The great debate

Unpacking the Planned Parenthood controversy

An anti-abortion group has accused Planned Parenthood of illegally selling fetal body parts. Here’s what you should know about the controversial subject of fetal tissue research.

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(Photo by David McNew/Getty Images)

It hasn’t been a great week for Planned Parenthood. Two congressional committees and at least eight states have launched investigations into the organization, thanks to two undercover videos that were released by the Center for Medical Progress (CMP), an anti-abortion activist group. The videos purport to show two prominent Planned Parenthood doctors—Dr. Deborah Nucatola and Dr. Mary Gatter—discussing the illegal sale of fetal body parts with people posing as representatives of a tissue procurement company.  Planned Parenthood asserts that the videos were “heavily edited” to “support false claims.”

The controversy has foregrounded an unpalatable corner of tissue research, sparking conversations about fetal cells, fetal tissue procurement companies, and the proper transfer of fetal body parts. It’s a deeply convoluted subject, and one that raises questions of both legal and ethical varieties. Here are some key things to know about Planned Parenthood and the practice of fetal tissue research.

Why is fetal tissue important to medical research?

Unsurprisingly, researchers use fetal tissue to study fetal development and abnormalities. But fetal tissue has many other applications. It has contributed to vaccines against several illnesses—including polio, rubella, and chicken pox—and has the potential to help cure severe diseases like Parkinson’s and Alzheimer’s.

Fetal tissue is so valuable to medical research because fetal cells are not yet fully developed, and so they can differentiate into many cell types. “The advantage of fetal cells [is] that they are pluripotent,” says Robert Klitzman, director of the Masters of Bioethics Program at Columbia University. “They have the power, the potency and ability to become many different kinds of things, in a very flexible, development-evolving context. They’re not yet in a programmed stage.”

What are “tissue procurement companies”?

Broadly speaking, procurement companies supply medical researchers with tissue specimens. The company StemExpress, which is mentioned in the first sting video, also isolates cells to meet researchers’ needs. Many hospitals host tissue procurement services, but agencies that deal with fetal tissue are usually independent. They work with abortion clinics to obtain specimens.

“We talk directly with the abortion providers,” explains Linda Tracy, president of a non-profit procurement company called Advanced Bioscience Resources. “Then we have people working with specialists of a medical background … and we teach them the techniques to acquire fetal tissue once the abortion is complete. The women who are participating have to sign a consent form … that explains to them that the tissue is going to be used—possibly, if not always—for medical research [unusable specimens are disposed of]. And if they consent to that, one of our procurement specialists identifies what tissue is needed and takes that.”

What is the proper protocol for obtaining human tissue?

The Planned Parenthood sting video claims that “buying or selling human body parts is a federal felony,” pointing viewers toward a statute that prohibits the purchase of human organs. What the video does not mention is that “reasonable payments” are permitted in the transfer of organs for research or transplant purposes. So the law does allow for the reimbursement of costs associated with the removal, transportation, processing, and storage of human body parts— adult and fetal alike.

According to the Anatomical Gift Act as adopted in most states, bodies or body parts can only be used post-mortem if they are gifted by a donor to a “donee.” The receiving party can then facilitate their use. Christina Strong, a healthcare law and policy attorney, explains how this would apply to the case of Planned Parenthood:  “The donor would be the woman undergoing the abortion, the initial donee would be Planned Parenthood, which provides the tissue either directly to a researcher, or to an entity which can properly prepare, process, preserve, test, and/or transport the tissue for research use.”

Why are there prohibitions against buying and selling human body parts?

“The concern most of us have ethically is that poor people would be selling their kidneys to rich people, and rich people [would] get kidneys and poor people end up without kidneys,” explains Klitzman. “The second concern is abortion, and particularly I would say the large national debate of ‘What is the moral status of a fetus?’ Many of us who are pro-choice believe that a fetus is not a full human being … [But] there’s a certain level of respect because it’s like us. And so we don’t want to be buying and selling fetuses or buying and selling parts of fetuses.”

Is there any indication that Planned Parenthood violated the law?

As of now, there is not.

In the first video that was released by the Center for Medical Progress, Dr. Nucatola says that Planned Parenthood is paid between $30-$100 for each tissue specimen, “depending on the facility and what’s involved.” Women in the World asked Linda Tracy, the president of Advanced BioScience Resources, if Planned Parenthood could possibly profit from those prices. “No,” Tracy said. “Not in any way. It’s a minimal fee that is paid. It covers the expenses that the law allows.” 

In fact, the unedited version of the footage—which is almost three hours long—shows Nucatola refuting the notion that procuring fetal tissue is a profitable venture for Planned Parenthood. “Our goal, like I said, is to give patients the option without impacting our bottom line,” she explains. “The messaging is this should not be seen as a new revenue stream, because that’s not what it is.”

The second video seems to be similarly unproblematic. When the topic of compensation for fetal tissue arises, Dr. Gatter suggests a compensation fee of $75 per specimen. The undercover actor offers Gatter $100, which she does not commit to, as the Daily Beast points out. Gatter also makes it clear that Planned Parenthood is not looking to profit from a partnership with the (fake) procurement company. “We’re not in it for the money,” she says. “We don’t want to be in the position of being accused of selling tissue and stuff like that. On the other hand, there are costs associated with the use of our space.”

Do the sting videos bring any ethical issues to light?

Yes.

The most disconcerting aspect of the sting videos is arguably the cavalier manner in which two prominent Planned Parenthood doctors discussed abortion. Dr. Nucatola chatted about extracting fetal body parts while eating salad and sipping wine. Dr. Gatter joked that she “want[s] a Lamborghini” while discussing the prices of fetal tissue. Being glib is not a crime, but Klitzman says the attitudes displayed in the videos shouldn’t be shrugged off, regardless of your stance on abortion.

“It is unfortunate that when taken out of context, the tone was not as respectful as it could have been,” he explains. “The undercover anti-abortion people filmed [Dr. Nucatola] while she’s eating lunch: she’s sticking the food in her mouth, and chewing, and swallowing, and talking with her mouth full of food, and drinking wine. It comes across as not appropriate and dignified in the way that it should be … This is a topic that deserves respect.” 

Another point of concern appears in the second video, when Dr. Gatter discusses the possibility of altering abortion techniques to preserve more tissue. She doesn’t commit to anything—and in fact notes that switching methods would transgress “the protocol that says to the patient, ‘We’re not doing anything different in our care of you.’” Gatter does, however, say she will discuss the subject with a Planned Parenthood surgeon. This, according to Klitzman, is problematic.

“The purpose of the abortion clinic is the woman’s health and the abortion,” he says. “It does get a little complicated if they’re doing the abortion in a way that is to maximize the amount of available tissue, rather than the way they would otherwise do it, which is in the best interest of the mother.” 

Of course, the Center for Medical Progress is hardly blameless in all of this. The outfit’s videos are flagrantly dishonest; they contain misleading snippets of complex laws, and are edited to make it seem as though Planned Parenthood illegally sells body parts of aborted fetuses. In actual fact, there is no evidence to suggest that this is true.

What is the bottom line?

That probably depends on how you feel about abortion, which really is at the heart of this controversy. Those calling for the defunding of Planned Parenthood in response to these videos tend to fall on the pro-life side of the abortion debate. Pro-choice advocates have asserted that the sting videos are thinly-veiled and groundless attempts to debilitate the country’s preeminent proponent of reproductive rights.

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