Understanding Fetal Tissue Donation — and Why It’s Such a Divisive Topic

Many of us had never heard of fetal tissue donation before last week, and now the issue is dividing the country. (Illustration: Getty Images)

Over the past two weeks, a pro-life organization called the Center for Medical Progress released two of what they say will be many undercover videos that have ignited a bitter battle on abortion and put Planned Parenthood, the women’s healthcare organization and abortion provider, under fire.

But the fight isn’t the usual baby-killing-vs.-women’s-rights, black-and-white argument over abortion. Instead, the Center for Medical Progress has chosen to focus on a little known byproduct of abortions: the use of organs and tissue from aborted fetuses and embryos for research, and the practices — both technical and monetary — that support such research.

David Daleiden (Photo: The Center for Medical Progress)

David Daleiden, the 26-year-old founder of the Center for Medical Progress and the driving force behind these videos, echoed the sentiment of many pro-life activists when he referred to fetal tissue donation as “the whole world of selling baby parts” in an interview with the New York Times, adding that “most fetal tissue work is real Frankenstein stuff.” And his highly edited videos seem to support his claims, with dramatic clips of two high-level Planned Parenthood doctors chatting cavalierly about extracting fetal tissue to harvest organs and seemingly haggling over payments for these specimens.

The first video purports to show Planned Parenthood senior director Dr. Deborah Nucatola discussing the sale of fetal organs and how Planned Parenthood harvests them. (Video: YouTube)

In the second video, Planned Parenthood Federation of America’s medical directors’ council president, Dr. Mary Gatter, is supposedly haggling over the price of fetal organs. (Video: YouTube)

Conservative pundits and lawmakers — including some contenders for the Republican party’s presidential nominee in 2016 — have seized momentum from the video, launching an investigation into Planned Parenthood and threatening to strip the nonprofit organization of its federal funding (though, it should be noted, none of these funds are used for abortion services).

Related: Who is the 26-Year-Old Man Behind the Planned Parenthood ‘Sting’ Videos

But the facts and history of fetal tissue research and donation present a less sensationalistic story about a form of medical research that has a long history in the United States and is credited with some of the most important medical breakthroughs of our time.

What is fetal tissue research?

Dating back to the 1930s, scientists have used tissue from aborted fetuses as a means of understanding cell biology and as an important tool in the development of vaccines, according to the Guttmacher Institute. Fetal cells were used to develop both the polio and rubella vaccines, and the 1954 Nobel Prize for medicine was awarded to American immunologists who developed the polio vaccine, based on cultures of human fetal kidney cells.

The Nobel Prize in Physiology or Medicine 1954 was awarded jointly to John Franklin Enders, Thomas Huckle Weller, and Frederick Chapman Robbins “for their discovery of the ability of poliomyelitis [polio] viruses to grow in cultures of various types of tissue.” (Photos: Nobelprize.org)

Fetal tissue research itself uses tissue taken from a fetus in a legal abortion that is then used to study potential treatments for diseases such as cancer, diabetes, and birth defects, and in some cases, the actual treatment of disease. In the case of Parkinson’s disease, for example, fetal tissue is grafted onto the brain of the recipient. The first study done on such transplants showed noted improvement for Parkinson’s patients in the absence of medication.

Related: Coincidence … or Is It? Planned Parenthood ‘Sting’ Video Isn’t First to Derail Legislation

“Tissue from the body is studied to understand the normal process of development and how the body changes when faced with a certain medical condition or illness,” Anne Davis, MD, the consulting medical director for Physicians for Reproductive Health and an associate professor of obstetrics and gynecology at Columbia University Medical Center in New York, tells Yahoo Health. “Fetal tissue has been used in research on Alzheimer’s, Parkinson’s, multiple sclerosis — these are common conditions that cause a lot of serious medical problems, and people are working really hard to see how they develop and what can be done to prevent them from happening in the first place. The best way to study these things isn’t from a computer model or an animal, but from actual human tissue.”

