Stung (UPDATED)

See update below. 

The release of the first Planned Parenthood sting video—in which Deborah Nucatola, the organization’s senior director of medical services, graphically explained, during lunch, how a physician might alter an abortion procedure to obtain certain organs, and what a clinic might expect to be paid for procuring such specimens—brought with it equal measures of outrage and skepticism. Outrage from prolifers (and those who don’t identify with the movement) that someone could so casually describe such a thing in between sips of wine and forkfuls of salad. Skepticism from prochoicers (and others) who weren’t convinced that the video, captured deceptively and edited to maximize shock value, fairly portrayed Nucatola or her employer.

The Center for Medical Progress—the group that carried out the sting operation—accused Planned Parenthood of selling fetal tissue in violation of federal law. (Reimbursement for expenses is legal. Making money on the process is not.) But that first video, especially in its unedited form, did not quite prove that charge. Nucatola explicitly says that Planned Parenthood wants to avoid seeming to profit from fetal-tissue donation. The activists posing as buyers push her to say how much Planned Parenthood expects to receive for a specimen, and she mentions a few numbers, thirty dollars on the low end, one hundred on the high.

Planned Parenthood promptly denied CMP’s allegation, explaining that their clinics follow the law:

At several of our health centers, we help patients who want to donate tissue for scientific research, and we do this just like every other high-quality health-care provider does—with full, appropriate consent from patients and under the highest ethical and legal standards. There is no financial benefit for tissue donation for either the patient or for Planned Parenthood. In some instances, actual costs, such as the cost to transport tissue to leading research centers, are reimbursed, which is standard across the medical field.

Yet almost as soon as Planned Parenthood released that statement, documents surfaced that called it into question.

First came a copy of one clinic’s tissue-donation consent form. It sells the patient a little on the medical benefits derived from fetal-tissue research. But mainly it exists to make sure the patient and clinic stay on the right side of the law. Do you acknowledge that you decided to have an abortion before choosing to donate? Do you know that you have no say about who receives the tissue? That you can’t be paid for the donation? But then it asks the patient to acknowledge something important about the procedure itself: “that there will be no changes to how or when my abortion is done in order to get my blood or tissue.”

Changing how abortions are done in order to obtain certain tissues is exactly what Nucatola is talking about in that first video. She is asked whether some doctors will adjust the way they perform abortions in order to preserve desired organs. “If they’re reasonable people, sure,” Nucatola replies. Later videos released by CMP suggest that at least some Planned Parenthood physicians are willing to alter the way they perform abortions in order to secure specimens desired by medical-research companies. Federal law holds that fetal tissue can be obtained only if there is “no alteration of the timing, method, or procedures used to terminate the pregnancy.”

How many Planned Parenthood doctors are willing to make such adjustments? Hard to say. The New York Times reports that Planned Parenthood participates in fetal-tissue donation programs in just three states: California, Washington, and Oregon. Yet in another CMP video, Melissa Farrell, director of research for Planned Parenthood Gulf Coast—the Texas affiliate—referred to “alter[ing] our process” in order to obtain certain fetal tissues so that “we can make it part of the budget.” (As Mollie Hemingway pointed out, Planned Parenthood claimed the Gulf Coast affiliate does not “currently” participate in fetal-tissue donation programs. These videos were recorded in April.)

“There are no financial benefits” to participating in tissue-donation programs, Planned Parenthood President Cecile Richards told George Stephanopoulos last month. But don’t such programs “improve the finances of the clinic?” he pressed. No, “absolutely not,” she replied. Which brings us to the second document that raises questions about Planned Parenthood’s official response to the sting videos: a page on the website of StemExpress, a tissue supply company that used to work with Planned Parenthood, pitching its services to clinics as “financially profitable.” “By partnering with StemExpress, not only are you offering a way for your clients to participate in the unique opportunity to facilitate life-saving research, but you will also be contributing to the fiscal growth of your own clinic,” according to another StemExpress flyer.

This is how Melissa Farrell seems to view the relationship between Planned Parenthood clinics and companies like StemExpress. “I think everyone realizes especially because my department contributes so much to the bottom line of our organization,” she told CMP activists. “In terms of areas that I can contribute to the organization both locally and nationally is diversification of the revenue stream.”

In the first CMP video, Nucatola doesn’t come out and say that Planned Parenthood wants to make money from fetal-tissue donation. “The messaging is this should not be seen as a new revenue stream, because that’s not what it is,” she says. But in the second video, Mary Gatter, president of Planned Parenthood’s medical directors council, refuses to come out and say how much money she would expect in exchange for procuring and delivering fetal tissue specimens. “You know, in negotiations whoever throws out the figure first is at a loss, right?” She continues: “I just don’t want to lowball.” You don’t negotiate reimbursement rates. Expenses are determined by the steps involved in procuring, storing, and transporting fetal tissue. But Gatter doesn’t mention any of that.

