Ethicist Tells CNN: Altering Abortion Procedures to Get Tissue Is a "Big No-No" • AfterAbortion.org

7/16/15

From the CNN story on the undercover video showing a Planned Parenthood official discussing harvesting body parts from aborted babies:

Another part of the video also raised concerns for [bioethicist Art Caplan of New York University] . Nucatola talks about doctors performing abortions in which ultrasound is used to ascertain the best location to grab the fetus with forceps.

“We’ve been very good at getting heart, lung, liver because we know that, I’m not going to crush that part,” she says.

Altering procedures in order to get tissue in the best condition would be a “big no-no,” the bioethicist said, because the patient’s health is paramount and that should be the only concern for doctors. Caplan did not comment specifically on whether the ultrasound procedure would endanger the mother, but he made it clear that any deviation from normal procedures is unacceptable.

“In abortion the primary goal is to give the safest abortion possible,” Caplan said. “Your sole concern has to be the mother and her health.”

There’s a parallel in patient care, he said. When someone is dying, doctors shouldn’t change how they treat the patient in order to harvest good tissue for donation after death.

Doctors should treat the patient as they normally would, and then use whatever is available after death. If a provider is considering how to get the tissue that’s in the best shape, “that’s a huge conflict of interest. … If you modify how someone dies, that’s unethical.”

The “ultrasound procedure” mentioned is described in the video transcript as follows, beginning on page 11:

Buyer: We need liver and we prefer, you know, an actual liver, not a bunch of shredded up—

PP: 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 [fetal head], 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?

PP: 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 [head first], 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 —

PP: Exactly, exactly. Under ultrasound guidance, they can just change the presentation.

Buyer: Okay.

Dr. Nucatola appears to be saying that consent to the type of the procedure isn’t being sought, claiming that it isn’t needed. From the transcript, beginning on page 12:

PP: You know, I think it’s good to have—so this is another consideration to make, because when you do partner with a clinic, you’re probably partnering with the manager, the owner, the director, you’re not so much having a relationship with the providers, but I think it helps to have a relationship with the provider, because if you do, you can have this conversation with them, and you can say, this is what we’re looking for today, and they’re more apt to—

Buyer: Keep it in the back of their mind.

PP: Absolutely. Of course I want to help. I’d rather this actually get used for something, so I think, as much as the patients, the providers absolutely want to help.

Buyer: And so, if it’s something as simple as converting to breech that doesn’t require a separate consent? Does that make the procedure take longer? Is that another step for the provider?

PP: No, it’s just what you grab versus what comes out. It doesn’t make anything any different.

There are several questions that need to be asked in any Congressional or state investigations: Is Planned Parenthood endangering women and girls by changing procedures in order to get the best tissue? Are the mothers informed of this and how it might affect their health?

And are they being manipulated or pressured into donating their babies’ organs and tissue? We already know that abortion businesses use pressure, coercion and misinformation to sell abortion, so why should this situation be any different?

Watch CMP’s video release.
Watch the full 3-hour video.
Read the transcript of the full 3-hour video.

Update:

CMP has released a new video showing a lunch meeting between their undercover investigators and Dr. Mary Gatter, president of the Planned Parenthood Medical Directors’ Council and an medical director for Planned Parenthood Pasadena. From LiveAction:

Gatter explains that there is a way to alter the abortion method that will increase the chances of getting a whole baby out. Most first trimester abortions are done with aspiration, and the most common is machine vacuum aspiration. In this method, an electric machine does the suctioning. Sometimes all of the baby doesn’t come out, and a dilation and curettage (D&C) is needed to clean out the uterus. It is more “crunchy,” as Gatter would say, because it sucks the baby out in pieces.

In a manual aspiration, also know as MVA or IPAS, the abortion doctor uses a manual syringe. The doctor inserts this syringe much like a plunger, and is then instructed to “evacuate by slowly and gently rotating cannula and aspirator 180 degrees in each direction while using an in-and-out motion.”

The difference between the machine and the manual suction is a topic of Gatter’s discussion with a fetal parts buyer in the most recent undercover Planned Parenthood video. The manual method is often referred to as IPAS because that is the name of the system.

The distinctions between the machine and manual method are not huge, and some actually prefer IPAS, but the concern in the video discussion is that the women are being told they are receiving one type of abortion, but might possibly receive the other – without their knowledge – for the sake of extracting the whole baby, yet another fact that might bother women if they were actually informed.

From the video transcript, beginning on page 12 (click here to see the full 1-hour video of the meeting).

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 [manual vacuum aspiration] 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.

Buyer: Mhm. IPAS is the manual suction, right?

Gatter: Yeah, our shorthand for that.

Buyer: So, would you, I could see where it might present some sort of problem
for you. So, to, if we could compensate more on something like that, or—

Gatter: Well, now you’re shading into the area of you’re paying me to do
something that’s not right. So [laughs] that’s not what I want to talk about!

Buyer: No, I don’t, I don’t see that. What I want to make sure is that you,
whatever you have to go through to deliver intact specimen, that that’s
compensated. Not that I”m paying you to do something shady or—

Gatter: Well I will discuss it with Ian, our surgeon. We’ll see what he has to say.
Do you have feelings about this?

Laurel: I’m just trying to think of it from his perspective. You know, I don’t know
what his opinion would be on that.

Buyer: You’re not putting the patient at any more risk, right? As you said.

Gatter: No. Just slight variation of the technique.

Buyer: Okay.

Laurel: Which, the consent they’re signing is for suction aspiration, it doesn’t
describe what kind it is.

Gatter: Yes, but I have heard people argue that for the tissue donation, it says
we’re not doing anything different, so.

Buyer: That’s what I need to understand, because what I’m seeing it as, of
course, I’m looking for intact specimens. You know from a medical perspective,
the patient is receiving just as good of care. So help me understand the problem.

Gatter: Well, there 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, is it local anesthesia or conscious sedation, so they’re technical arguments having to do with one technique versus another.

Buyer: So it’s technicalities, is what I’m hearing.

Gatter: It’s something that I need to discuss with Ian, before we agree to do that. [Emphasis added]

Live Action notes:

If investigators can prove that Planned Parenthood has indeed changed abortion methods on women, the implications could be huge. It is against federal law not only to sell fetal parts, but also to alter an abortion procedure to get these parts. 42 U.S. Code § 289g–1 says: “No alteration of the timing, method, or procedures used to terminate the pregnancy was made solely for the purposes of obtaining the tissue.” …

If Planned Parenthood alters the technique, possibly adding several minutes to the procedure and causing more pain to the woman, that is a significant difference. Does Planned Parenthood truly believe that increasing a woman’s pain unnecessarily is a merely “technical”? So much for “Care. No Matter What.”

Read the whole thing here. Again, this is very concerning and something that should be raised in any investigation of Planned Parenthood (and any other abortion businesses involved in obtaining fetal body parts).

Watch CMP’s video release of the meeting with Mary Gatter.
Watch the full 1-hour video.
Read the transcript of the full 1-hour video.