Diane speaks with Dr. Roger Kligler who is living with advanced stage cancer on why he's suing the state of Massachusetts for the 'Right to Die' and with Dr. Jessica Zitter, and intensive care and palliative care specialist on why better communication is so needed between doctors and patients facing end-of-life issues.
Guest Host: Frank Sesno
The latest in a series of secretly-recorded videos attacking Planned Parenthood was released Thursday. The videos appear to depict executives of the organization discussing the sale of fetal tissue, and make use of graphic footage. The group that created the videos says Planned Parenthood is illegally selling fetal tissue for a profit, a claim Planned Parenthood vehemently denies. The videos have set off a new wave of furor among anti-abortion activists, many of whom protested at the Capitol in Washington, D.C., this week, while Republican lawmakers are making a new push to cut government funding for the organization. But this latest debate over Planned Parenthood has galvanized supporters, too, many defending the use of fetal tissue in medical research. We look at the latest chapter in the fight against Planned Parenthood and abortion rights in America.
- Dawn Laguens executive vice president, Planned Parenthood Action Fund
- Louise Radnofsky health policy reporter, The Wall Street Journal
- Mallory Quigley president, Susan B. Anthony List
- Terry O'Neill president, National Organization for Women
- Arthur Caplan director of the division of medical ethics, New York University Langone Medical Center
MR. FRANK SESNOThanks for joining us. I'm Frank Sesno of the George Washington University and Planet Forward sitting in for Diane Rehm who is on vacation. A series of videos produced by the group, The Center For Medical Progress, have put Planned Parenthood front and center in the news in recent weeks. At issue is the organization's handling and sale of fetal tissue and I should tell you that the latest video has been released just this morning.
MR. FRANK SESNOThe videos have energized groups on both sides of the issue, have shown a spotlight on what's done with fetal tissue after an abortion. Here with me to discuss the situation is Louise Radnofsky of The Wall Street Journal, Terry O'Neill of The National Organization For Women. Joining us by phone is Marjorie Dannenfelser of The Susan B. Anthony List which says it works to elect candidates and pursue policies that will reduce and ultimately end abortion.
MR. FRANK SESNOFirst, on the line, from her office in Washington, D.C. is Dawn Laguens. She's executive vice president of the Planned Parenthood Action Fund. Thanks for joining us, Dawn.
MS. DAWN LAGUENSHi, Frank. Good morning and I just want to jump right in and say, the word "sale" is just completely inaccurate. We have a small fetal tissue donation program at Planned Parenthood in some states and to use that word is just to really bias this in a way that is not fair and not actually what takes place. And people know that Planned Parenthood, for 99 years, has been the nation's leading reproductive care organization seeing 2.5 million people every year for cancer screenings, breast exams, birth control, abortion, STD testing, a wide range of services and that's why they know that these claims are the manipulative fabrications of extreme anti-abortion opponents.
SESNOOkay. Well, I will come back and we'll talk about -- with you and with the panel the use of fetal tissue and what the right terminology and what the right intent of the whole thing is. But let me start by asking you about these videos themselves, specifically some of the concerns that have been expressed, even by your allies. I mean, Hillary Clinton said she found them disturbing even though she had plenty of nice things to say about Planned Parenthood in the process.
SESNOHarry Reid says this should be looked into. Tim Kane called it very troubling. So lots of folks who are typically your allies are concerned by what they have seen. What is your response to them?
LAGUENSWell, one, Hillary Clinton and all of those folks have been extremely supportive and have completely said that they do not believe that Planned Parenthood is doing something wrong.
SESNONo, but what they said is, what they found...
LAGUENSAnybody who would watch a very...
SESNOIf I may just -- but what they found disturbing was the content of these videos.
LAGUENSWell, people are definitely not used to having people basically break in using phony identities and phony companies to go tape people's private medical procedures and those things can be disturbing to see. But what is really disturbing is the way that these videos are edited, just like all the other videos these anti-abortion extremists have put out in the past for decades and for years in attacking Planned Parenthood and safe, legal abortion.
LAGUENSAnd what they do is try to create a disturbing picture that is inaccurate.
SESNOIs there anything that you have seen in these videos that you consider to be a disturbing picture, besides the tactics and the way the videos -- I'm talking about the content of the videos themselves?
LAGUENSWhat you see in these videos are doctors talking about safe, legal abortion procedures and completely following the law. Now, we have said that some of the settings and conversations we don't think were appropriate for where they took place, but these are committed physicians who work hard every day to serve women and men in this country and what we are seeing is the disturbing tactics of a militant group that wants to get rid of safe, legal abortion in this country and will do anything to do that.
SESNODawn, we'll be joined in a few minutes on this program and this discussion by medical ethicist, Arthur Caplan. In a recent piece, he wrote, and I'm quoting here, "there's reason for concern in what is said on these edited videos about what might be going on, but the concerns can and should be examined." Then he says, "Planned Parenthood does have something to think about, such as does it want to continue to be involved with fetal tissue donation?" Do you?
