- - Wednesday, September 9, 2015

One of our early guiding principles here at “Jesus in the Public Square” is to let voices from within the Christian community speak on issues on which they have a specialized training and voice.

Let those who know the terrain be the guide.

Recently, one of my good friends, a veteran medical doctor and instructor in medicine, told me about an article found in the latest issue of the New England Journal of Medicine. The article discussed the ethics of using fetal tissue for research and therapy—obviously a charged discussion with all that has happened the past few months. 

He was troubled by the arguments made in the esteemed journal, so he took up his keyboard and worked through a thoughtful response for us.


by Dr. Clay Smith, M.D.

A recent New England Journal of Medicine (NEJM) article opined, “We have a duty to use fetal tissue for research and therapy.”  To support this statement, the author, R. Alta Charo, J.D., a member of the National Medical Committee for the Planned Parenthood Federation of America from 2004-2006, made several assertions that deserve closer consideration.

She begins, “Morality and conscience have been cited to justify defunding, and even criminalizing, the research, just as morality and conscience have been cited to justify not only health care professionals’ refusal to provide certain legal medical services to their patients…”

Do we want healthcare providers who practice what is “legal” without regard to what is moral and in keeping with a good conscience?  Think of the alternative.  Would anyone want an immoral healthcare provider who does what is unconscionable?  Many things are legal but reprehensible.  Murder of Jews in Nazi Germany was legal as were the horrific Nuremberg experiments by Nazi physicians.

The United States has a long history of performing unethical but legal research on human subjects.  For example, military experiments were performed to test chemical warfare agents on enlisted men.  The infamous Tuskegee syphilis experiments withheld treatment of black men with syphilis in order to see what would happen to them compared to others who were treated.  I want to be a doctor who knows the difference between what is legal and what is moral.

Abortion is a procedure in which a living person is grasped with forceps and forcibly removed, or scraped and suctioned, from the uterus.  This often causes the affected person to be dismembered.  It is certain it causes them pain.  Is this moral?  Does this not cause a pang of conscience?  Why is it considered illegal to kill an infant person moments after they are delivered but not illegal to do so just prior to delivery of the head, as in the dilation and extraction procedure?  How is this determination made?  Is it not based on a moral judgment?  We, as a society, have made a moral judgment that infanticide is wrong, but strangely that if the brain is suctioned out just prior to delivery of the head, then it’s OK. Contrary to the author and legal scholar’s opinion, morality and conscience are essential checks that keep not only physicians, but all of us, including lawyers, from doing reprehensible things that are perfectly legal.


Hope at what price?

Dr. Charo further prosecutes the argument.  “But this duty of care should, I believe, be at the heart of the current storm of debate surrounding fetal tissue research, an outgrowth of the ongoing effort to defund Planned Parenthood. And that duty includes taking advantage of avenues of hope for current and future patients, particularly if those avenues are being threatened by a purely political fight — one that, in this case, will in no way actually affect the number of fetuses that are aborted or brought to term, the alleged goal of the activists involved.”

If “avenues of hope” for one group results in the death and destruction of another group, namely in utero persons, is this not unethical?  Such research would never be tolerated in any other quarter.  Think if a vulnerable population, such as prisoners, were harmed or killed so others could benefit from the research.  Would such an “avenue of hope” be considered or receive Institutional Review Board approval?  Not at my institution!  Yet this most vulnerable population, those persons in utero, who cannot speak for themselves or defend themselves, are exploited for the benefit of others.  Did we learn nothing from Nuremberg?


Wikipedia vs. New England Journal of Medicine

The author then makes the unfounded claim that defunding Planned Parenthood would “in no way actually affect the number of fetuses that are aborted?”  What is the evidence for this claim?  I find it surprising and disconcerting that not even Wikipedia would allow this statement to stand unsupported; yet here we find it in the New England Journal of Medicine.  I have great respect for this journal and have been a subscriber for years, yet their bias in favor of Planned Parenthood is blinding.  In fairness, I am biased against Planned Parenthood.  We all have biases.  Blindness occurs when we fail to acknowledge how these biases affect us.  As far as I can discover, the author’s assertion is unfounded.  If anything, increased taxpayer funding of PP has resulted in increased numbers of abortions.

“From 2000 to 2013, taxpayer funding shunted to Planned Parenthood jumped from $202,000,000 in 2000 to $528,400,000 in 2013. In 2000, Planned Parenthood performed 197,070 abortions while making 2,486 adoption referrals. In 2013, they performed 327,653 abortions and made just 1,880 adoption referrals. That means a percent increase in taxpayer funding resulted in a 66 percent increase in the number of abortions and a 61 percent decrease in the number of adoption referrals.” Susan B. Anthony List


Video editing sleight of hand?

The author scolds that in the videos, “an antiabortion activist, posing as a biomedical research company representative, captured on video — which he then edited in the most misleading way possible — discussions by Planned Parenthood physicians…”

Of course David Daleiden had an agenda and edited the footage.  But the full, uncut versions are available on the Center for Medical Progress website.  The fact is, the uncut videos make PP look even worse.  There was much left out of the edited versions that PP should be very glad didn’t make the cut and will be unwatched by most people.


What constitutes a “service” by Planned Parenthood?

Charo laments that there are now numerous, “calls to end funding for all Planned Parenthood services — more than 95% of which involve such things as contraception and screening for sexually transmitted diseases, rather than abortion.”

