Updated: this article was updated at 3:14 pm Thursday, February 4th to include a portion of the statement released by Planned Parenthood Federation.

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Lila Rose and Live Action Films have released a second video in their promised expose of Planned Parenthood.

And the only thing shocking about this video is that Rose and her cohorts think there is something shocking about it.

It exposes…..wait for it……a health care worker providing information about health care.

It’s the most shocking thing I’ve encountered since the mailman delivered my mail today.

In the video and in the transcript, the clinic worker is seen and heard calmly doing her job. She is assisting her clients and answering their questions about testing and treatment of sexually transmitted infections, about contraceptive methods and unintended pregnancy.  No minor is present in the room.  When asked about abortion, she calmly discusses the options a minor in need of abortion might have, such as judicial bypass, which lest anyone be confused, is the perfectly legal recourse provided to minors who face an unintended and untenable pregnancy and who can not for whatever reasons secure their parents’ “permission” to procure an abortion.  Parental consent laws are widespread but have been shown in study after study to be useless in their supposed efforts to dissuade minors in need from seeking abortion.  Moreover, as extensively noted by the Department of Justice, minors involved in sex work or who have been trafficked into sex work often are abandoned by their families, so they are not likely to be seeking out their parents’ permission for much.

These children “generally come from homes where they have been abused, or from families that have abandoned them. They often become involved in prostitution as a way to support themselves financially or to get the things they want or need.”

After the visit, this clinic worker and her colleagues in other sites where the “sex traffickers” sought services reported these visits to their supervisors, who in turn reported to Planned Parenthood Federation’s head office which, in turn reported this to the Department of Justice and the Federal Bureau of Investigation.

So they did things exactly right. Sought to meet the immediate health needs of the patient while in turn reporting suspicious activity to the police.

In a statement, Planned Parenthood Federation of America said:

Today, Live Action, an anti-abortion groups led by Lila Rose, a self-described
“extremist”1, who has called for abortions to take place in public2 and has vowed to “take down” Planned Parenthood, released videotapes secretly taped at Planned Parenthood Health Centers in Virginia.

In a recent round of secret videotaping in January 2011, at least four health centers in Virginia received visits in a short period of time from persons claiming to be involved in the sex trade, involving vulnerable minors. Local authorities, as well as federal authorities, were alerted to these visits. In this morning’s publicized tape, the Planned Parenthood staff member reacted professionally to a highly unusual person posing as a patient. After the encounter, the staff member immediately notified her supervisor, who subsequently notified members of Planned Parenthood’s national security team, who are working with the FBI, which is investigating these visits.

Come to think of it, this might be even less shocking than the fact that a half inch of snow can close schools across Montgomery County, Maryland.

That a health care worker at a Planned Parenthood would be offering clear, concise and evidence-based information on testing and treatment of infections, contraception and abortion is kinda the antithesis of shocking, really, because in case Lila missed it, these are the services that sexual and reproductive health clinics provide.

The fact that a health worker would be doing so in a manner that earns the trust of the client is not only normal, but a central ethic of health care and medicine.

The fact that she didn’t say: “Hey traffickers, sit yourselves down and have a cup of coffee while I go call the police,” but instead ended the visit and reported to her supervisors also is exactly the protocol she is supposed to follow.

The American Medical Association states, for example:

Physicians have always had a duty to keep their patients’ confidences. In essence, the physician’s duty to maintain confidentiality means that a physician may not disclose any medical information revealed by a patient or discovered by a physician in connection with the treatment of a patient. In general, AMA’s Code of Medical Ethics states that the information disclosed to a physician during the course of the patient-physician relationship is confidential to the utmost degree. As explained by the AMA’s Council on Ethical and Judicial Affairs, the purpose of a physician’s ethical duty to maintain patient confidentiality is to allow the patient to feel free to make a full and frank disclosure of information to the physician with the knowledge that the physician will protect the confidential nature of the information disclosed. Full disclosure enables the physician to diagnose conditions properly and to treat the patient appropriately. In return for the patient’s honesty, the physician generally should not reveal confidential communications or information without the patient’s express consent unless required to disclose the information by law.

In fact, when it comes to sexual health and to the sexual health of minors in particular, the emphasis is first placed on the needs of the patient, and on confidentiality, and later on legal issues.  See this paper on sexual health disclosure in the military for example  and this from the Office of Adolescent Health of the State of Oregon.

The process to ensure health care access, confidentiality and privacy can be quite complex when it pertains to minors. Every day, health care providers are attempting to figure out: (1) which services a minor can obtain without parental consent; (2) when a parent can access a minor’s health information; and (3) when minor consent must be obtained before the provider can share the minor’s health information. State statutes, federal laws and regulations provide a complicated patchwork of requirements that often do not fit neatly together and may be challenging to interpret and implement.

Unfortunately, no single rule can be applied to all situations. However, a good place to start is with a resource like this that compiles all the requirements. Great care has been taken to present accurate information that is as clear as possible with citations to the entire text of the law or regulation. We encourage anyone wrestling with these issues to use this document as a starting place while establishing a process that will encourage minors to seek care while maximizing their confidentiality and privacy.

The fundamentalist right in this country wants to criminalize sexual behavior of all kinds and turn doctors into investigators.  This is the essence of all sorts of laws seeking to limit teen access to comprehensive sexual health education, contraceptive methods, safe abortion services and so on.  It is and was the essence of Don’t Ask, Don’t Tell in regard to health care. As Dr. Kenneth Katz pointed out in an article for Rewire last year, this was indeed the same dilemma he faced in treating patients under DADT and the ways in which restrictions on sex and in this case sexual identity affected his ability to serve his clients and make sure they were healthy. 

So I repeat, there is nothing shocking–whatsoever–about a health care worker addressing a patient with respect and respectfully answering their questions.  And then, later, reporting to their supervisor if in fact there is suspicion. In fact, it is protocol.

Rose keeps asking in her voice overs: “Will Planned Parenthood comply with the law?”  Only she doesn’t want to give you the answer to that question–yes–by also reporting that indeed PPFA reported the suspected trafficking to the authorities.  That would ruin the whole thing!

The point is this: Health care workers are there to guard individual and public health.  In doing so, they face dilemmas on a daily basis. Anyone who thinks otherwise is neither interested in the health of minors nor of trafficked minors, does not understand either public health or medicine, and is not interested in ethical behavior. 

But we already knew that about Lila and her colleagues. And that is not very shocking at all.