MISGUIDED POLITICIANS AND UNWANTED PREGNANCIES

 

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Recent medical research, as reported in the highly respected New England Journal of Medicine, has provided us with both good and bad news about unwanted pregnancies:

First, the good news: The rate of unintended pregnancies in the U.S. has recently diminished. Less than half (45%) of pregnancies were unintended in 2011, as compared with 51% in 2008, declining by 18% overall in women between the ages of 15 to 44 years. While this reduction is not eye-popping, it represents progress, especially when compared with a minor increase between the years 2001 and 2008.

But now the bad news: Rates of unintended pregnancies during this last period among those who are below the federal poverty level are two to three times higher than the national average noted above.

Although the study explored several possible explanations for the reduction of unintended pregnancies, they concluded the most likely was an increased use of contraceptives, especially long-acting types such as intrauterine devices (IUDs) and hormonal injectable implants, both of which are relatively expensive. Although birth control is a basic and essential health care need for most women in all socioeconomic categories, those least able to afford these methods are placed at the greatest disadvantage.

Fortunately, the Affordable Care Act (ACA) requires that health insurers cover women’s preventive care services with no out-of-pocket costs. Although the ACA has brought the establishment of health insurance marketplaces nationwide and Medicaid expansions in 32 states, low-income women are disproportionately affected by limited information and access to the preferred methods. To fill this need, Planned Parenthood has constantly advocated for health care reforms and provided publicly funded programs that support expanding women’s access to all forms of birth control.

But here is where politics becomes the “fly in the ointment”. Those politicians with extreme views on reproductive health—often based upon incomplete facts and specious arguments—are trying to cut public funding for family-planning services through programs such as Medicaid and Title X, which have been critical in reducing costs and expanding access to preferred and effective contraceptives for low-income women.  Medicaid sources provide a range of methods that are twice as successful in comparison with those provided by similar providers that do not receive such funds.

But can we verify the negative consequences of such public fund withdrawals? The state of Texas provides a good (or bad?) example. Beginning in January, 2013, Texas withdrew support for Planned Parenthood affiliates from a Texas Medicaid fee-for-service family planning program. After the funding exclusion, there was a 35% reduction of provision of long-acting—the most preferred—forms of contraception, and during the same period, the number of pregnancies increased by 27%. The inescapable conclusion is that the vast majority of these births were unintended.

Sadly, withdrawing funds from Planned Parenthood has occurred in many states, including Ohio (Governor Kasich can bear responsibility there).  Unfortunately, Indiana is attempting similar action. Government agencies, such as local and county health departments, would be prevented from funding Planned Parenthood affiliates or abortion providers for services that include birth control as well as cancer screenings. Importantly, since the Hyde amendment was passed many years ago, Planned Parenthood has been denied the use federal funds to provide abortion services anywhere.

All these measures are obviously affecting those vulnerable women who are least able to provide support for unwanted children, or even their own health. Regardless whether one is for or against abortion—legal or otherwise—these data indicate that the numbers of these unfortunate souls seeking abortions by any means in states such as Texas are likely to increase in the future. Obviously, pregnancy, delivery, and early post-natal care are far more costly than preventive measures.

Sooner or later, the taxpayers will be penalized—directly or indirectly—and I for one subscribe to the old adage, “An ounce of prevention is worth a pound of cure”!

Our lawmakers would be well advised to stop the ill-informed decision to defund Planned Parenthood!

 

 

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IS PLANNED PARENTHOOD DOING SOMETHING WRONG?

  In the case of adults, donation of organs or tissues before or after death is clearly a noble gesture. When you fill out an organ donor card with your driver’s license, you’re agreeing to donate all or some of your organs when you die. At this moment, more than 105,000 people in the U.S. are waiting for an organ. Each of these people is in desperate need of a kidney, liver, heart, or other organ. More than 6,500 people a year—about 18 a day—die before that organ ever becomes available. It is, therefore, no stretch of the imagination that if additional organs and tissues were donated not only for individual recipients but also for medical research for the benefit of all humanity, nearly everyone would benefit and would approve resoundingly and harbor no moral or legal reservations.

But should the same principle apply to the donation of fetal tissues and organs—after legal death—to be donated for medical research? And what advantage can be gained from such an act?

Historically, the use of fetal tissue has produced some groundbreaking scientific discoveries. According to the American Society for Cell Biology, a nonprofit group representing a large consortium of scientists, “Fetal cells hold unique promise for biomedical research due to their ability to rapidly divide, grow, and adapt to new environments. This makes fetal tissue research relevant to a wide variety of diseases and medical conditions.”

