Friday, July 17, 2015

Analysis of Planned Parenthood baby body parts scandal

Recently, the Center for Medical Progress released an investigation into Planned Parenthood, provider of approximately one-third of abortions in the United States. Undercover video footage features correspondence between Dr. Deborah Nucatola, senior director of medical services for Planned Parenthood Federation of America. Nucatola speaks with men posing as potential buyers of infant body parts for the purposes of medical research.

Excerpts from Nucatola garnering attention include:
Nucatola: I think every provider has had patients who want to donate their tissue, and they absolutely want to accommodate them. They just want to do it in a way that is not perceived as, ‘This clinic is selling tissue, this clinic is making money off of this.’ I know in the Planned Parenthood world they’re very very sensitive to that. And before an affiliate is gonna do that, they need to, obviously, they’re not—some might do it for free—but they want to come to a number that doesn’t look like they’re making money. They want to come to a number that looks like it is a reasonable number for the effort that is allotted on their part. I think with private providers, private clinics, they’ll have much less of a problem with that. 
Buyer: Okay, so, when you are, or the affiliate is determining what that monetary—so that it doesn’t create, raising a question of this is what it’s about, this is the main—what price range, would you—? 
Nucatola: You know, I would throw a number out, I would say it’s probably anywhere from $30 to $100 [per specimen], depending on the facility and what’s involved. It just has to do with space issues, are you sending someone there who’s going to be doing everything, is there shipping involved, is somebody gonna have to take it out. You know, I think everybody just wants, it’s really just about if anyone were ever to ask them, “What do you do for this $60? How can you justify that? Or are you basically just doing something completely egregious, that you should be doing for free.” So it just needs to be justifiable. 
And later, in the interview, Nucatola explains methods of abortion used to accommodate a body part buyer's request:
Buyer: We need liver and we prefer, you know, an actual liver, not a bunch of shredded up— 
Nucatola: Piece of liver. 
Buyer: Yeah. Or especially brain is where it’s actually a big issue, hemispheres need to be intact, it’s a big deal with neural tissue and the progenitors, because those are particularly fragile. If you’ve got that in the back of your mind, if you’re aware of that, technically, how much of a difference can that actually make if you know kind of what’s expected or what we need, versus— 
PP: It makes a huge difference. I’d say a lot of people want liver. And for that reason, most providers will do this case under ultrasound guidance, so they’ll know where they’re putting their forceps. The kind of rate-limiting step of the procedure is the calvarium, the head is basically the biggest part. Most of the other stuff can come out intact. It’s very rare to have a patient that doesn’t have enough dilation to evacuate all the other parts intact.
Buyer: To bring the body cavity out intact and all that? 
Nucatola: Exactly. So then you’re just kind of cognizant of where you put your graspers, you try to intentionally go above and below the thorax, so that, you know, we’ve been very good at getting heart, lung, liver, because we know that, so I’m not gonna crush that part, I’m going to basically crush below, I’m gonna crush above, and I’m gonna see if I can get it all intact. And with the calvarium, in general, some people will actually try to change the presentation so that it’s not vertex, because when it’s vertex presentation, you never have enough dilation at the beginning of the case, unless you have real, huge amount of dilation to deliver an intact calvarium. So if you do it starting from the breech presentation, there’s dilation that happens as the case goes on, and often, the last, you can evacuate an intact calvarium at the end. So I mean there are certainly steps that can be taken to try to ensure— 
Buyer: So they can convert to breach, for example, at the start of the—” 
Nucatola: Exactly, exactly. Under ultrasound guidance, they can just change the presentation.
One of the first questions that comes to mind, what are the ramifications of this matter according to U.S. law? Peter Jesserer Smith, writing for the National Catholic Register, responds to Nucatola's descriptions as such: "much of it may actually be legal." The possibility of legally selling baby body parts concerns the National Institutes of Health Revitalization Act of 1993 which states:
It shall be unlawful for any person to knowingly acquire, receive, or otherwise transfer any human fetal tissue for valuable consideration if the transfer affects interstate commerce. (498b)
The phrase "valuable consideration" is said to exclude compensation related to the "transportation, implantation, processing, preservation, quality control, or storage of human fetal tissue.'." (498b)

In other words, it is lawful to accept money for donated "human fetal tissue" if that money is applied to the necessary handling and presevation of the "tissue." The question then seems to be whether or not Planned Parenthood, in selling baby body parts, exceeded compensation necessary to handle the body parts.