As Sarah Kliff points out at Vox, that is a problem:

She [Gatter]engages in what I think can fairly be called a negotiation, discussing price points ranging from $50 to $100 without any discussion of the actual costs involved in procurement. This is a discussion that should, at the very least, raise questions for Planned Parenthood supporters about how the organization handles these types of situations.

Earlier this month, Kliff watched all the unedited CMP videos available at the time. She found that yes, CMP had cut the footage to make Planned Parenthood look bad. For example, the shorter versions omit the moment when a CMP activist urged Nucatola to order wine with her lunch. And it’s clear that CMP representatives were driving the conversations about money. Still, Kliff writes,

There are also moments that should give supporters of the women’s health provider pause—moments when officials with the group seem to haggle over fetal tissue compensation and appear to make women’s health a secondary priority.

These are moments that do not appear any less troublesome when watched in the full video. They are not simply a product of biased editing—and, if anything, the biased editing is making them too easy for Planned Parenthood’s supporters to ignore.

That’s exactly right. The James O’Keefe school of undercover activism is not something I endorse. But that doesn’t mean that CMP’s videos don’t contain deeply troubling information about the way some Planned Parenthood affiliates seem to operate. That information cannot be waved away by claiming that “anti-abortion minions want to bully us into silence,” as a now-deleted Planned Parenthood tweet claimed. Telling a patient her abortion procedure will not be changed in order to obtain fetal tissue—a process that is “reimbursed” at rates significant enough to constitute a “revenue stream”—and then turning around and violating that promise is not only egregiously unethical, it is also illegal. These are serious charges. Serious enough for Sen. Tim Kaine (D-Va.) to say that “certainly…[the] sale of fetal tissue issue in that way post-abortion would be highly troubling and it ought to be looked at.” “You have my commitment,” he continued, “that it will be gotten to the bottom of.” His rating from NARAL Pro-Choice America? 100 percent.

UPDATE: Planned Parenthood commissioned a forensic study of CMP's allegedly full videos and transcripts. Turns out the "full videos" available on CMP's website are anything but. The transcripts were edited too. From the report:

Many CMP transcripts also alter their operatives’ dialog so as to make it seem less like they are baiting Planned Parenthood staff into making unethical statements. For example, in the Colorado transcript, CMP portrays its staff as consistently asking about specimens of a different gestational age than they actually request in the videos. 

And:

At other points, the CMP transcript of the Texas video appears to omit dialog totaling over 4,000 words. In this segment, apparent in the independent transcript and the video, Farrell asserts that Planned Parenthood will not collect tissue from minors or incarcerated people. Also in this segment, “Susan” asks if Biomax can offer participation bonuses to doctors, and Ferrell responds, “no way.” Whereas the content that CMP inserts into its transcript serves to portray Ferrell as flexible regarding Planned Parenthood policies and regulations, the content it omits portrays her as committed to following ethical and legal guidelines.

The numerous errors, discrepancies, and omissions in the CMP transcripts render them useless as “evidence.” They also cannot be relied upon in official inquiries as a credible text record of what is said in the videos. 

The study found no evidence that CMP inserted dialogue into the videos, nor did it find evidence of audio manipulation--although experts did find that CMP tampered with the transcript, in part by including dialogue that is inaudible.*

According to CMP, the missing material was of little consequence: bathroom breaks and waiting around. But Sarah Kliff isn't buying it, in part because the "full videos" contain lots of other inconsequential moments (asking for directions, etc.), and neither am I. These revelations don't necessarily let Planned Parenthood off the hook. They don't mean that CMP didn't catch Planned Parenthood staff members describing ways in which their physicians could alter abortion procedures in order to obtain fetal tissue. And they don't erase the fact that one of them talked about tissue-donation programs as a "revenue stream" for the organization. Still, they do underline CMP's problem with honesty. CMP lied to get access to Planned Parenthood staff. And now it appears that they have deceived the public by falsely claiming the longer versions of their videos, along with their transcripts, were unedited. If CMP wants to be taken more seriously, the group must release the full, unedited videos, along with independently produced transcripts.

* This sentence has been corrected. The original version erroneously claimed the report found no evidence of transcript tampering. In fact the study did find that CMP altered the transcripts by including some dialogue the report deemed inaudible.

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Grant Gallicho is an associate editor of Commonweal. You can follow him on Facebook and Twitter.

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