Is it legal?

Fetal tissue research is legal, with scientists acquiring fetal tissue for their research from hospitals, nonprofit tissue banks, and abortion clinics. But there can be no profit made from the fetal tissue, and it must only be done with the explicit consent of the patient. It’s also law that a fetal tissue provider must be paid for the cost for the removal and transport of the specimens, but cannot make a profit from them.

Is fetal tissue donation a “secret” industry?

The National Institutes of Health spent $76 million on fetal research in 2014; It is not, as the videos from the Center for Medical Progress make the practice seem, a secret, black-market industry. Rather, it plays a large role in biomedical research, and Planned Parenthood is one of many healthcare providers that make fetal tissue donation available to its patients, something only enacted with a patient’s consent.

Why are some against fetal tissue donation?

There are four main reasons:

It could encourage abortion: Many people who believe that abortion is immoral also believe that using fetal tissue from elective abortions both encourages and legitimatizes it, according to an article in the Kennedy Institute of Ethics Journal. Some believe that women who may not otherwise have an abortion because of their moral beliefs may be compelled to do so if they believe that the fetus can be used for scientific research.

It could incentivize abortion providers: As the Center for Medical Progress videos underscore, there is also a concern among many pro-life activists that fetal tissue donation and research creates financial incentives for those who perform abortions — and motivates them to perform more abortions for the sake of profit.

It could change the way the abortions are conducted: Another ethical concern for many who are opposed to both abortion and fetal tissue donation is that physicians would alter the way in which they perform abortion procedures on patients with the intent of being able to “better” increase the chances of preserving the fetal organs most needed in medical research. These opponents take issue with any healthcare practice being dictated by a secondary goal, such as preserving a certain fetal organ for research, as opposed to the primary goal of patient care.

Life begins at conception, so the fetal tissue donation should be illegal: Others believe that fetal tissue donation treads dangerously close to the question of personhood, or the belief that life begins at conception and that a fertilized egg is thus entitled to the same rights and protections under the law as born-and-living human beings. Opposition to fetal tissue research tends to go hand-in-hand with opposition to in vitro fertilization (IVF) and the belief that the practice can result in the destruction of embryos or that monetary incentives would motivate couples to sell unused embryos for research and for profit. While unused embryos harvested for the IVF process can be donated to research, or donated to another couple, it is presently illegal to sell an embryo.

Why do women choose to donate their fetal tissue?

Davis compares fetal tissue donation to donating blood — “You don’t do this because you get something out of it, but because someone else gets something out of it. In abortion, when a woman chooses to end a pregnancy and says, I didn’t want [to need to have] an abortion — no one does — is there any way I can donate fetal tissue so that something good can come out of what I’m going through. And that’s great. That’s amazing that people can be that compassionate when they’re going through something so stressful.”

Are women always aware that their fetuses are being donated to research?

When a woman decides to terminate a pregnancy, if her physician has the ability to collect, store, and transport fetal tissue, he or she will let the woman know that she has the option to donate the fetal tissue specimen. Fetal tissue may be legally donated from any spontaneous abortion (miscarriage) or induced abortion as long as the woman provides a signed, written statement and knowingly consents to denote her fetal tissue for research.

Physicians themselves also must sign a form stating that the consent for the abortion was obtained prior to the request and receipt of the request for any fetal tissue donation; that no alteration was made in terms of timing, method, or procedure to induce abortion for the sake of fetal tissue donation; and that the abortion was performed in accordance with state laws.

Related: ‘I Set Her Free’ —What One Woman Wants Lawmakers to Know About Her Late-Term Abortion

“When someone makes a donation, there are a series of steps that have to be taken to make sure that donation gets to the right person in the right lab to make sure that [donation] is useful,” Davis explains of the process, which involves expensive transportation and storage of the donated materials.