This very matter was considered in an interview conducted by Al Kresta of Kresta in the Afternoon radio show on July 14 with David Daleiden, project lead of the Center for Medical Progress' undercover investigation. Kresta asked Daleiden to address the matter of receiving costs associated with the handling of "human fetal tissue" and this is the reply:
Daleiden: The most important thing is that most of those ancillary costs that might come with trying to facilitate human organ donation or a tissue donation–– none of those costs are actually incurred by Planned Parenthood. Because in a situation that you have in Planned Parenthood and StemExpress, for example, StemExpress is an outside, middle-man, biotech company that comes into the Planned Parenthood clinic. They send their technicians into the clinic. The clinics consent the patients. The clinics identify the patients that they want to harvest from. The clinics receive the fetuses in the pathology lab after they've been aborted. The StemExpress technicians do the dissection. They package up the body parts. And they drive over to the FedEx and ship them off across the country at the end of the day. So literally, the only thing that Planned Parenthood is doing is they're opening the front door for them in the morning, or sometimes the back door. And they're carrying the fetus from the operating room to the pathology lab which is across the hallway which is in the back of the clinic. And that's something that they do every day anyway because that's their standard processing of specimens anyway when they're doing abortions. So the Planned Parenthood clinic doesn't have any cost with the tissue procuring. In fact, they're actually saving money already because it's less volume of medical waste that they have to dispose of. And on top of that, the procurement company is paying them 50, 75, 100 dollars per specimen extra. 
At one point in the undercover video, Nucatola communicated that she had "8 cases yesterday." Let's say that is a normative number, and if, as Daleiden asserts, PP incurs zero or negligible handling costs with regard to the fetuses, that would mean a PP clinic could make upwards of $800 per day, and that's if each fetus was only used for one body part. If such is the case, PP would be in violation of federal law. This amount is unnerving if one calculates the thousands of dollars that could be earned in a year, and the added incentive for clinics to steer clients toward abortion. The legality and dollar amounts could also depend on variations between PP affiliate to affiliate, as not all of them may necessarily be arranged in exactly the same way Daleiden describes.

It may also be legally suspect that the PP consent form, acquiring permission from a woman to use her aborted baby for medical research, does not disclose that the clinic receives money for the donated body parts. NIHRA, however, states a doctor must reveal any "physician's interest" in the research process, which may legally be considered to include financial compensation. As quoted above, Nucatola did suggest clinics attempted to "come to a number that doesn’t look like they’re making money." A lengthier quote from Daleiden in the next section expounds on this.

The NC Register article describes what may be a more definitive violation of federal law, which is the alteration of the abortion procedure for the purpose of harvesting body parts. NIHRA states:
[I]n the case of tissue obtained pursuant to an induced abortion-- ... no alteration of the timing, method, or procedures used to terminate the pregnancy was made solely for the purposes of obtaining the tissue. (498a)
This law appears to have been violated as we see in Nucatola's words such as:
I’m not gonna crush that part, I’m going to basically crush below, I’m gonna crush above, and I’m gonna see if I can get it all intact. And with the calvarium, in general, some people will actually try to change the presentation so that it’s not vertex...
These are explicit deviations in the "method" of the procedure for the purpose of harvesting suitable organ specimens. Such deviations could well qualify as illegal "methods."

The NC Register article also identifies one point in Nucatola's statements that potentially describes a partial-birth abortion, which was declared illegal in 2003.

Upon revelation of this undercover video, PP soon released a statement denying any illegalities and that the Center for Medical Progress unethically edited the video. Responding to that during the Kresta interview, Daleiden states the following:
Daleiden: Basically to summarize what was interesting about Planned Parenthood's response through Planned Parenthood's statement is that they make two really key admissions and then they tell three lies afterward. And the two important admissions are that they admit that some of their clinics supply aborted fetal tissue and they admit that there is money involved with supplying aborted fetal tissue.  The three lies that they tell are: Number one, that their patients asked for it and consent for it; Number two, that there is no financial benefit to Planned Parenthood, and; Number three, that there's nothing illegal going on there. Number one, the patients are consenting to donate tissue like we discussed in the previous segment with the consent form. But it's not being disclosed to the patient that there's money involved and that Planned Parenthood receives remuneration for the fetal tissue. So patients are consenting to donate. They are not consenting to selling. Selling is what's actually going on.  Point number two. In the document vault section of our website at we have actually a flyer advertisement from one of the main, real-life purchasers of Planned Parenthood baby parts. They're a company called StemExpress. They're a private LLC, for profit company in northern California that partnered with very many Planned Parenthood clinics across the country. … That flyer advertises four different times to Planned Parenthood clinics the financial benefits that they can receive if they supply fetal tissue. It uses the phrases "financially profitable," "financial profits," "financial benefits to your clinic," and "fiscal growth of your own clinic." And that advertisement to Planned Parenthood clinics includes an endorsement printed on it from another Planned Parenthood medical director.  And so then the third lie that nothing illegal is going on about this. It all hinges on Planned Parenthood's claim that there's no money involved. But that's patently false, because every other source that you can go to, other than their communications director, will prove otherwise.
A female caller in the second hour of Kresta's July 14 show says, "I'm very happy my father's dead because he [did] not live to see this. He would have felt that the Nazis had won. ... Mengele must have taught that doctor [Nucatola]." And the caller's reaction is not unique.

