Wednesday, August 05, 2015

The Newest Planned Parenthood Video: Not Three Shots from a Smoking Gun

The Center for Medical Progress (CMP) released another Planned Parenthood video yesterday in which Melissa Farrell, Director of Research for Planned Parenthood Gulf Coast, appears to be saying that Planned Parenthood will deliberately abort fetuses intact in order to harvest their organs.

Because of CMP's misleading editing of the first video, I was very hesitant to affirm the current claims against Ms. Farrell. In the release of that first video, and subsequently, CMP claims that Dr. Deborah Nucatola admitted that Planned Parenthood uses illegal partial-birth abortions to harvest fetuses for their organs. As I explained elsewhere, she said no such thing. In fact, the use of a partial-birth abortion (PBA) would be counter-productive because the last step in a PBA is to collapse the fetal head by suctioning out the brain. One could hardly harvest an intact calvarium (head) in order to get an intact brain if one sucked out the brain, thus pulverizing it.

With this in mind I will looked at both the edited Farrell video and the transcript of the unedited video, available here. (The unedited video is not yet available on the CMP web site.) I'll examine three issues: procurement of intact specimens (with the implication of infanticide that goes with it), modification of abortion technique in order to obtain specimens, and profiteering from procurement of fetal tissues and organs.

Intact Specimens/Infanticide

CMP asserts that in the new video, Planned Parenthood is admitting to delivering intact fetuses, which would have to be delivered alive in order to be of any use in fetal tissue harvesting. Thus, CMP says, this implies infanticide. I think that the evidence from the transcript only indicates the possible live delivery of pre-viable infants of 20 or fewer weeks of gestation, though there is mention on page 104 of some clinics within the Planned Parenthood Gulf Cost doing abortions up to 22 weeks.

Allowing for the normal margin of error by ultrasound, 20-week babies might turn out to actually be 22 week babies at the cusp of viability. Abortions at 22 weeks might end up delivering a 24 week baby, typically considered viable.

Planned Parenthood in New Jersey has already been caught admitting to live births up to 22 weeks, entirely independent of fetal tissue harvesting, and allowing the preemies to die, A Planned Parenthood representative testifying in Florida has admitted to simply letting the mother and doctor decide whether or not to just let a live-born infant die if he or she survives an abortion. This is independent of any attempt to harvest fetal tissue. So is it possible that if a live-born, potentially viable infant was born during an abortion at PPGC that the baby would be killed to harvest his or her organs? It's entirely possible.

What about the idea that these babies would deliberately be delivered alive and intact in order to harvest the organs? At the bottom of page 9, when the buyer asks about getting intact brains from 18 to 22 week fetuses.
Yeah, I think we could do that. Some of it ... will be happenstance, because you know sometimes as the procedure's happening, you know the procedure itself, for the removal, is generally standardized. .... But it's something that we can look at and explore how we can make that happen so we can have a higher chance. .... when it matters, and the cases where it's mattered and the physicians have needed an intact specimen -- So, we can make it happen. We just need to figure out how that we can do this under our project needs.
So Ms. Farrell is willing to try to get her doctors to change their procedures to increase the chances of an intact delivery.

On page 97, when they are in the lab, Tram Nguyen, the Ambulatory Surgery Center Director for Planned Parenthood Gulf Coast, says, "we can't really intend to bring it out intact." On page 98 he reiterates that "we can never intend to complete the procedure intact - you can't intend to, but it happens."

I'd say it's a bust, therefore, on the idea that Planned Parenthood admits to currently delivering live fetuses to harvest their organs. Ms. Farrell expresses a willingness to see if the doctors are willing to modify their techniques to get intact deliveries, but Dr. Nguyen is clearing giving a "No" before even being asked.

Modification of Abortion Techniques

Beginning at the bottom of page 9, Ms. Farrell says some pretty damning things:
[W]e've had studies in which the company or the investigator has a specific need, for certain portions of the products of conception. And we bake that into our contract, and our protocol, that we follow this. And we deviate from our standard in order to do that. 
This sounds like it goes beyond mere willingness to modify a procedure and into a willingness to deviate from Planned Parenthood's standards of care. But on page 12, we have this exchange:
Buyer: So it sounds like you have physicians that would be able to change the procedure, that if they're knowing --
Farrell: Yeah.
Buyer: That's okay, this patient could provide certain specimens, and we want 'em intact, so that physician  has the knowledge and the ability to change the procedure just a bit to  make sure we can get --
Farrell: Right. And it will depend, obviously the change in the procedure will have to be where it's not gonna put the patient at more risk, prolong the procedure and put her at  more risk. .... And that's something we'll have to discuss with our doctors and see how they could do it. Because some of our doctors have projects and they're collecting the specimens, so they do it in a way they can get the best specimens. So I know it can happen --
This sounds more like what Dr. Nucatola was saying about just changing where to place forceps in order to avoid crushing desired organs and switching to a breech presentation when trying to get an intact head. As I said before, I don't see changing where you grasp the fetus and which you grab first classifies ad really changing the procedure.

At the bottom of page 14, Ms. Farrell says, "we get what we need to do to alter our standard of care so that we're still maintaining patient safety," which again indicates willingness to make changes to the abortion method.

On page 16, she in the context of compensation, she says, "obviously, the procedure is more complicated. .... So anything of a higher gestational age, there's more opportunity for complication...." This goes counter to what she said previously about not compromising patient safety. A prolonged and higher-risk procedure in order to harvest tissue would clearly be illegal.

This looks like an admission of making some changes to the abortion procedure, to the point of increasing patient risk.