Davis notes that the Institutional Review Board (IRB) ensures that any time a doctor does research, certain standards of protection are met — and these standards are especially stringent when they involve human subjects or material donated from human subjects. “There are processes in place to make sure that the context of any research is ethical. This is day-to-day. There is nothing special about this.”

Is there any way this research could happen without relying on fetal tissues from abortion?

Not really. This type of biomedical research can only happen when there are fetal tissue specimens available. Fetal cells are preferred over adult cells in many of these cases because they “elicit less of an immune response than do adult cells, lowering the risk of tissue rejection … and are more able to accommodate to the host,” according to the American Society for Cell Biology.

While fetal tissue can occasionally be collected through miscarriages, it is more available as a result of abortion. Couples undergoing in vitro fertilization can also opt to donate their unused embryos to research.

Has it always been legal?

The Uniform Anatomical Gift Act, which allows for the donation of all or part of the body of a dead fetus for research or therapeutic use, was enacted nationwide between 1969 and 1973. The National Commission for the Protection of Human Subjects was established in 1974. It was the first national body to shape bioethics in the U.S., and its first initiative was an investigation into whether or not fetal research could be conducted or funded by the federal government. The Commission concluded that living fetuses were not to be used for such research and that a heartbeat or respiration of a fetus could not be terminated outside of the womb.

In 1988, the political climate changed, and a moratorium on biomedical research utilizing fetal tissue was issued by the Reagan administration, after scientists began experimenting with a new technique involving implanting fetal tissue into the brains of adults with Parkinson’s disease, according to the Guttmacher Institute. Politicians questioned the ethics of using fetal tissue as a source for cell transplantation versus using it solely as a research tool.

At the end of his presidency in 1992 — once he was no longer courting the conservative vote — President George H.W. Bush signed an executive order creating a fetal tissue bank for material collected from miscarriages and ectopic pregnancies for the purpose of disseminating this fetal tissue for medical research. And Clinton lifted the moratorium on biomedical research in 1993. A study published that same year found that more than 1,000 patients worldwide had been the recipients of fetal tissue donation.

Today a patchwork of laws exist governing the practice of fetal tissue donation and specifying the contextual and medical conditions needed for the collection of certain kinds of fetal tissue for the use of certain kinds of research.

Could Planned Parenthood be profiting from fetal tissue donations?

No. The $30 to $100 per fetal tissue donation per specimen described by Dr. Deborah Nucatola, the senior director of medical services for Planned Parenthood Federation of America — and the unwitting star of the first video — covers the handling and transportation of the fetal tissue, with costs varying depending on the facility and location of each individual facility. The industry standard reimbursement fees for costs associated with tissue donation are outlined by federal law. She explains these details in the unedited version of the video.

Davis calls attention to the fact that in the unedited versions of both videos, both Planned Parenthood representatives repeatedly comment about how none of their work in fetal tissue donation is done for profit.

In the full-footage version of Dr. Deborah Nucatola’s lunch with actors from the Center for Medical Progress, she clearly explains that Planned Parenthood does not profit from fetal tissue donation. (Video: YouTube)

Sherilyn Sawyer, the director of Harvard University’s Brigham and Women’s Hospital, told FactCheck.org that at such rates, she imagines that Planned Parenthood would be taking a loss as a result of the markedly higher amounts it costs to cover collection, processing, storage, and inventory of fetal tissue specimens.

Related: Planned Parenthood Head Sorry for Tone in ‘Sting’ Video on Fetal Tissue Use

Davis concurs, saying, “My personal reaction to [the allegations that Planned Parenthood was making a profit from fetal tissue donation] was that [the claims] were laughable. How can there be any profit from a sample after collection and transportation to the appropriate lab is done for $50? The doctors [in the Center for Medical Progress videos] make statements repeatedly, saying, ‘We’re not trying to make money from this.’ That’s not the idea. This is about altruistic people who are trying to make a contribution to scientists and research for diseases — this is actual medical progress. And you can get these two people together so something good might come from it.”

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