LAGUENSWe do. As I mentioned, this is a very small program in two or three states where we are able to make tissue donation, which many people ask for, many women ask for tissue donation as something that is comforting to them during the abortion procedure and process. And what we did yesterday, I don't know if you seen this, Frank, is Cecile Richards, the president of Planned Parenthood, sent a letter to the director of the National Institutes of Health, Francis Collins, actually asking for a review of this whole question around fetal tissue research.
LAGUENSThe last time that this was ever looked at was in 1988 during the Reagan administration and during that time, a bipartisan panel of people, including Mitch McConnell, Fred Upton, many Republicans agreed that this was a good thing to do. It is an active area of research for NIH and many leading institutions. And so we've said if there's an issue with that larger context or frame, we are happy to participate in that. But we follow that law -- beyond that law and so, again, we welcome a reasonable, medically-based conversation about this, but the political circus of defunding and shutting down the government is, to me, shows exactly what the purpose is.
SESNODawn, let me ask you -- and we're almost out of time so let me ask it briefly and ask you to respond briefly. How does Planned Parenthood use fetal tissue and is this something you're going to continue? I think you indicated yes, but give a brief explanation, if you would, as to what you do with this.
LAGUENSAgain, what happens in a fetal tissue donation program is that a woman decides that this is something that she would like to do, to donate tissue in a nonprofit capacity to research institutions that then do important research around Alzheimer's, around Parkinson's, ALS, miscarriage and many other things. And, again, I think the last I looked, NIH was sponsoring some 150 or more fetal tissue research programs that were endorsed, again, by a bipartisan group that set out the whole range of laws that govern this area and which Planned Parenthood follows.
SESNOOkay. Dawn Laguens, thank you very, very much for your time. You're executive vice president for Planned Parenthood Action Fund. Appreciate you joining us.
SESNOAll right. So let's turn to the room here and get some more comment on all of this. Louise Radnofsky of The Wall Street Journal, turning to you. What is your response to what you've heard? We've seen attacks on Planned Parenthood before. How does this differ?
MS. LOUISE RADNOFSKYWell, first of all, it's different because we're talking about fetal tissue donation again for the first time in a couple of decades. That's an issue that really had been under the radar and some younger activists, some of whom were in middle school the last time it was being debated, chose to put it at the forefront again in videos that I think, at this point, probably folks on all sides would agree have been remarkable effective in kickstarting a discussion that's lasted longer than previous discussions around this, whether or not they agree with the tone and the content of the discussions coming forward.
SESNOHow about the videos?
RADNOFSKYThe videos are interesting and a new shift for the anti-abortion movement in that they have rallied folks who have previously disagreed over the use of graphic images, around images that fall somewhere between the graphic poster boards the people might be familiar with from, for example, the '90s outside clinics and the sort of softer, more social media-friendly approach. This really...
SESNOMore social media-friendly because they can be transmitted and because they are viral and they...
RADNOFSKYI mean, because they can be transmitted -- because the content allows them to be transmitted in a way that perhaps those posters might not have been able to be.
SESNOMarjorie Dannenfelser, I want to ask you -- from the Susan B. Anthony List -- how is this campaign different from past campaigns from your perspective, from the anti-abortion perspective?
MS. MARJORIE DANNENFELSERWell, it is certainly different, but it is not about a messaging tactic. I would say that. I mean, there is certainly a difference between showing visual images of an aborted child and actually going in and the message coming from the mouth of the procurer of the aborted child and the person who is going to be selling it to somebody else or -- and so the change is instead of trying to push this ball uphill, instead of trying to push out a message that perhaps people aren't willing to -- aren't happy to look at or embrace, let's just hear what they themselves, the purveyors of abortion want to say.
MS. MARJORIE DANNENFELSERAnd the question about why it's disturbing, why Hillary Clinton would find it disturbing, it's the same reason why the women in the House and the Senate who are leading the charge against the defunding Planned Parenthood find it disturbing. It is not because it's a tactic so the people going into the clinic. It's because of the words going out of the -- coming out of the mouth...
SESNOLet me ask about that, though. I mean, are you disturbed by the fact that these videos have been so heavily edited? Because I can edit anything and make something sound disturbing and they are heavily edited. So does that, in any way, from your perspective, raise some questions about, you know, what exactly the public is seeing?
DANNENFELSERWell, the good news is, every single minute of the footage is also put out at the same time as the edited version. But I would ask you, again, to listen to -- and anyone who is interested in this topic, to actually listen to an unedited stream of words that are connected to an idea coming out of the mouths of the top executives of Planned Parenthood. They are saying, we will alter the method of the abortion, illegal, do -- in order to crush certain parts of the child so that we get intact heart, lungs and thymus.
DANNENFELSERThey say that out loud. Nobody made them say it. Nobody sliced and diced a sentence that said that. They say they do it. And then, when discussing profit or discussing how much money is going to be involved here, if there is a certainty of no profit being made, you know the answer to that question. That is not a trick question.
SESNOWell, you heard -- but you heard what we heard a moment ago from Dawn Laguens that this is not for profit, that, you know, there are costs that need to be covered, but they are not selling body parts of tissue. They are making a donation. We're going to take a quick break. We'll come back to all of our panelists and bring in Terry O'Neill from the National Organization For Women. You're listening to "The Diane Rehm Show."