Beginning on page 13, the buyer starts speaking about compensation  Ms. Farrell mentions that the staff is already trained
on how to protect human subjects. And so they know how to consent the patient, they know how to do everything and doing to where, we're kind of aware of the burden on the administrative side.... So, as far as the administrative burden it's working out the logistics on our end as we're having a research department like ours. .... I'm not saying it's necessarily easy but one of the things that we really work to do is integration. Seamless integration, the best we can, taking into consideration what the standards are and why these standards are here and the needs of the client and getting the samples, in the time, in the manner, in the condition that you need them. Not compromising patient safety, and we're not compromising clinic flow. .... And you said something about wanting to be on site?
The purported buyer says, "Well, if you've got someone, that's great because when we have to be on site we kind of get in the way." At this point it sounds as if Planned Parenthood would have to invest the time in doing the informed consent and do the work in the lab. Elsewhere Ms. Farrell spoke about how they typically managed tissue, which is to check it for completeness then dump it in a common bucket for disposal. Having to set aside a specimen and pick through it using sterile technique would be additional work and staff time.

Starting at the bottom of page 14, Ms. Farrell says, "we will definitely need to work out something as far as covering additional cost for additional things related to it -- .... I'm very particular about working with the language of the budgeted contract to where the language is specific to covering the administrative costs and not necessarily the per-specimen, because that borders on some language in the federal regs that's a little touchy." This is starting to muddy the waters. Is she really speaking of carefully covering additional costs, or about making it appear as though they are merely covering administrative costs?

On page 16, where she speaks about modifying procedures, she says that when collecting fetal tissue, "Sometimes the procedures are longer. So then, anything that we piggy-back onto that for collection purposes, obviously, would have to, that additional time, cost, administrative burden." She goes on, "we even will go as far as to have timed trials where we go up there with a stopwatch and time how much, so we can at least know what our cost is. Because I think, in terms of budgeting, if you don't even know your cost, how can you develop a budget to cover that." This indicates a mere desire to offset costs.

On page 17, she says:
And that's the thing that it's, a lot of folks I get this mainly from academic institutions, they see Planned Parenthood and think, "Oh, you're non-profit. That means you're non-budget." And they will come to us with budgets that are, quite frankly, insulting. I mean, really? Where in the United States can you, an 8-page consent form for this amount of money? it takes 30 minutes to administer that to a patient. .... If anything, we serve the community and we have to provide services to the community at a very very low cost, and we can't underwrite anyone's research project.
Ms. Farrell reiterates this concept on page 53, when she says:
They know they want to come to Planned Parenthood to get it but they don't bring us enough money. Then there's teh mentality where "you're no profit, you should just give us the stuff." I wasn't joking when I said insulting budgets, I mean they're wanting us to do all of these things consent the patient, collect the specimens, and do this, and do that and for nothing, literally, literally, zero.
Here, this seems to indicate a desire to recoup costs. On page 18 she even seems to be indicating that the additional per-patient time would mean that they could schedule fewer patients, thus forgoing some patient fees. She also indicates that staff drive the specimens to FedEx for shipping.. She speaks about packaging on page 20, going into detail about the material, and by implication time, that needs to go into preparing specimens for shipment. However, further down she says:
Typically, our sponsors set up a FedEx account for us, and we just use that account. We go online, and we have it set up in our FedEx world account, put everything in, print up the air bill, put it on dry ice, put it in the freezer, bricks, whatever we need to do and either drop it off -- whatever we need to do -- we have FedEx pick up here about three or four pm. Then anything that is late, something that was collected late, we drop it off at FedEx. It's literally on the way home for me, so yeah.
So this indicates that the transportation of the package to FedEx isn't any additional staff time or mileage reimbursement.

But on page 21 she talks about delivering tissue to Louisiana, which is clearly expensive and time-consuming: "I rent a Ford explorer or something. I pack everything in the back because it's the only way I know, for sure, it's going to get there."

On page 59, Ms. Farrell mentions that she has a financial background in that she used to help her mother to do taxes. This is where we find the comment, "In terms of areas that I can contribute to the organization both locally and nationally is diversification of the revenue stream, so we can continue to do good work" She segued into that after talking about the movie After Tiller and how clinics get all sorts of inspections and audits, and how she started working at Planned Parenthood. The context isn't compensation for fetal tissue procurement. The purported buyers talk about profit and gold and bringing in money, and Ms. Farrell just makes the kind of "Yeah" comments one makes to indicate that one is listening.

On page 76 is where Ms. Farrell starts talking about line items:
And if we are able to obtain intact fetal cadavers, then we can make it part of the budget that any dissections are this, and splitting the specimens into different shipments is that, that's, it's all just a matter of line items.
This strikes me as billing for services, not for parts.

On page 77 she talks about "a tissue banking part" where Planned Parenthood would freeze harvestable organs that don't have buyers yet, so that they could be provided later. The purported procurers indicated that these would be less desirable but perhaps some researchers would want them. The procurers bring up money again, though it's not clear if Ms. Farrell is thinking in terms of monetizing fetal parts or in terms of streamlining the harvesting process by collecting and labeling whatever is in good enough shape and then worrying about who wants what.

I would have to say that I'm not detecting anything other than fees for services rather than fees for tissues. If the fees were beyond the actual costs, this could constitute profiteering, but if it's on a by-service basis rather than a by-specimen basis, it might well be legal.

Final Verdict:

Aborting live fetuses and harvesting their organs: Possible but not verified.

Modifying abortion techniques to harvest organs: Confirmed to the point of willingness to increase patient risk.

Profiteering: No evidence.

This video, like the first one, is edited to produce clear evidence of guilt that most likely isn't there in some areas. I would admonish my readers to avoid Planned Parenthood Derangement Syndrome and refrain from asserting that this video shows any Planned Parenthood employee expressing willingness to deliver live babies in order to harvest their organs, and to refrain from asserting that this video shows profiteering.

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