On Balance

Came across article by Roger Highfield, “Fetuses feel pain at 20 weeks: study”, Daily Telegraph via Ottawa Citizen, August 29, 2001, p. A14:

Unborn babies may be able to feel pain as early as 20 weeks into pregnancy, a finding that suggest pain relief should be considered for the 2,500 extremely premature babies born each year who may be subject to painful procedures.

The head of a British government-appointed expert group said a fetus was definitely aware of pain by 24 weeks, perhaps as early as 20 weeks, according to a review of the latest research.

The expert group, chaired by Eve Johnstone of Edinburgh University, makes a strong case for additional research on ways to prevent the unnecessary suffering of extremely premature children…

The issue of fetal pain has been highly controversial. Some claim that it is merely a pretext used by pro-life organizations to attack the use of abortions.

Others believe that more thought has been given to preventing the suffering of laboratory animals than to the suffering of the unborn child.

The 20-week theoretical limit suggested by the MRC group is significantly earlier than the 26-week pain limit laid down four years ago by Britain’s Royal College of Obstetricians and Gynaecologists.

Wondered how this had played out, over fifteen years or so, particularly in terms of research developments. Found that it is in fact used by those with reservations about the current state of abortion law, and also subject to a “it’s nothing but myth” view on the part of some who favour the right to “choose”.

In terms of the myth-disparaging views, the British research is not cited. Instead, they focus on one researcher, whom they describe as Dr. Kanwaljeet “Sunny” Anand, at the time of the University of Tennessee, now of Stanford University. As reported by Kate Sheppard, “Fetuses Feel Pain at 20 Weeks, and 4 Other Anti-Abortion Myths”, Mother Jones, June 20, 2013:

The House of Representatives passed a law on Tuesday banning abortions after 20 weeks across the country, based on the scientifically dubious claim that a fetus can feel pain at that point. The federal “Pain-Capable Unborn Child Protection Act” draws from a model bill promoted by the National Right to Life and mirrors laws that have passed in a dozen states in the last three years.

Where does this premise for a 20-week abortion ban come from? In the debate on Tuesday, House members repeatedly cited the research of Dr. Kanwaljeet “Sunny” Anand, a University of Tennessee professor of pediatrics, anesthesiology, and neurobiology who has promoted the idea that 20 weeks post-conception is the point when a fetus begins to feel pain. His work, which has been the go-to resource for anti-abortion groups, was mentioned at least four times on the House floor. Citing Anand’s findings, Rep. Virginia Foxx (R-N.C.) argued that “the baby responds the same way you and I respond to pain, by recoiling.” She went on to claim that the pain of a fetus at 20 weeks is “possibly more intense than that felt by older newborns.”

But Anand is an outlier. A 2005 paper in the Journal of the American Medical Association surveyed the medical literature and found little evidence to support his conclusions. There is an established body of evidence that finds that fetuses start developing the biological pathways related to pain sensation at this stage of gestation, but there is not enough evidence to suggest that they can actually experience pain as we do. The majority of the scientific literature on the subject finds that the brain connections required to feel pain are not formed until at least 24 weeks.

Where the link is to this news report by Andy Couglan, “24-week fetuses cannot feel pain”, New Scientist Daily News, June 25, 2010, where the link to the committee report upon which the news coverage is based appears to be no longer functional:

Fetuses aged 24 weeks or less do not have the brain connections to feel pain, according to a working party report published this week by the UK Royal College of Obstetricians and Gynaecologists (RCOG).

Its conclusion is the latest to challenge the rationale for a law introduced in the US state of Nebraska in April. This law, which bans almost all abortions beyond 20 weeks of pregnancy, was introduced primarily on the grounds that the fetus feels pain.

The report, which reviews recent scientific literature on the subject, also concludes that the fetus is sedated throughout pregnancy by chemicals such as adenosine contained in the amniotic fluid that surrounds it.

Pain-free existence

Because the fetus is unable to feel pain before 24 weeks, no pain relief is needed for medical procedures up to that time, including abortion, the report concludes. This reverses the position the RCOG took in its previous report on fetal pain in 1997, which supported the use of analgesia.

“We have now advised that analgesia is not indicated up to 24 weeks,” says Allan Templeton, chairman of the working group that produced the report. He adds that administering painkillers carries risks of harming the fetus.

The report concludes that fetuses under 24 weeks must be pain-free, because at that age the wiring doesn’t exist to send pain signals from nerves around the body to the cortex, the area of the brain where pain is experienced. At which later point such connections form is unknown, so analgesia should still be considered after 24 weeks, the RCOG says…

The report notes that the same reflexes are seen in seriously malformed fetuses that have no brain at all, and therefore can’t possibly experience pain.

Pain signals

Templeton says the working party rejected the claims of Kanwaljeet Anand of Le Bonheur Children’s Medical Center in Memphis, Tennessee, who contends that young fetuses can feel pain in a more primitive part of the brain called the subcortex, which receives pain signals before the cortex has been wired up.

“Our scientists say there’s no evidence that the subcortex can provide for the pain experience,” Templeton told New Scientist. Anand’s evidence is widely cited by anti-abortion groups.

Templeton says that Anand’s evidence comes mainly from observations of responses in babies born prematurely, and that it cannot be assumed that these are expressions of pain, rather than painless reflex responses.

“Anand’s conclusions apply only to neonates,” Templeton says. “He has written opinions about how that might apply also to fetuses, but it’s not evidence, it’s opinion.”…

Allan Templeton being a Professor of Gynaecology at the University of Aberdeen, whose specialities include “in vitro fertilization and medical abortion“. No bias there. And where Professor Eve Johnstone, chair of the earlier “20 week” study, is identified as a Professor of Psychiatry, specializing in schizophrenia. Lots of expertise there. And where Dr. Anand is a “Professor of Pediatrics (Pediatric Critical Care) and of Anesthesiology, Perioperative and Pain Medicine at the Stanford University Medical Center“, described (dismissed?) as “Sunny”.

So, the longer the period before pain is felt, the longer the period that abortions can be permitted. Painless extraction, excision or vacuum process. Doing the jerk is just no pain. When the heart stops, there is no pain.

Move on over from the gravity. Hear something funny, it’s my mating call:


About brucelarochelle

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