SESNOAnd welcome back to "The Diane Rehm Show." I'm Frank Sesno sitting in for Diane today. We're talking about the controversy over these videos that have been released regarding Planned Parenthood and their use of fetal tissue. Joining us for the discussion today is Louise Radnofsky, she's a health policy reporter for The Wall Street Journal, Terry O'Neill, who's president of the National Organization for Women, Marjorie Dannenfelser, who's president of the Susan B. Anthony List, and Arthur Caplan, director of the division of medical ethics at the New York University Langone Medical Center.
SESNOTerry O'Neill, to you, what's the response -- your response to what's going on, these videos that have been released and the controversy that it has ignited or reignited.
MS. TERRY O'NEILLSo, first of all, I have nothing but admiration and pride in Planned Parenthood. Planned Parenthood has done nothing wrong. And I strongly disagree with Hillary Clinton and the other elected officials who have said that they find something in the video disturbing. I will say that when I emerged from the Capitol South Metro station on Tuesday morning and saw big posters of bloody fetuses, I found that disgusting and disturbing. So to the degree that these videos are, as Louise said, trying to amplify through social media disgusting and disturbing images of bloody fetuses, of course that's horrible.
O'NEILLBut that's not Planned Parenthood's doing, that's the doing of the Operation Rescue-linked shadowy group calling itself the CMP. I can't remember what it stands for.
SESNOIsn't it disturbing though to hear someone from any organization -- what could be taken for haggling over body parts?
O'NEILLNo. That is not what they were doing, I don't think. I have seen the edited version. I have not forced myself to watch through all those hours. I actually have a lot of other things to do with my day. But, no, I don't think that's disgusting. I think that when doctors talk to doctors in a private setting that they believe is confidential, they use jargon, they use shortcuts. It's not -- it's not something that the public needs to be listening to or should be listening to. I'm a lawyer. Same things happen in conference rooms when lawyers are talking about this, that and the other for a deal that you want to put together or a settlement you want to put together. The public really should not be listening to it and doesn't need to.
SESNOWell, let me turn to a doctor and ask him about that, because Arthur Caplan is on the line with us and I appreciate your time. What is your response to that?
MR. ARTHUR CAPLANJust to correct, he's just a humble ethicist, not a...
SESNOOkay. I'm sorry. I promoted you or demoted you then, I guess.
CAPLANSideways, something. So I did find things on the tape excerpts disturbing. It almost goes without saying that it's edited to make it disturbing. I would absolutely concede that. But even though I have no doubt that Planned Parenthood is not trying to profit from making fetal tissue available to researchers, I think what they need is a fee schedule that's fixed. You shouldn't be haggling. I've been writing about the ethics of fetal-tissue procurement for about, oh, 25 years now. A fundamental principle is you don't do anything that makes it look like you're trying to set prices at the max, even if it's just processing fees. Have a schedule, stick to it and don't vary. Don't hint that you're going to change the abortion technique.
CAPLANWhen you see it on the tape, even if it's not happening in the clinics -- and we certainly don't know that it is, this was just, as was said, conversation in a restaurant -- but you don't want to give any suggestion that you would ever do anything other than get the abortion done in a safe way, women's health being the primary focus and whatever happens afterwards with fetal remains happens. But you don't modify the technique or suggest that you would do it in a different way for any reason having to do with fetal-tissue procurement.
SESNOLet me go back to Terry O'Neill from -- because I know you want to jump in. Before you do, though, I do want to remind our audience that if you want to join our conversation, we'll be opening the lines to your calls in a few minutes at 1-800-433-8850. Or you can email us at email@example.com. Terry O'Neill.
O'NEILLWell, I love that the conversation could be about fetal-tissue donation and the fetal-tissue donation program that was authorized by the United States Congress some time ago, that was voted for by Mitch McConnell and strongly supported by Mitch McConnell, none other than. The problem is that the shadowy, secretive, dishonest people who are promoting these videos have no intention of talking about the fetal-tissue donation program. They have no intention of talking about, as Art says, the ethical issues should be a fixed fee schedule and so forth. What they are trying to do is stop almost 3 million women from accessing Planned Parenthood services every year.
SESNOMarjorie Dannenfelser, you want to talk about the ethics around fetal tissue and fetal-tissue research?
DANNENFELSERYes. When this debate occurred, there were two major items that had to be, quote, "dispensed with," which Henry Waxman did a good job of crafting legislation that purported to dispense with, it was the -- it was, there were two things. One, you do not change the procedure in order to get intact body parts from the child. That had -- that was put in the bill. The other was that you may not profit. We were concerned at the time that there would be abortionists that would not follow that, that they would -- without a lot of scrutiny, which Planned Parenthood doesn't have -- that they would be in violation of that.
DANNENFELSERAnd these videos -- you can talk about the messenger and you can talk about their intent but when you look at a clinician holding a, you know, pointing out a body part on a pie tray and saying how much money that would be and that, you know, maybe one part -- because the brain, the neuro-tissue is so important, that this would cost a little bit more than the other and that there's a lack of clarity in that person's mind about how much it would cost. Well, you're right.
SESNOLet me -- let me ask -- let me ask...
