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The hidden ethics battle in the Planned Parenthood fetal tissue scandal

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(RNS) In a flood of outrage over Planned Parenthood videos — executives caught talking callously about supplying fetal tissue for medical research — some key points have washed out of attention, ethics experts say.

  • The use of fetal tissue in medical research is legal — and scientifically valuable.
  • It’s taxpayer-funded, to the tune of $76 million last year, and Planned Parenthood isn’t the only provider.
  • Done with dignity, it can be ethical, too, both religious and secular experts say.

But they also say there may be an unresolvable impasse in the public response: Can or should the leading provider of women’s health care be shut down in a showdown over the moral status of embryonic and fetal life?

“You can’t make this fundamental clash of perspectives go away,” said Tom Beauchamp, Georgetown University professor of philosophy, senior research scholar at the Kennedy Institute of Ethics and co-author of one of the foundational texts in the field, “Principles of Biomedical Ethics.”

“If you think that, never mind the stage of development from embryo to fetus, this is a human life, a person, and any intervention is an act of killing, it’s an unforgivable crime because a fetus has full moral status including, at the very least, the right not to be killed.”

Neither can an embryo or a section of tissue give informed consent to be used for research — a fundamental ethical requirement, said Beauchamp.

“But if you don’t see this embryo or tissue — whether from an abortion or a miscarriage — as having a moral status, you don’t see the issue of giving consent for its use in research. It’s not a person to you,” he said. “There is no neutral concept of personhood. Everyone picks their starting point.”

(RNS2-jan22) Pew Research Center graphic depicting consistent support for maintaining Roe v. Wade over the past 20 years.  For use with RNS-ABORTION-BELIEFS, transmitted on January 22, 2013, RNS graphic courtesy the Pew Research Center’s Forum on Religion & Public Life, © 2013, Pew Research Center. http://www.pewforum.org/.
(RNS2-jan22) Pew Research Center graphic depicting consistent support for maintaining Roe v. Wade over the past 20 years. For use with RNS-ABORTION-BELIEFS, transmitted on January 22, 2013, RNS graphic courtesy the Pew Research Center’s Forum on Religion & Public Life, © 2013, Pew Research Center. http://www.pewforum.org/.

The common ground, however, may come if significant treatment or cures are found with fetal tissue research by scientists anywhere in the world. “Just wait until people need these cures. They won’t say no,” said Beauchamp.

The National Institutes of Health budgeted $76 million for fetal tissue research in 2014 and roughly the same amount for 2015 and for 2016, according to The Washington Post. Grant recipients included scientists at a private company looking at a condition that causes enlarged spleens, HIV researchers at Massachusetts General Hospital and scientists studying neurodevelopmental disorders at Stanford University. Time magazine reported that fetal tissue has contributed to vaccines for polio, rubella and chicken pox.

There’s a 25-year history of such research. In 1990, the Journal of the American Medical Association outlined how fetal tissue “has the potential to save lives.” The journal said such tissue is “derived from elective abortions” and must be used in “a morally acceptable manner” that distinctly separates the decision to have an abortion from consent to donate the resulting tissue.

Federal regulations specify there can be “reasonable payments associated with the transportation, implantation, processing, preservation, quality control, or storage of human fetal tissue.”

No guidelines or codes can suffice for any use of fetuses killed in an elective abortion, said Ron Hamel, who recently retired as senior ethicist for the Catholic Health Association.

“The church would see what Planned Parenthood is doing as a double indignity to human life. There is both the willing destruction of a life and the sale of the fetal tissue,” Hamel said.

He pointed out that the sale price — which was strictly a reimbursement to cover costs, according to a letter from Planned Parenthood to Congress — is irrelevant. Catholic doctrine forbids intentionally killing an embryo or fetus.

But this does not mean the Catholic Church would object to all such research. It all depends on the source.

For example, Hamel said it is ethical at a Catholic health facility for parents to consent to donate remains of a miscarried fetus or an “indirect abortion” — when a fetus is unavoidably harmed during essential treatment to the mother for a life-threatening condition.

Still, it is essential that “fetuses, even dead fetuses, need to be treated with respect and dignity” at every stage, including burial of the remains after research is completed, said Hamel.

Ethicist Laurie Zoloth, former president of the American Academy of Religion, watched both Planned Parenthood videos at length and was horrified by the “cavalier” way that such a fraught issue was discussed.

Beyond their crude conversations, the Planned Parenthood executives may have spotlighted gaps in ethical integrity that alarmed Zoloth, who holds dual professorships at Northwestern University, one in medical humanities and bioethics at the medical school and another in religious studies.

Were women able to give informed consent based on full information — including the specifics of the procedure and that tissue donated would be used for medical research? Did Planned Parenthood alter its procedures in order to obtain tissue, without making this clear to the client?

“These are all part of clear, transparent informed consent for any surgery and we care a lot about consent,” she said.

However, Zoloth also sees the Planned Parenthood videos in the context of the anti-abortion rights activists’ campaign to shut the agency down, despite “substantial public consensus that abortion should be safe, legal and rare.” It’s a view she personally shares, coming from a branch of Jewish tradition that permits abortion “under very specific conditions” and the donation of tissue for research.

Like the New York Times editorial writers, who called out lawmakers for “promoting their own anti-choice agenda” and said they are “rewarding deception and putting women’s health and their constitutionally protected rights at risk,” Zoloth does not want to see Planned Parenthood shut down.