According to the nonprofit Guttmacher Institute, focused on sexual and reproductive health, tissue from fetuses has been used since the 1930s for a variety of purposes. Perhaps most famously, the 1954 Nobel Prize in medicine was awarded to researchers who managed to grow polio vaccine in fetal kidney cell cultures.

In another example, Leonard Hayflick created a cell line from an aborted fetus in the early 1960s that has been used to create vaccines against measles, rubella, shingles and other diseases. Paul Offit, director of the Vaccine Education Center at the Children’s Hospital of Philadelphia, told the journal Nature in 2013 that “[t]hese cells from a fetus have no doubt saved the lives of millions of people.” In more recent years, the use of stem cells from legally aborted fetal tissue for therapeutic and research purposes have been the focus of even more attention.

So why are many politicians raising such a ruckus about donation of fetal tissues? In comparison to the voluntary donation of our own parts—before or after we die—what is the possible harm in voluntarily donating fetal parts—after they are no longer living?

The political objections Planned Parenthood seem to be directed in two ways: 1) Taking parts of expired fetuses is a “gruesome” spectacle, and 2) Planned Parenthood is illegally “profiting” from the sale of such parts.

In answer to the first question, anyone who has had little or no prior exposure to fresh human parts—adult or unborn—is likely to be upset. For instance, when I first participated in a surgical procedure as a young medical student, both my psyche and my stomach were serious casualties. But after repeated exposures, I later overcame this discomfort enough to understand the ultimate benefits of these procedures. For most rational humans, what seems gruesome initially is almost always surmountable enough to allow one to appreciate the greater eventual good!

But was Planned Parenthood really “profiting” from the illegal “sale” of such parts? Relying on a heavily edited video, several Republican presidential candidates have claimed that Planned Parenthood is “profiting” from abortions.  But the full, unedited version of the video shows a Planned Parenthood executive repeatedly saying that its clinics want to cover their costs, not make money, when donating fetal tissue from abortions for scientific research. At one point in the unedited video, Deborah Nucatola, the senior director of medical services at Planned Parenthood, said: “Affiliates are not looking to make money by doing this. They’re looking to serve their patients and just make it not impact their bottom line.” Outside experts in the field of human tissue procurement maintain that the price range discussed in the video — $30 to $100 per patient — represents a reasonable compensation. Clearly there is no way to profit at that price, an amount usually less than the average new drug prescription.

What are the legal implications?

In 1993, a law pertaining to federally funded NIH research was enacted that does allow donation of fetal tissue from induced abortions if certain criteria are met. These include that the abortion timing, procedures or method itself would not be altered for the sole purpose of obtaining the tissue. This law also says that it is unlawful “for any person to knowingly acquire, receive, or otherwise transfer any human fetal tissue for valuable consideration if the transfer affects interstate commerce.”  But the term “valuable consideration” does not include reasonable payments associated with the transportation, implantation, processing, preservation, quality control, or storage of human fetal tissue. Agreeing with this concept, the American Medical Association stated in its ethical guidelines: “Fetal tissue is not provided in exchange for financial remuneration above that which is necessary to cover reasonable expenses.”

But those who are attempting to defund Planned Parenthood respond in an irrational way. A typical and representative statement from the pro-life Republication group came from the chief political strategist for Rand Paul’s campaign, who rendered the following statement: “Planned Parenthood and their supporters in the media are willing to say anything to defend their taxpayer funded abortions and profiteering from selling aborted fetuses. They want to argue about what week they kill a child or how much they do or do not profit? What’s blatantly obvious is that Planned Parenthood is trying to distract from their extremist positions and immoral ‘business’.”   Paul’s characterization of abortions is wrong on all counts: Stating that they are done at taxpayer expense is an outright lie: Federal law prohibits the use of tax dollars for abortions. Planned Parenthood covers these costs, to the extent patients cannot—with private donations. Moreover, did he actually mean “Kill a Child”!? That clearly is a blatantly false and irresponsible statement, especially on the part of Rand Paul, who, as a physician should know better!

   Summary Statement from Planned Parenthood, July 14: “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”.

CONCLUSION

The irrational withholding of governmental support of Planned Parenthood appears to be another of the repeated attempts—albeit poorly concealed—to repeal Roe v. Wade.  The religious moralists that constitute much of the Republication party these days may be at least partially successful in the near term, but it is highly likely that this worthwhile human support organization (for both women and men), if government support is lost, will later make up for any financial shortfall through private donations. On the other hand, the misguided politicians who wish to destroy Planned Parenthood will probably see their efforts backfire and pay more dearly at the ballot box, for the majority of the electorate, both men and women, are intelligent enough to cast aside such scare tactics in favor of understanding the real issues.

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