DANNENFELSERThere is -- there's no way that -- there's no way to ensure that there's no profit. But the most important thing here still -- and everybody else has gotten a whole lot of time about this -- is that Planned Parenthood clearly has not been able to be trusted: Number one, to obey the law. And number two, to actually look out for the best interests of women.
SESNOWell, let me ask Louise Radnofsky, because you, as health policy reporter for The Wall Street Journal, you've been covering this story. What degree of scrutiny is there -- this is an issue that Marjorie just raised -- on Planned Parenthood and these transactions?
RADNOFSKYWell, there's not a great degree of scrutiny over fetal-tissue donation in general, and that's a point that Art Caplan, I think, made as well. Just to clarify, because I think this might be helpful context for folks, it is illegal to profit from the sale of tissue. It is legal to charge reasonable expenses, for example, you know, wet ice or FedEx expenses. And...
RADNOFSKYI believe so. But the sort of amount of money that would qualify for that is unclear. Hence, the call for a fee schedule there. The amount of money that has appeared so far on the Planned Parenthood videos ranges from $30 to $100. It's easy to see how folks, if they started adding that up, per specimen, could reach a big total. But it's also easy to see how that could be a reasonable expense. And so the question really is, that there's not a lot of scrutiny over this and whether there will be in the future.
SESNOArt Caplan, you recently wrote a commentary, "Planned Parenthood's Awkward Clash," you called it. And you're -- and you start the piece by writing the following: "Planned Parenthood finds itself under attack by anti-abortion activists. Not much new about that. But the terrain of the battle has shifted." What terrain has shifted?
CAPLANWell, Planned Parenthood has always been under attack for providing abortion services. The terrain shifted when this sting operation was conceived and carried out to get people wondering: are they really profiting, as the critics say, from the sale of baby parts? Again, we don't have any reason to think that's so. Fees charged for processing is not sale. In fact, there are groups that may be profiting. It's the middlemen -- the very people these folks pretended to represent -- brokers in fetal tissue. Once they get the tissue from Planned Parenthood, their markups are pretty remarkable. And that has not been the subject of as much scrutiny because those folks don't do abortion.
CAPLANSo, look, there's no doubt the ultimate end-game here is to stop funding Planned Parenthood or make Planned Parenthood go away because many people, some people don't like their doing abortions. Improving the ethics of fetal-tissue procurement, which I've tried to do for many, many years now, I don't think is going to satisfy the critics.
SESNOAll right. Let me go to an email from Pat, who writes from Oakland Park, Fla. And you mentioned, Art, just now, the defunding. And I'd like to ask both Marjorie and Terry to respond to this. Pat writes the following: "If Planned Parenthood is defunded, then birth control will not be distributed to low-income women, resulting in more pregnancies among a demographic that cannot afford them. In turn, this will result in more abortions. The anti-abortionists will actually increase the number of abortions in this country." Marjorie?
DANNENFELSERIf defunding actually is successful, that money will go to organizations that have integrity, that actually understand and obey the law, that care more about women's health, and that don't provide abortion services. Because this organization has proved that it is the profit motive that has kept abortion alive in its own industry. It is the -- taxpayers pay for a third of their budget. They do more than a third of the abortions in this country. They claim to be the primary provider of pregnancy care. Ninety-four percent of their pregnancy care is abortion. This is an abortion industry. And they can't survive without abortion.
DANNENFELSERSo we would suggest -- and I -- and it's not just "we," it is a legitimate decision that they should make -- is to separate their selves from abortion, only do contraception services and all the other services that are actually good for women. And then this debate will go away.
SESNOAll right. Let me -- I'm not sure the debate will ever go away but I understand your point. Terry?
O'NEILLRight. So the reason that Planned Parenthood is being attacked is because it is the largest provider of reproductive health care services for people in this country. In fact, by one estimate, one in five women in the United States has actually utilized Planned Parenthood's services over the long history of this organization. I think they've been around for 99 years. The reason that they are the largest is that they provide excellent medical care. Three percent of the work that they do is abortion care. One in three women will have an abortion by the age of 45. Abortion is a common and necessary aspect of...
SESNOOne in three women?
O'NEILLOne in three women, by the age of 45. It's common. It's necessary. It is not something that we need to be ashamed of. And it is something that we do need to have full funding for. The claim that we can somehow replace Planned Parenthood overnight -- you shut down all the Planned Parenthood's clinics and that they could be replaced overnight, is silly and specious. They serve 2.7 million women and men and young people every year. You can't scale up to that in anything like a short period of time. And Planned Parenthood has the expertise and the compassion and the caring for their patients. And in fact, Planned Parenthood has worked hard not to be political.
O'NEILLMy organization, the National Organization for Women, we do the political stuff. They provide care.
SESNOArt, let me direct a question to you that we also got via email from Marie, who writes the following: "Please point out that hospitals and other clinics also utilize this practice, fetal-tissue donation. If you're defunding Planned Parenthood, " she writes, "for fetal-tissue donations, shouldn't all hospitals that do the same thing be defunded from any government monies and all services as they want to do for Planned Parenthood?"
