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Thomas did make a number of recommendations, including the recommendation that the ''[[mohel]]'' place a glass tube or a glass tube attached to a rubber bulb around the infant's penis before suction so as not to allow the lips of the ''[[mohel]]'' to come in direct contact with the child's [[bleeding ]] penis. However, since a ban was not to be placed, and since "some religious authorities consider metzitzah b’peh the only acceptable way to draw blood", he encouraged parents to "weigh the risks of [[Metzitzah b'peh|metzitzah b’peh]]" before choosing it over alternatives.<ref name='commish-letter'/>
Frieden failed, however, to consider the right of the child to physical integrity, the rights of the child under international [[human rights]] laws or the limitations on consent of parents to non-therapeutic surgery on minor children.