That, in case you weren't following, is a doctor at PP admitting that he will change the procedure in order to preserve tissues that a potential buyer wants
Detail exactly what the procedure is that he is changing.
Sorry. Need to make a minor correct. She. Not he. The procedure, clearly mentioned is an abortion where the doctor admits to changing the position of the fetus to breech in order to make it easier to obtain an intact brain. Which, as I'm sure you're aware, is a complete violation of the law.
Show evidence that the doctor is actually changing the procedure rather than making choices within the normal operation of the procedure.
Now you're playing the same game you did last time we had this conversation. Any change to the procedure is a change to the procedure. Changing the procedure so as to move the fetus into a breech position is clearly going to require additional effort and risk to the patient (the woman having the abortion, since someone got confused about that last time). If the fetus would normally come out one way, and you have to actually make an effort to adjust its position, you're changing the procedure (or the method, or whatever. Can we agree that sufficient language exists in the law to cover this?). You're seriously reaching to argue otherwise. Remember that the intent of the law is to ensure that doctors do not face a conflict of interest situation where the desire to obtain tissues may negatively impact the health of their patient. Even the slightest change could have that negative effect. Which is why the HHS guidelines for this very issue say that the doctor performing the procedure should not be aware that tissue collection is an issue in the first place. While not the law itself, those guidelines exist to help doctors ensure that they not in violation of the law.
In this case, not only did the doctor know that the patients fetuses were subject to tissue collection, but actively modified the method of extraction so as to protect the desired tissue.
If the procedure is, for instance "Use forceps to remove the fetus" then where the forceps are placed does not constitute a change of procedure.
That's an extremely narrow interpretation of the law Joph. A ridiculously narrow one. And one which, incidentally, significantly reduces the protection to the patient that this law was expressly written to provide. If using the forceps in one manner increases risk to the patient compared with another, but happens to also increase the amount of usable tissue recovered, are you seriously arguing that this wouldn't violate the law? Of course it would. Your proposed standard would effectively make it impossible to actually violate the law. How would anyone ever be able to prove that a doctor "changed the procedure"?
You have to have a usable test. You don't. In this case, we do. The doctor admitted to making decisions about how to perform an abortion based on what tissues a buyer wanted from the fetus. What's next? You gonna argue with me over what the definition of "is" is?
If the procedure is "place the forceps only at this specific location" then you perhaps have an argument.
No. If any procedure is defined that narrowly, you'd have an argument. But they aren't. Which is why the distinction you're trying to make is silly. The law in question clearly must apply to more than just the name of the procedure, otherwise, it has no weight at all. There's a hundred different ways to do a D&E. Some are presumably more or less dangerous to the woman than others. And some are presumably more or less likely to produce usable tissue. And guess what? In most cases, the methods that are more likely to produce usable tissue are more likely to be dangerous to the woman. Which, presumably, is precisely what the law in question is talking about. Saying "well, he performed a D&E, so it doesn't matter *how* he performed it" is ridiculous.
But just because it's funny, here's the same doctor explaining this very thing later:
Buyer: So, when you’re- when you know, in the back of your mind you’ve got X,
Y, and Z organs that need to be procured and we want them to be reasonably
intact, and you convert to breech, are you saying that pretty much, I mean there’s
no guarantees with any of this, but we can pretty much count on having you
know, the major areas, torso, thorax, abdomen intact-
PP: I’ll actually collect what you want sometimes, and put it aside.
Buyer: Oh, so you actually do the-
PP: If I see it. Why not? I’m right there. Oh, for sure, I mean to me, I don’t know,
it makes the procedure that much better, like I’ve done something better. Like I
said, I think that forming a relationship with the providers, like you did at NAFF
because that was a lot of providers. the providers as much as the patients want
to do this. I think they would all love to participate in something like this. It just
adds another level of interest to what they’re doing. You know, everyone has a
different technique, so that's the thing. There’s definitely local variance, like
no two people do a C-section the same way, no two people do a hysterectomy
the same way. No two people do a D&E the same way. With that said, If you
maintain enough of a dialogue with the person who’s actually doing the
procedure, so they understand what the end-game is, there are little things,
changes they can make in their technique to increase your success.
Buyer: Even though they have a set way that they do it, they’re open to
PP: Reasonable, if they’re reasonable people, sure. I’m mean there’s
always going to be that one person who’s like: “This is my thing I’ve been
doing it for one-hundred years-
You're trying to apply a ridiculous standard. Oh. And anyone have any doubts about what the "end-game" she's talking about here. I'll give you a hint: It's collecting tissue. I'll also point out that while I haven't read through the entire thing, it's worth noting that I have yet to find a single point where she puts the health of the woman ahead of the "end-game". In a couple spots, she jokes about "well, we're not going to do something crazy like <this> to get tissues, but where we can we do <something not as silly as this>" (paraphrase obviously). But she doesn't make any sort of effort to say clearly "we're not going to ever put a patient at greater risk to get you tissue". Now maybe she's just working the business side of this, but it does come off as cold and odd. Her priorities seem a bit skewed.
I'll note yet again
that the prohibitions against changing procedure or method only apply to tissue being used for federally funded research. What PP was doing was donating the tissue to middlemen who would then sell it to universities, research facilities, etc. Unless the middlemen were getting federal research funding, it's unlikely that this prohibition would even apply, weak as your argument already is.
Or the research facilities themselves. You can't launder your way out of the legal restrictions by just hiring a third party to transport stuff for you. Also, my understanding is that the law when written was an exception to the existing law, which made it illegal to use such tissue for any research or medical purposes at all. So this law is saying "when the Secretary is supporting research (ie: funding it), then it's legal, but only under these circumstances". Making it legal for strictly regulated government funded research in this area, doesn't magically make it legal for completely unregulated research by wholly private parties. Cause that would also be really ridiculous.
You kinda have to look at the history of the law itself. Edited, Sep 15th 2015 6:59pm by gbaji