

[10]See Marcheshess cheilek 1 siman 43.

[11]Shulchan Aruch Y.D. 157:1, Shach ibid. s.k. 3.