Planned Parenthood, which serves one in five U.S. women with reproductive health care, family planning and health screenings, including mammograms, is “a necessary place for medical care for millions of women,” Zoloth said.

To survive the crisis, Planned Parenthood will need to follow the same path of repentance every religion outlines — apologize, reform, do better.

“They need to start with a public apology,” said Zoloth. They need to explain exactly what their costs are and give a full accounting of them. There should be some sanctions toward the doctors who spoke on tape. There needs to be clear revision to “never ever” modify a medical procedure. There may be sanctions for the two doctors on the videos. And everyone must be trained to be aware of the moral gravity of their actions.

“If all those things are done, and if there is a true need for the tissue, it is better to donate it than to throw it away,”  said Zoloth, who wants to move the public debate to a different framework.

She said: “I wish all those people raising a furor would take all that passion and enthusiasm for the welfare of babies and address it to birth control, nutrition and early childhood education. If you really want to make the world safer and better for women and children, I have a lot of things on my list.”

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12 comments

  1. “It’s a view she personally shares, coming from a branch of Jewish tradition that permits abortion “under very specific conditions” and the donation of tissue for research.”

    I heard on the radio a jewish woman abortion doctor say that Jewish teaching(?) is that abortion is ok as long as the baby’s head is not more than half way out.

    Is that true?

  2. e people raising a furor would take all that passion and enthusiasm for the welfare of babies and address it to birth control, nutrition and early childhood education. If you really want to make the world safer and better for women and children, I have a lot of things on my list.”

    This argument is so tired. It’s not an either or to prolife people like myself, we advocate for life on issues from war to womb.

    • The problem is, now it makes Planned Parenthood look to some the public even supporters, as though they are caught up in a giant conspiracy theorist’s and science fiction fans dystopic vision — wherein Planned Parenthood is a front for harvesting human at their most vulnerable. Planned Parenthood has worked for decades to make themselves a family friendly and family-promoted service and change their image. I’ve been wondering who is calling into question the markets and industrial forces which allow for this kind of exploitation? It links in, as well, unfortunately, with the eugenics of Sanger and the worst kinds of neo-liberalism, which talk equal rights, but all too often forget that for women who are poor and minorities just the ability to reproduce is a human right, and many women while wanting choice, also feel they are being pushed into being childless because of their stature. How many science fiction books and movies have been about these very topics? Oh, that’s an article.

    • I don’t doubt these people’s passion, just their ability to reason. How can you be against abortion but campaign to defund the country’s largest provider of services to prevent unintended pregnancy (who, also, occassionally, perform abortions)?

      Most pro-life people I know of (though there are exceptions) are passionately against comprehensive family planning, proper sex education, and a well-funded social safety net, all of which are the solutions to preventing unwanted pregnancies.

      • Well, as a pro-life dude, I’m against killing babies, blacks, gays, transgendered.

        I’m absolutely against killing for profit, science, ideology or religion.

        I’m an advocate for Health service providers to manage the care of their patients under the “Do no harm” ethic.

        Free preventive birth control service through health insurance and local community care.

        Tax cuts & tax funded support services for adoption seekers and participants.

        Increased funding for broad based sex education for local communities.

        Stop rewarding personal sexual and relational irresponsibility through poorly managed, welfare programs.

        I support the full coverage provided in ACA/ObamaCare for reproductive services, care and support.

        I think abortion services should be under the care and execution of a woman’s primary care doctor & health plan. Remove the private third party orgs. to provide stricter oversight, financial accountability and broader access to preventative or emergency care.

        • Then we have a lot in common. My perception is that, based on your positions, you’re an outlier in the pro-life movement. Would you say that’s fair?

          • Maybe from the 1980-2000 type of pro life advocates. But there’s a emerging front that is gaining more traction, action and results in the goal to make abortion ‘rare’ and it’s no longer made up only of evangelicals or conservative catholics etc. It’s feminists, gays, atheists and moderate, young adults who see that there’s ground to stand on that is pro-woman and children and responsible sexual ethics that hold accountable those engaged in sex and the culture that provides abortions. It’s not going to be an either or legal end, so whose going to work towards a tenable pro-life position and a pro-choice position that actually gives a little both ways in order to actually reduce and reeducate on the issues? I would say not the older guard from either camp. It’s time for a new vision that cross the battle lines a bit in order to actually help promote life from the issues of war to the womb.

          • I’m not sure what the difference between this new pro-life movement, and the pro-choice movement is? Can you elaborate?

            Seems to me the only tenant of the pro-choice movement is to not make abortion illegal or inaccessible. Is the main difference the conditions under which abortions are available (like age of fetus, etc)?

          • It friends on who you ask, I imagine. For me it’s age of termination and funding, personhood of fetus, that rise to the top of the differences.

        • I agree, Eric. Abortion is not desirable, and we need better services for our children and families. Those would reduce the need for abortions. Give good services and let the prospective parents decide what is best for them and their families. That is a good moral goal.

  3. As a pro-life Democrat, I’m constantly puzzled by a party that stands up for the vulnerable and disenfranchised but often glazes over a voiceless demographic that cannot stand up for itself — the legions of unborn children in this nation that fall victim to abortion. In cases like rape, incest and health of the mother, abortion makes sense but, in this country and others, it has become a horrific and disturbingly common form of birth control. For a very informative read, check out “Unplanned” by Abby Johnson, a former Planned Parenthood worker, who sheds light on practices that will literally make your stomach turn. Yes, let’s focus on education and prevention, but please don’t group those topics into the same category as taking the life of an innocent, unborn child.

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