British commentary calls abortion-linked U.S. legislation into question
By Amanda Gardner
FRIDAY, April 14 (HealthDay News) -- Fetuses cannot feel pain, therefore U.S. legislation requiring doctors to tell women that the fetus will feel pain, or to provide pain relief during abortions, has no scientific basis and may harm the women involved, a leading expert contends.
"This is an unwarranted piece of legislation because there is good evidence that the fetus cannot feel pain at any stage of gestation," said Stuart Derbyshire, senior lecturer in psychology at the University of Birmingham, U.K.
He authored an review of the available data on the subject in the April 15 issue of the British Medical Journal.
"I don't think the question of pain resolves the argument about abortion," said Derbyshire, who said abortion remains a social, moral and political question. However, he said that, based on the evidence, "it's illegitimate to use the possibility of pain as a way of trying to prevent abortion from occurring, because the possibility of pain doesn't exist."
Some other experts agreed.
"No one wants to inflict pain in fetuses unnecessarily, nor do physicians want to put the mother at risk by the unnecessary administration of analgesics to treat her fetus, not her," said Dr. Henry J. Ralston, a professor of anatomy and neuroscience at the University of California School of Medicine, San Francisco. "I agree with Dr. Derbyshire's primary conclusion, that 'Legal or clinical mandates to prevent pain in fetuses are based on limited evidence and may put women seeking abortion at unnecessary risk.'"
Pro-life representatives took issue with Derbyshire's findings.
"This is a bit more propaganda than science," said David Christensen, director of congressional affairs for the Family Research Council in Washington, D.C.
Specifically, Christensen faults the author for being selective in the research he chose to include and for presenting a "circular argument."
"He redefines pain such that not even a newborn could experience pain in the way he defines it, and then concludes that fetuses can't experience pain and that's absurd," Christensen said.
"The purpose behind the legislation is to make sure women are informed about the possibility that an unborn child from 20 to 25 weeks on could experience pain," Christensen said. "This author wants to maintain the choice of abortion but not allow women to make an informed choice and I think that's pretty telling."
The U.S. government is presently considering legislation that would require doctors to inform women seeking abortions that "there is substantial evidence that the process of being killed in an abortion will cause the unborn child pain."
The legislation would additionally require that a fetus of more than 22 weeks' gestational age receive anesthesia before the abortion procedure. Doctors who refuse to comply could be fined $100,000 while also losing their license and their Medicaid funding.
More than a dozen state legislatures -- including those in New York and California -- have debated such bills. Several states have already passed laws.
Congress is also considering whether to require doctors to provide anesthesia to fetuses in all cases of abortion after 22 weeks of gestational age.
But is there enough evidence to conclude that fetuses actually experience pain?
After examining the available neurological and psychological literature, Derbyshire says "no."
The neural circuitry needed to process pain is complete, if not mature, by 26 weeks' gestation, he said. "From about 26 weeks you can talk about there being a complete system in terms of biology, a link from the skin to the spinal cord to the brain, and we know that set-up is reasonably functional," Derbyshire explained.
But to properly experience pain, the mind must also be developed, something which cannot happen until after birth. The mind permits the subjectivity of pain, said the U.K. expert, who has previously served as an unpaid consultant to Planned Parenthood of Virginia and Planned Parenthood of Wisconsin, as well as the U.K.-based Pro-Choice Forum.
"The key thing is representational memory," Derbyshire explained. "If you want to discriminate pain from hunger, from vision, or from any other sensational experience, you need to be able to label it in some way, and that will come from interactions with the primary caregiver," -- in other words, after birth.
"I agree that pain is a complex sensory experience that requires activation of many regions of the cerebral cortex and that 'Without consciousness there can be nociception [response to noxious events] but there cannot be pain,'" Ralston said. "I do not know when that necessary neural circuitry is fully developed and functional, but it certainly is not established by 20 weeks gestational age, as encoded in legislation in several states in laws penalizing physicians for not informing mothers about pain in their fetuses."
The problem with the actions encoded in the legislation is that it could put the mother at risk, according to Derbyshire.
"It does introduce risks to the mother if we start to inject drugs to the fetus and increase the time of the procedure," Derbyshire said. "That would be unnecessary and involve unnecessary costs and risks."
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