During World War II, Nazi scientists conducted a number of horrific experiments on prisoners in the name of scientific and medical advancement. Victims of the Nazis were subjected to such experiments as high-altitude tests to determine viable altitudes at which pilots could parachute, freezing experiments to determine treatments for hypothermia, as well as subjugation to multiple diseases in the name of finding a cure.
Victims of Dr. Josef Mengele's medical
experiments at Auschwitz-Birkenau.
Poland, 1944. (Image courtesy of
 US Holocaust Memorial Museum)

That these prisoners were subjected to such violations of humanity, against their will, is all but universally held as evil. The sober philosopher recognizes the tragic irony of cruelly destroying mass human life in the name of preserving it. How did these scientists justify these crimes?

In the book The Nazi Doctors and the Nuremburg Code, authors George Annas and Michael Grodin identify 12 arguments made by Nazi scientists in defense of their actions. Argument #10 reads as follows:
Sometimes it is necessary to tolerate a lesser evil, the killing of some, to achieve a greater good, the saving of many. That the experiments were useful, the defense claimed, was evident by the use of the data derived from Nazi human experimentation by the United States and Britain in the war against Japan. (p. 133)
This argumentation is similar to those who now appeal to the "research" benefits garnered from the harvested body parts of aborted babies, as trafficked by the likes of PP (although many defendants of abortion for research deny it as an evil of any kind). Even PP-friendly media headlines have played this angle. This past week, the Washington Post actually altered their headline. It originally read "Undercover video shows Planned Parenthood exec discussing organ harvesting" but was changed to the more benign: "Undercover video shows Planned Parenthood official discussing fetal organs used for research."

The question comes down to this: If that which is in the womb is a human life,* then abortion, as well as the harvesting of that life's body parts for human experimentation, is murderous and horrific. And if that which is in the womb is a human life, then we are indeed living amidst the echo of Nazi concentration camps and human experimentation against unwilling victims, even if that reality is more difficult to see.

Our moral sensibilities recognize the violation done to an unwilling victim in these tragic events. Again, if that which is in the womb is a human life, the "consent form" used by PP is tantamount to asking Person A for consent to harvest the organs of Person B. The victim in question has granted no consent. The victim has been declared expendable in the name of science by someone else. (And, it should not be ignored that cures and medical advancements have been and will continue to be made in great strides without the mutilation and destruction of human victims.)

Furthermore, if that which is in the womb is a human life, as the Church and many allied souls recognize, then the victims of abortion have exceeded 57,000,000 since Roe vs. Wade in 1973. How can even the Nazi scientist, who would argue that the killing of "some" is worthy to save the "many," justify veritable infanticide and subsequent organ harvesting for human experimentation.

Related to this, the Catechism, in the section on abortion, offers what I think is valuable insight:
2273 The inalienable right to life of every innocent human individual is a constitutive element of a civil society and its legislation: "The inalienable rights of the person must be recognized and respected by civil society and the political authority. These human rights...belong to human nature and are inherent in the person by virtue of the creative act from which the person took his origin. Among such fundamental rights one should mention in this regard every human being's right to life and physical integrity from the moment of conception until death."  –– "The moment a positive law deprives a category of human beings of the protection which civil legislation ought to accord them, the state is denying the equality of all before the law. When the state does not place its power at the service of the rights of each citizen, and in particular of the more vulnerable, the very foundations of a state based on law are undermined.
The tragedy of abortion and organ trafficking for research (or the Nazi human experiments) is at least twofold. First, the victim is violated in the most capital sense. Second, when these persons are classified as expendable subjects, the entire system of humanity incurs a seismic shift of injustice, effectively denying the equal dignity of all persons.

