The Oregonian on Sunday examined the Cascadia Placenta Registry, which, unbeknownst to many patients, collected placentas from as many as 700 women from hospitals in Oregon, California and Washington between 1996 and 2003. Cascadia -- which was started in 1995 and financed by Northwest Physicians Mutual Insurance Company, Oregon's largest malpractice insurance provider -- received and analyzed placentas from several hospital districts on the West Coast, including Providence Health System, Legacy Health System, Adventist Health, PeaceHealth, Kaiser Permanente Northwest and Good Shepherd Health Care System. "Its purpose was rather idealistic -- to gather more information about the physiology of the placenta and how it related to birth injury," Bob Taylor, former medical director of Northwest Physicians Mutual, said. However, promotional materials released by Cascadia suggested the research could be used to fight malpractice lawsuits, the Oregonian reports. "The burden on the physician can be eased when placental pathology provides evidence in court that poor outcomes are not the result of clinical care," one brochure said.

Lawsuit
The Oregonian article also profiled Angela Desbiens, who alleges that she did not learn of the report analyzing her placenta until after she sued Providence St. Vincent Medical Center for improper care. Desbiens claims she was never asked to consent to the placental analysis, calling it "a violation of privacy." Waldemar Schmidt, who oversaw Cascadia, in a deposition said he dissected Desbiens' placenta to determine the cause of complications during the birth of Desbiens' infant. Jeffrey Wihtol, Desbiens' attorney, said the condition of Desbiens' placenta after Schmidt's analysis made it difficult to get a second opinion from another pathologist, giving the hospital an advantage in court. Many pathologists say there are ways to examine the placenta without hindering future examinations of the organ, the Oregonian reports. In a review of Schmidt's report requested by the Oregonian, Randall Craver, professor of pathology and pediatrics at Louisiana State University, called its findings "sloppy or misleading," adding that Schmidt had drawn conclusions "that aren't based on his pathologic findings."

Conclusions
Experts say the hospitals may not have broken any state or federal laws, but their association with Cascadia, which closed in 2003, raises ethical questions about the clarity needed when seeking consent from patients. Arthur Caplan, a medical ethicists, said, "If you're going to take things from patients, ... subjects have an absolute right to know that and must consent" (Goldsmith, Oregonian, 2/12).

Related Editorial
An Oregonian editorial on Tuesday says that by taking women's placentas without their consent, "several of Oregon's most prominent hospitals got it wrong," which hurts the hospitals' ability to treat patients and "damage[s] their credibility." The editorial concludes, "For now, a woman in labor can go to the hospital worrying whose side her doctor is on, ... [and s]he can give birth knowing that if anything goes wrong, the hospital's lawyers will be among the first to know" (Oregonian, 2/14).