CAPLANThat's a great question. There are some tissues that come from hospitals that still do provide abortion services. So I guess Congress might look and say, "Hey, you're getting federal grants or you get tax subsidies of a certain sort. We're going to defund you if you don't stop doing this." It's a battle that I don't think we want to provoke. I think it raises a separate issue. Fetal tissue is important for research. It's not hugely, hugely important, because stem-cell research has taken its place. It was bigger in the early '90s than it is today. Now we have embryonic stem-cell research, adult stem-cell research, other forms of stem cells.
SESNOSo you're saying we don't need it?
CAPLANSo the question is, could we get the supply that's needed for fetal research -- which is basically done to benefit fetuses, ironically -- we might import that tissue from other places, China, Britain, Sweden.
SESNOOkay. Louise Radnofsky, let me turn to you before we go to break and then come out to phone calls. Can you break out for us, as the journalist in the group here, how funding for Planned Parenthood actually works and whether the government -- federal funding -- is actually supporting abortions?
RADNOFSKYSure. So there are long-standing federal restrictions on any federal funds funding abortion in most circumstances. Planned Parenthood received around $528.4 million in the 2013 through '14 year, according to its own annual report. The lion's share of that probably was for Medicaid, in which the federal government and the states jointly fund the program and it's, under federal law, difficult but not impossible -- if this bill, for example, in the Senate were to pass -- to bar states or anybody else from kicking out certain providers unless they've committed fraud. There's also a separate stream of money for family planning -- it's Title X -- in which Planned Parenthood affiliates are certainly a significant participant.
RADNOFSKYThey look after about 37 percent of the women in that program, although they're only 13 percent of the affiliates. And then Planned Parenthood centers in various parts of the country also received grants under the Affordable Care Act to help with enrollment work. Those are the three big areas.
SESNOFederal monies for abortion?
RADNOFSKYBut not federal money for abortion.
SESNOAnd how is that walled off?
RADNOFSKYSo the -- Planned Parenthood is required to wall it off. But the funds are for specific services. For example, enrollment under the ACA providing contraception.
SESNOI'm Frank Sesno and you're listening to "The Diane Rehm Show." And our conversation today is the controversy surrounding these released videos and fetal tissue, with Planned Parenthood in the middle of it all. Louis Radnofsky joins us. She's the health policy reporter for The Wall Street Journal. Terry O'Neill, the president of the National Organization for Women. Marjorie Dannenfelser joins us by telephone, president of the Susan B. Anthony List. And on the phone, Arthur Caplan, director of the division of medical ethics at the New York University Langone Medical Center.
SESNOI'm going to go to the phones in just a minute. But, Louise, you've been covering this and related stories for a long time. The question is -- this coming in a political season, as it is -- will this have a different or an outsized effect or is it more of the same?
RADNOFSKYCertainly this has already hit in the Republican primary and been an issue that Hillary Clinton, as well, has had to address. This fight more squarely falls into the 2016 cycle than the last fight that began in 2011, hit in 2012. Of course, what Planned Parenthood has pointed out is that they were able to use attacks on it extremely effectively, and I say disagree a little with Terry here, in quite a political way in the 2012 election cycle, Democratic candidates felt like they benefited from it that time. The case this time -- the question this time is whether they will in the 2016 cycle or whether the videos have changed the conversation.
SESNOAnd? And? Well, have they?
RADNOFSKYCertainly, so far, the videos appear to have changed the conversation...
RADNOFSKY...because they are different. Because they are being perceived differently.
SESNOAll right. Let me go to the phones and invite Pat into the conversation. Pat, you join us from Fort Myers, Fla., I believe. Is that right?
PATYes. Yes, I do.
SESNOThank you so much -- thanks for your patience. Go ahead with your question.
PATMy question is, I am not against abortion. It's a woman's choice and I think Planned Parenthood does a very good job. But I hate fetal tissue. I hate that. It dehumanizes -- it just dehumanizes things. There has to be a better way to talk about it. And also, to the person who said that we don't have the right to hear conversations. If it's tax money that's keeping it alive, I have the right to know everything that's going on. That's it.
SESNOInteresting. Interesting point. Okay, Louise, let me let you respond to that.
RADNOFSKYWell, as a journalist, I certainly feel very strongly that I have a right to hear a lot of things that are going on that are funded with federal tax dollars that sometimes federal officials disagree with me over. But I certainly -- I sympathize with the sentiment.
O'NEILLYeah. I just don't know how you can have -- people need to be able to do their work in some sort of reasonable expectation of privacy. Certainly journalists need to be able to talk to doctors and providers.
SESNOArt, how do you feel about it? You're an ethicist here. Should this be done in private or is this something that, if a transaction is going to take place, the public should know what that transaction is?
CAPLANWell, I'm a big believer in knowing publicly what's going on. So I think transparency is important. It's sometimes grim, it's sometimes awful. Look, in organ donation -- the cousin to fetal-tissue donation -- we get organs from children who were beaten to death by their parents, suicides, murders, all kinds of horrible, horrible circumstances. It's not easy to look at. But I think we have to understand it. The worse situation is to have something come out after the fact and look accusatory. No, I think transparency, it's got to be there.
SESNOMarjorie, do you feel this is fundamentally changing the conversation?