Staying abreast of the latest news on this issue may require active searching, as the media has not shown a historic propensity to expose that which validates Christian thought.From a legal perspective, time will tell whether or not PP and/or any of its affiliates will be found guilty of criminal wrongdoing. As the weeks pass, expect further details regarding PP nationally, as well as other individual PP clinics, which may be absolved or further incriminated in illegal organ trafficking or abortion violations. What will be PP's defense? Will they claim Nucatola exaggerated at times to land a sale? Will further incriminating facts surface?

Certainly, from a moral perspective, the spiritual crime of abortion has multiplied to an unnerving total. And the matter of dismembering aborted babies serves as a visible icon of the amputation of human consideration from the situation. Many prayers are warranted for this situation and all involved.

EDIT (7/21/15) TO ADD:
A second undercover video was released July 21, 2015 by the Center for Medical Progress. This video contains interview footage with Dr. Mary Gatter, president of Planned Parenthood Federation of America’s for-profit Medical Directors’ Council.

The legal matters of altering the method, as well as profits, again, surface in this interview. At one point, Gatter begins a negotiation by tossing out the figure of "$75 a specimen." The buyer rejoins with, "That’s way too low." And Gatter admits:
I was going to say $50, because I know places that did $50, too. But see we don’t, we’re not in it for the money, and we don’t want to be in a position of being accused of selling tissue, and stuff like that.
Her claim about not being in it for the money could either be taken honestly or cynically. If honestly, PP should be able to substantiate the per-"specimen" dollar amount, that PP incurs that cost to handle the specimen. According to Daleiden's assertions above, PP incurs no such costs. If we are to take Gatter's words cynically, perhaps she is acting as a salesman, convincing the buyer that she is not out to overcharge them. As well, the cynical view would ask why there is a negotiation at all, if PP is not in it for the money. Later in the transcript, she also indicates she will increase the cost based on what her peers charge:
Well let me agree to find out what other affiliates in California are getting, and if they’re getting substantially more, then we can discuss it then.
And, as Nucatola states in the prior video, the goal is to make sure PP "doesn't look like they're making money."

As speculated above, a PP affiliate can collect tens of thousands of dollars per year from these sales. For their part, the Center for Medical Progress speculates a yield of over $86,000 for one affiliate. Whereas $30-$100 here or there may be easier to disguise than larger quantities, the sum total over time can prove lucrative. The accounting side of this matter appears quite pertinent to the investigation.

As for methodological red flags in this second video, Gatter candidly explains the legal concern of altering the procedure for the purpose of procuring intact body parts. The exchange goes as follows:

Buyer: The intact specimens, I wanted to touch on that. What I was trying to say is if the 10 to 12 week specimens, end of the 1st trimester, if those are pretty intact specimens, that’s something we can work with.
Gatter: So that’s an interesting concept. Let me explain to you a little bit of a problem, which may not be a big problem, if our usual technique is suction, at 10 to 12 weeks, and we switch to using an IPAS or something with less suction, and increase the odds that it will come out as an intact specimen, then we’re kind of violating the protocol that says to the patient,“We’re not doing anything different in our care of you.” Now to me, that’s kind of a specious little argument and I wouldn’t object to asking Ian, who’s our surgeon who does the cases, to use an IPAS at that gestational age in order to increase the odds that he’s going to get an intact specimen, but I do need to throw it out there as a concern. Because the patient is signing something and we’re signing something saying that we’re not changing anything with the way we’re managing you, just because we agree to give tissue. You’ve heard that before. 
Buyer: Yes. It’s touchy. How do you feel about that? 
Gatter: I think they’re both totally appropriate techniques, there’s no difference in pain involved, I don’t think the patients would care one iota. So yeah, I’m not making a fuss about that.

Later, Gatter admits:
[T]here are people who would argue that by using the IPAS instead of the machine, you’re slightly increasing the length of the procedure, you’re increasing the pain of the procedure...
You may notice that Gatter earlier said there is "no difference in pain involved" in the alternate procedure, yet here admits others say doctors using the alternate procedure are "increasing the pain." On this matter, Gatter ultimately implies she will defer to a doctor, Ian Tilley, on whether or not they will violate the patient agreement by changing the abortion method to which the client-mother agrees:
And then, if we want to pursue this, mutually, I talk to Ian and see how he feels about using a “less crunchy” technique to get more whole specimens.

*Just to clarify, I don't say "if that which is in the womb is a human life" to suggest the matter is unclear. I use this verbiage as a thought exercise, to invite even skeptics to confront the crux of the issue. I fully embrace the Church's and other philsophers', scientists', and religious persons' views that life begins––at the beginning. Thus, can a skeptic at least understand the perspective of a thoughtful pro-lifer, which reflects philosophical and quantifiable measures of the existence of life.