By Mose Apelblat
A police raid last month in Antwerp at the home of a person who performs circumcision in the local orthodox Jewish community has upset the community and drawn the attention to an unregulated medical – religious issue which concerns both Jews and Muslims in Belgium.
The police confiscated evidence of the alleged crime and requested a list of the boys he had circumcised over the past year following a decision by the Antwerp prosecutor’s office.
In Judaism, circumcision, known as Brit Milah, is a religious ritual where a male infant’s foreskin is removed on the eighth day after birth but the ritual can be postponed for health reasons. Circumcision at that early age is considered safe and reduces the risk for complications when performed at a later age.
The circumcision is performed by specially trained and experienced persons that not necessarily have to be physicians. While there may be health reasons behind the practice, it is in Judaism an ancient religious commandment and covenant.
“The police action was prompted by a complaint by a private person in conflict with the Jewish community in Antwerp,” Michael Freilich (N-VA), the only Jewish member of the federal parliament, told The Brussels Times.
The person’s allegations that Jewish boys were “mutilated” and “infected” when circumcised were taken seriously by a former Belgian justice minister who instructed the prosecutor’s office to launch an investigation.
“The decision wasn’t motivated by antisemitism,” Freilich says. Those who oppose circumcision argue that it should require consent and therefore only be performed at a later age.
The accusations shocked the Jewish community in Antwerp and also took them by surprise, according to Freilich.
It is a relatively small community which has been performing the circumcision procedure according to ancient religious traditions. There has always been supervision by the local child welfare authorities.
“The accusations are patently absurd,” Freilich says. “If there would had been any problems they would have been reported to the authorities.”
But he admits that there is a potential weakness in the Belgian system. Someone acting with bad intentions can therefore claim that the procedure is illegal, something which the Jewish community refutes.
Freedom of religion
The investigation is still on-going and a judge is expected to rule on whether non-medical circumcision is a matter of freedom of religion or whether regulation or some form of authorisation of those who perform it is required.
“We are law abiding citizens and want to follow the laws of the country. We are just asking to be partners in the process and believe now we are being heard,” Freilich adds.
According to Freilich, male non-medical circumcision is largely unregulated in the EU, with only two Member States, Sweden and Germany, requiring licensing of the persons who perform it in the Jewish communities. In both countries, circumcision can be performed by non-physicians if the persons have been authorised by the authorities at the proposal of the religious community.
The Swedish law for example applies to the circumcision of boys up to the age of eighteen and requires that their attitude to the procedure shall be clarified as far as possible.
However, special permission to perform circumcision may be granted to a person “who has been proposed by a religious community for which circumcision is part of a religious tradition, and who is deemed capable of performing the procedure in accordance with the requirements that apply to the procedure and who is otherwise suitable to perform circumcision.”
Circumcision also plays an important role in other religions.
In Islam, circumcision is considered a sign of belonging to the Muslim community and is usually performed by trained medical practitioners at hospitals but there is no fixed age for it. While Jesus Christ was circumcised, the practice is not compulsory in Christianity but relatively prevalent in Western countries such as the US for preventive health reasons.
“Circumcision in the Muslim community in Belgium is carried out by physicians at hospitals,” Dr Michael Privot, board member of the Muslim Council of Belgium (CMB), told The Brussels Times. “Muslims are satisfied with this arrangement.”
However, they are concerned about recent legislative proposals concerning non-reimbursement of non-medical circumcision because it could push people towards cheaper circumcision by non-certified persons.
Reimbursement of costs
Former MP Goedele Liekens (Open VLD), a psychologist and sexologist, submitted a legal proposal already in 2020 to end the policy of refunding fees for non-medical circumcisions performed in hospitals. In her view, most circumcisions are not medically necessary and should not be refunded by the health insurance.
The proposal did not result in any legislation but last year two similar proposals were submitted by MPs from Open VLD and N-VA.
The bills aim at canceling the health insurance reimbursement for circumcisions that are not medically necessary. A doctor can still perform non-reimbursable circumcisions, but the patient will bear the full cost of the fees.
In Belgium, circumcision costs over €100 and is fully reimbursed by the health insurance. Figures are uncertain, but according to a report by the Consultative Committee on Bioethics, some 25,000 circumcisions were performed in Belgium in 2014, at a total cost of nearly €2.6 million to health insurance, with approximately 57% of these procedures being performed on children aged 0 to 4.
Michael Freilich questions why non-medical circumcision should be covered by the health insurance in contrast to other countries where it is a private matter and is carried out at private cliniques. He describes N-VA as a centre-right party, with specific views on budget discipline.
“The real costs for circumcision are higher than stated in the bill if hospitalisation and anesthesia are included. With an estimated 25,000 cases per year and ca €1200 per case, we are talking about €30 million.”
Asked if he takes into account that circumcision is as important for Muslims as for Jews, Freilich says he “would never accept a ban on circumcision but I do accept that there is a budget debate about it.”
“It’s about applying the principle of not funding operations that aren’t required medically.”
Freilich is seeking to harmonise legislation and regulate the authorization of those carrying carrying out circumcision in Belgium as in other EU countries. “I’m in contact with the European Commission and Health Commissioner Olivér Várhely.”
“We propose to establish a centre of excellence for authorising experts from the religious community alternatively harmonizing EU legislation or issuing guidelines that acknowledge that they are competent in this specific health matter. Everything needs to be regulated nowadays, including circumcision.”
The Brussels Times contacted the European Commission for a comment but did not receive a response by the time of publication.
This article was originally published in The Brussels Times.