DANNENFELSERYes, it is. I think the speed and intensity with which Republican candidates came out in outrage, governors have come out and said exactly, "Yes, there needs to be transparency. We will investigate." Chairmen of committees of the House...
SESNOAll right. We're going to take a quick break. You're listening to "The Diane Rehm Show." We'll rejoin our conversation in just a moment.
SESNOWelcome back to "The Diane Rehm Show." I'm Frank Sesno sitting in for Diane today. Our discussion, Planned Parenthood and the debate, the controversy around fetal tissue in these recently released videos. The most recent released just this morning. Our conversation includes Louise Radnofsky, health policy reporter for The Wall Street Journal, Terry O'Neill, president of the National Organization for Women, Marjorie Dannenfelser, president of Susan B. Anthony List, and Arthur Caplan, director of the Division of Medical Ethics at the New York University Langone Medical Center.
SESNOAnd I want to go back to your calls. You can join the conversation at 1-800-433-8850. You can send us an email at firstname.lastname@example.org. We have on the line Rachel who joins us from Baltimore, Md. Hi, Rachel.
RACHELHi, thanks so much for taking my call. I have a question. It's kind of a comment. So I keep hearing people, you know, depending on which side of the argument you're listening to, as I'm trying to kind of decide what side I'm falling on. You hear people calling it tissue. You got people calling it, you know, brains, hearts. I don't mean to be disgusting and parse words, but I do feel like in calling it, quote, "tissue," it's a very sterilized kind of attitude about it. And I find that sometimes when I'm seeing things coming from, you know, the Planned Parenthood side of the argument, there's an effort to really kind of like make it seem less, I mean, I don't know, disgusting. Or...
RACHEL...I need to kind of sterilize the whole issue. And in an effort to, you know -- are we talking about completely intact body parts? Are we talking about the cells? I know that maybe to some people that's just semantics, but it doesn't sit the same way, depending on how you look at it.
SESNOLet me turn to Art on this one, because Art you have been working and writing on this for a very long time. So with the degree of dispassion that you bring to the conversation, what are we talking about here?
CAPLANTalking about cells and talking about small organs. There is an interest sometimes in having an intact kidney or other organ. People are interested in fetal development, how do organs come about, so to speak. There are definitely people interested in cells because they want to know kind of...
SESNOI've read about that eyes are also useful in looking at...
CAPLANOh, yes, right. So you have both cells and organs. They're both used in research. I'll say again, I checked this, there were about 170 papers published over the past two years involving fetal tissue or fetal organs. That may sound like a lot, but it isn't. It's a relatively small area of work. The parts, the remains that are used are basically used to understand fetal diseases, fetal development.
SESNOYou know, we were talking earlier when we were in the break about something that's kind of a related conversation in IC that we've got a note from someone in Virginia who asks, "Compare the donation of fetal tissue to the donation of body parts on my driver's license." And, Art, let me stay with you on this just a moment, because I'm an organ donor on my driver's license. And I wonder whether the conversation about what would happen to my organs would -- and maybe I'm just deceased, I may not even be dead yet actually, might not be, if my wife heard that, deeply, deeply disturbing because they're talking about carving me up for things that I've given permission for.
SESNOSo is it language? Is it that this is an unborn fetus? Is it just that we don't talk about this normally and so it's so disturbing when we hear about it in such graphic terms?
CAPLANWell, I think you could keep going there. I think that list is somewhat comprehensive. I don't think people like to make that connection between fetal remains and fetuses, and sort of developing human bodies, that is unnerving to many, and we'd prefer to look at that. I think at the same time organ donation has, as I said earlier, many of the same tough emotional issues. As I said, I've been present when we're trying to get permission to obtain scarce pediatric hearts from someone we think might've battered their own baby to death. It can be just an unbelievable set of moral compromises.
CAPLANBut I think, Frank, the key difference you're pointing to is this, organ donation from the dead is governed by the federal government. There's a system to do it, agencies licensed to do it. Fetal tissue like other tissues is governed by states. Bone, whatever the material is, skin, cornea, fetal tissue, it is really much less regulated, much less oversight. It tends to be a state issue. And believe me, it is just an accident of history, how the two (unintelligible).
SESNOAnd it's murkier. It's much murkier.
CAPLANIt's much murkier.
SESNOBecause obviously for my own organ donation, I have consented, and that is a fundamental difference. In the case...
SESNO...of the fetus, it's the mother who's consented.
CAPLANAnd the women -- and the women consent, too...
CAPLAN...to fetal tissue donation. Let's not, you know, get away from that. But, again, whether someone comes and examines the companies that are brokers and so on, that tends not to happen much because that area's not well regulated.
SESNOYeah, let's go back to the phones. Mike's been waiting patiently from Florida. Hi, Mike.
MIKEHow are you?
SESNOVery well. Thanks for calling.
MIKEThank you for having me on the phone. Two things, one is there seems to be kind of like an elephant in the room that both sides, and when I say both sides, I'm talking about the Planned Parenthood and then the approach -- or antiabortion group. They're absolutists. And I think -- and the woman from Wall Street Journal could probably back me up on this, I think that the vast majority of Americans are prochoice up to a certain part of the pregnancy, and then they become prolife or antiabortion after it reaches a certain point.
