Ethicist Tells CNN: Altering Abortion Procedure to Get Tissue Is a "Big No-No"

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.

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