Charlie:
Correct, the Penn study was not a statement that MBP is totally safe. However, the study pointed out that while the evidence from the four studies (in the updated version there were six) under review is consistent with HSV-1 being transmitted via the mohel (e.g. every mohel that was tested, tested positive), there is not enough evidence to demonstrate a causal link. In the four studies combined there were only 22 babies (in the updated version there were 31). In a few of the cases it could not be verified that MBP was performed. In some of the cases the mother was not tested, or tested positive, which leaves open the possibility that the mother was the source. There were several other limitations delineated in the Penn study. So there does seem to be a strong case against mandating consent forms since there is very little documented evidence that MBP causes HSV-1. That being said, it is obvious that it is POSSIBLE for HSV-1 to be transmitted via MBP, and a large portion of the population can transmit it. Which is why all the studies recommended against it. The only claim I can hear against Agudah or others who quote the Penn Study to justify MBP (since I am unaware of a specific instance where anyone said or wrote that the Penn Study shows that MBP is safe) is that if they only quote the part about the limitations of the studies, then laymen (who will probably not actually read the studies and had they actually read the studies might decide not to do MBP) might be given the impression that there is no reason to have any concerns with MBP.