MIKEI know there's gray area in there, but how does that figure into what we're discussing here with the feel -- I mean, was it like at 20 weeks, 16 weeks, 24 weeks? Was the fetus feeling pain? I don't know. But every side thinks the other one's radical because, like the Planned Parenthood, one woman said that they're radical, want to eliminate abortion, and the other people are kind of like middle of the road, kind of feel like they are okay with late term abortion. And a lot of people in the middle of the road think that's extremist.
SESNOOkay. Well, let me let...
MIKE(unintelligible) thank you.
SESNOSure. Thank you for your question. It's a good one. Louise.
RADNOFSKYI think the most helpful way of thinking about the state of American public opinion on abortion is that there's a minority, depending on how you ask the question, around 20 percent who believe abortion should be legal in almost all circumstances. And there's a similarly sized, slightly smaller minority who believe abortion should be illegal in almost all or all circumstances.
RADNOFSKYAnd in the middle you have a group of people who generally believe abortion should be legal in at least some circumstances, but have the potential very quickly to change their mind if they're presented with an issue like abortion later in pregnancy where they believe that that's a circumstance that should be illegal, but then have the potential to change their mind back if they're thinking about cases of rape or incest. And so really the battle over abortion in America is for that middle group of people. And this is the kind of issue that's hitting them squarely right now.
SESNOMike asked about whether there's an awful lot of gray in the middle nuance, and whether the conversation isn't absolutist. Marjorie, are you an absolutist?
DANNENFELSERWell, I think he gave a very reasonable assessment. I think he did the best job so far I've seen in a long time of assessing what -- really where America is. I think he's right about that. I think that...
SESNOAre you an absolutist?
DANNENFELSERI believe in life from conception. But let me just -- please let me make one point. And that is that the most salient piece of legislation that is moving now in the country addresses that very area that Louise and he just spoke to, and that is the five month pain-capable bill that passed the House. It will be brought up in the Senate next month. It's passed in 14 states so far. It's the same dynamics and the same conversation and same focus as to the partial birth abortion ban was. And I predict that will be the next thing. Right now there is no limit until the end...
DANNENFELSER...on the federal level.
SESNOThank you. Fair is fair. Terry, are you an absolutist?
O'NEILLSure. I think that's something that I share with Marjorie. She is an absolutist, and so am I. I like Marjorie, and we've had these conversations before. Look, the 20-week abortion ban...
SESNOBut isn't -- I don't mean to interrupt, but I'm going to, because isn't -- I mean, the question -- Mike's question was, is the debate somehow distorted by absolutists on both sides? And as Louise was pointing out, so much of public opinion resides in the middle. But when the debate is driven by the absolutists, it becomes extreme, it becomes harsh, and it becomes difficult to find that middle ground and that nuance.
O'NEILLI think the politicized part of the debate has to do with women's autonomy, women's self-regulation, and whether we trust women to make decisions for their own health care including decisions to terminate a pregnancy or to continue it. The vast majority of people actually believe in Roe v. Wade as it was changed by Planned Parenthood v. Casey. In other words, they believe that viability is the cutoff. Viability of course as we know happens at about 24 to 25 to 26 weeks last menstrual period. The 20-week abortion ban would criminalize abortions well before viability. And when people understand that 20 weeks is well before viability, they are overwhelmingly opposed to the 20-week ban.
SESNOAll right. Back to the phones, and now Paula from Washington, D.C. Hi, Paula.
PAULAHi. I'm a professor of social movements and communication. And I have been a prochoice fighter for, I guess, now almost 30 years. And I listen to this and I see the current moment of manipulative language, I hate to say that, but I'm concerned about where we're headed. I would ask that both sides remember that one -- according to Goodlocker (sp?), one-third of abortions occur at six weeks of pregnancy or earlier. 89 percent occur in the first 12 weeks.
PAULAThat means that at seven weeks the fetus is the size of a blueberry. And that's important to remember as we think about it. And my interpretation and understanding as we look at this issue, we all interpret the facts unfortunately today, especially my students, and it's important to remember to stay with the facts. And I would ask the -- well, Terry O'Neill at least to address the issue of the "Silent Scream" and how that particular film was -- oh, I'm sorry, did I say the wrong thing?
SESNONo, no. Finish and then I'm gonna take the question.
PAULAWell, both. Just to suggest that -- thank you. Thank you. But just the idea that a similar tactic was used over 20 years ago with the "Silent Scream," and it was suggested that it was manipulated. And you had used that language earlier to describe the current video. So I know it's a difficult issue, and I thank you for having the opportunity to talk about it this morning. And I appreciate your panel's points of view.
SESNOThank you. And I appreciate your call very much. Louise, before I come and we go to the "Silent Scream," and I'd like to spend very little time on that because we're so much in the present and looking to the future. But, Louise, these issues of language, inflammatory issues, images, how do you as a journalist incorporate this into your reporting? Because there are standards that you use to convey these stories.
RADNOFSKYThere are, and we work very hard to make sure that we reflect the issues in a way that I think both sides can believe are fair and often of people with good faith on both sides have reasonable disagreements with it, but we're trying.