Although it is certainly true that Planned Parenthood performs a valuable service in treating several pressing women’s healthcare needs, it is duplicitous to claim that only 3% of all “services” rendered by PP are abortion, as the PP Annual Report states.  If an abortion patient also has a PAP smear, sexually transmitted infection (STI) testing, HIV testing, contraception counseling or prescription, pregnancy testing, and urinalysis, the abortion is only 1/7 (14%) of the “services” for that visit.  But the reason the patient is there is for an abortion.  “Abortion patients constitute 12 percent of Planned Parenthood clients – 332,000 of 3 million unduplicated clients in its most current report. 37 percent of all Planned Parenthood clinic income revenue is from abortion procedures, according to conservative estimates.” Susan B. Anthony List  No one who knows argues that PP does far more than provide abortions.  But it seems like creative accounting to tally up each pregnancy test or urinalysis as a “service” and equate that to an abortion as a “service.”


Did the video embellish?

Dr. Charo seems to indicate that the video embellishes and dramatizes what takes place in some Planned Parenthood locations as the reason for the public and legislative outcry.  Using horror movie lingo she writes, “Portrayed as ghoulish vivisection and body-part snatching, it was decried as barbaric by members of Congress.”

I can only ask of the author and the readers, have you taken the time to watch the videos?  Apparently, the White House and press secretary Josh Earnest haven’t found time to do so.  What is on the pie plates?  Severed arms and hands with perfectly formed fingers, hearts, kidneys, legs, brains…  These are shredded people on a pie plate!  And it happens at Planned Parenthood over 900 times a day, 365 days a year.  For God’s sake, if that’s not ghoulish, what is?  If that’s not assaulting to your sensibilities, something is terribly wrong.  Try to emerge from the political fight for a moment and really see the human tragedy that is abortion and the inevitable conflict of interest PP faces as they receive payment for providing fetal tissue.


Are we all unwitting beneficiaries?

“Any discussion of the ethics of fetal tissue research must begin with its unimpeachable claim to have saved the lives and health of millions of people.”

Here the author is spot on.  This statement is correct.  In addition, Nathalia Holt wrote in the New York Times, “Fetal cells extracted from the lungs of two aborted fetuses from Europe in the 1960s are still being propagated in cell culture. They’re so successful that today we still use them to produce vaccines for hepatitis A, rubella, chickenpox and shingles. From two terminated pregnancies, countless lives have been spared.”  I am an Emergency Physician and by no means a stem cell researcher, so I depend on others with expertise in this area.

Dr. Maureen Condic is a professor, actively involved in stem cell research, and is quoted in the National Review.

“WI-38 and MRC-5 cell lines are useful for vaccine production not because of their fetal origin, but because they were selected for the ability to easily incorporate the ‘foreign’ DNA required to make vaccines. Using current technology, adult cells have identical properties to fetal-derived cell lines. Fetal cells are not required for life-saving vaccines or therapies. Researchers in the 1960s and ’70s used fetal cells to produce transformed cell lines because, given the limited knowledge at the time, fetal cells were easier to propagate prior to transformation. Yet in the modern world, fetal cells are not required to produce transformed cell lines. Using current technology, adult cells are readily transformed in a similar manner and have identical properties to fetal-derived cell lines.”

She goes on the say,

“Scientists and industry continue to use fetally derived, transformed cell lines today for purely historical reasons: Because these lines have been in use for more than 40 years, we know a great deal about their properties and have built a large number of ‘improvements’ into them, which makes them valuable laboratory tools. And the fact that these man-made cell lines have not been replaced by freshly isolated fetal stem cells argues strongly against Holt’s conclusion that fetal cells ‘save lives.’ Vaccines save lives. And many vaccines are manufactured using highly manipulated, entirely unnatural, ‘immortalized’ cell lines that, as a sad legacy of history, were originally isolated from fetal tissue.”


They’re throwing it out anyway

Referring to the 1988 Fetal Tissue Transplantation Panel, Charo says, “The panel also considered the pointlessness of refusing support for this research, which uses fetal tissue that will otherwise be discarded.”

In the same National Review article, Dr. Condic provides an apt response, though she was not writing in response to this NEJM op-ed:

“We could gain equally valuable information from experiments on organs taken without consent from death-row prisoners — individuals who are going to die anyway, with their mortal remains ‘bound for the trash.’  Yet we rightly condemn using organs from prisoners without consent as a revolting commodification of human beings, even if the ‘donors’ were legally terminated under the law. And we should condemn research on human fetal body parts for exactly the same reasons.”


Why bother writing this?

There are clearly ideological and possibly professional ties that bind the NEJM to Planned Parenthood. In the same issue, the Editor-in-Chief, Dr. Jeffrey Drazen, Associate Editor, Dr. Michael Greene, and Dr. George Topulos, a volunteer member of the Medical Committees of both Planned Parenthood League of Massachusetts and Planned Parenthood Federation of America, wrote an editorial literally praising Planned Parenthood.  “Planned Parenthood, its physicians, and the researchers who do this work should be praised, not damned.”

The editorial PP hagiography continues with this closing paragraph:

“It is shameful that a radical antichoice group whose goal is the destruction of Planned Parenthood continues to twist the facts to achieve its ends. We thank the women who made the choice to help improve the human condition through their tissue donation; we applaud the people who make this work possible and those who use these materials to advance human health. We are outraged by those who debase these women, this work, and Planned Parenthood by distorting the facts for political ends.”

As if the only reason anyone would ever take action against abortion and selling fetal tissue would be for political ends!  Could it not be that I speak out as a fellow human being with a conscience?  Could it not be that I am a Christian?  Could it not be that I am a husband and a father of 7 children that I consider to be precious gifts from God?  Could it not be that I am a physician who has taken an oath to do no harm yet see my fellow physicians doing just that?  This is what compels me to speak out.  I certainly don’t write “for political ends.”  I write to awaken some readers to see this for what it is.  And I do so at my own risk, knowing my opinions are unpopular with many who have power over my employment.  No, this is the shameful thing: that atrocities against people are being legally committed, and sadly, the editors of the NEJM are unable to see it.


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