O'NEILLSure. I think that, as I said, the political part is really about women's autonomy. The health care part is really about women and their families. And I think that because abortion is simply a normal part of women's reproductive health care services, those decisions on terminating a pregnancy, you get a virus, you know that the pregnancy is going to make you very, very sick, and your husband is telling you you've got to turn terminate this pregnancy, I care about you, and you're torn.
O'NEILLI mean, I've seen this happen with women that I know. These are health care decisions that women have to make with the people that they love best. It is clearly not the role of my organization or Marjorie's or any politician to tell a woman how to make that decision when it comes.
SESNOOkay, Marjorie, let me come to you, if I can ask you to be very brief because we've got to take another break.
DANNENFELSERWell, I think the most important thing would be to look at a baby at 20 weeks who is going to be -- whose parts are going to be harvested, and then look at a baby at 20 weeks whose life -- that one is trying to save with prenatal surgery, and say, what is the moral difference between those two babies? I think it's an important thing for us to discuss. It doesn't involve extremism. It just involves the human heart. And what do we really think about protecting humanity.
SESNOOkay. Thanks. I got it.
DANNENFELSEROf course, we're all blueberries (unintelligible).
SESNOI'm going to take a -- we got to take another quick break, but we'll be back in just a moment. You're listening to "The Diane Rehm Show." And indeed we are back and I want to turn to Art Caplan for just a moment, because a number of the themes that we've heard raised here today come back to sort of this ethical terrain, this very difficult gray area. So just raised, for example, is a question of, at what point we intervene to try to save the life of a fetus and whether and how that's overlapping with that same timeframe when that pregnancy might be ended. So where do you come down on that?
CAPLANWell, I'm one of the few people that seems comfortable with Roe versus Wade. I think fetal viability is an important landmark when a fetus can live outside the mother's body, and can live. It's not suffering from a fatal disease. I think it's moral status shifts. I think in America we recognize people are dead when their brains have totally ceased to function. That may be another important landmark, that when your brain starts to really function, maybe there's a shift in your moral status there. Most people would put that around the time of Roe versus Wade. So there may be scientific confirmation.
CAPLANFrank, I was going to split our issue this way. One set of debates is how to get fetal tissue recovery done, and done in a way that people think is done properly. Separate issue is beating on Planned Parenthood because it's involved with fetal tissue recovery. I think even if we got the former done, I'm not sure the critics of Planned Parenthood would be satisfied.
SESNOSo in the few minutes remaining, and we have a number of people on the phone, and I'm going to apologize to them for not being able to get to more calls. Let me ask each of you to spin it forward. Not pay it forward, but spin it forward. Where is this going? We've had conversations about the impact it might have on public opinion, about the impact it might have on a political debate during campaign season, about the impact it might have on the actual research that uses fetal tissues. So each of you take it in your own way. I'm going to ask you to speak for about 20, 30 seconds, because that's about what we've got time for. Terry, I'm gonna let you go first.
O'NEILLWell, unfortunately I don't think we're going to have a reason to discussion and debate about the fetal tissue donation program. Clearly the opponents of Planned Parenthood have no interest in that. I think what's really unfortunate from the point of view of women's rights is that what's happening is the Republican party is making itself the enemy of women voters. They will lose millennial voters both male and female for generations. They will lose the women's vote because they are jumping on this anti-Planned Parenthood bandwagon.
O'NEILLRepublican women, independent women, and Democratic women love Planned Parenthood and trust Planned Parenthood, which has provided services for many of their daughters. So this is a bad thing for the Republican Party, and that's bad for women because we want the Republicans and the Democrats to have to compete for our vote. And increasingly the Republicans are making themselves irrelevant to women.
SESNOMarjorie, where do you see this going?
DANNENFELSERWell, this issue has touched the conscience of a nation. Women more than men support banning abortion after 20 weeks. This will affect the debate in the U.S. Senate coming up. And there will be an overwhelming majority that passes the pain-capable bill then. And most important moving forward, it will affect the general election between the Republican and the Democratic candidate. This will be an election where it will be front and center and high profile in ways that it has not been in the past.
SESNOArt, your sense of the future.
CAPLANI think Planned Parenthood has a decision. It might get out of the fetal tissue procurement area completely, just deciding politically it's not worth it. Leave the supply to others, and see if that actually then brings out the real debate which is back to abortion.
SESNOAnd does any of this have effect on the actual research that's taking place, Art?
CAPLANIt could. I mean, you do need fetal tissue if you want to understand fetal development and fetal diseases. It would be in my view sad if abortions are going to go on, to not use some of that material to learn. But I'm not sure it's worth Planned Parenthood's political standing to be involved.
SESNOLouise, you're the journalist here. We now turn you into the fortune teller. Where's it going?
RADNOFSKYI think if you think about the intensity of the three opinions that we've heard already, the existence of more footage and the likelihood that they'll be more videos, you can certainly expect that you'll be hearing about it and we will be watching.
SESNOAnd a political issue in a political year. To all of you, thank you very much on a very difficult issue for a very thoughtful conversation. You're listening to "The Diane Rehm Show." I'm Frank Sesno. Thanks for listening.
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