Post subject: Can fetuses feel pain?

Researcher Stands by Fetal Pain Findings
By Randy Dotinga
HealthDay Reporter


WEDNESDAY, Aug. 24 (HealthDay News) -- A controversial new research article questioning whether early-term fetuses feel pain has triggered a heated debate on how the research might influence the flash-point realm of abortion politics.

But a neuroscientist who helped write the paper, published Wednesday, said there's no doubt about the conclusion: Humans only feel pain if they have a properly functioning brain, and fetuses in the early stages of development don't.

"The circuitry is not there," at least in the first 20 weeks, said Dr. Henry Ralston, a professor of anatomy and neuroscience at the University of California, San Francisco. "Without the connections, the sensation can't take place."

The report, a review of known research by four doctors and a researcher at UCSF, goes even further: In examining the effectiveness of giving anesthesia to a fetus for therapuetic procedures or abortion, the researchers concluded that fetal perception of pain is unlikely before the third trimester, at 29 to 30 weeks.

Other doctors disagree, however, as do anti-abortion activists who criticized the findings, which appear in the Aug. 24/31 issue of the Journal of the American Medical Association.

Dr. K. S. Anand, a pediatrician at the University of Arkansas for Medical Sciences, told The New York Times, "There is circumstantial evidence to suggest that pain occurs in the fetus."

Anand said premature babies only 23 or 24 weeks old cry when their heels are pricked for blood tests and become conditioned to cry when someone nears their feet.

"In the first trimester, there is very likely no pain perception," Anand said. "By the second trimester, all bets are off, and I would argue that in the absence of absolute proof we should give the fetus the benefit of the doubt if we are going to call ourselves compassionate and humane physicians."

The study is also raising eyebrows, according to a Philadelphia Inquirer report, because one of its authors is the head of an abortion clinic. Her affiliation was not disclosed in the study, nor was that of the lead author, a medical student who once worked for an abortion-rights organization, the newspaper said.

The researcher, UCSF obstetrician-gynecologist Eleanor A. Drey, is medical director of the abortion clinic at San Francisco General Hospital. She told the Inquirer: "We thought it was critical to include an expert in abortion among the authors. I think my presence ... should not serve to politicize a scholarly report."

JAMA editor-in-chief Catherine D. DeAngelis told the newspaper she had been unaware of that.

"This is the first I've heard about it," she said. "We ask them to reveal any conflict of interest. I would have published" the disclosure if it had been made.

The issue of fetal pain, once fairly obscure, has taken an increasingly prominent position in the public consciousness in recent months. More than a dozen state legislatures -- including those in New York and California -- have debated whether to require doctors to tell women getting abortions about the potential pain felt by fetuses during the procedures. The proposed laws would require doctors to offer anesthesia for the fetus.

Arkansas, Georgia and Minnesota have already passed such laws.

And Congress is considering whether to require doctors to provide anesthesia to fetuses in all cases of abortion after 22 weeks of gestational age. (The new study noted that only 1.2 percent of abortions in the United States are performed at or after 21 weeks.)

Ralston said he and his colleagues launched their study, an analysis of previous research, to provide some perspective on the debate.

The researchers examined studies that looked at feelings of fetal pain before the age of 30 weeks. They found that while there hasn't been much research, the evidence suggests that fetuses aren't able to sense pain before the third trimester. They also report that "little or no" research provides guidance about the use of anesthesia on fetuses.

Advocates of anesthesia legislation have pointed to medical reports that fetuses shy away from painful stimuli, like the stick of a needle, in operations during pregnancy. Some doctors argue that infants between 20 and 30 weeks actually suffer pain more intensely than older fetuses and babies because their neural systems aren't set up to adequately process the sensations.

But Ralston said early fetal reactions are simply reflexes stemming from the spinal cord, not a matter of brain response to pain. The spinal cord develops earlier than the brain, as early as eight weeks, he said.

So when do fetuses actually start feeling pain? Ralston said it's not clear, but the lack of feeling before 20 to 22 weeks is "open and shut."

However, Dr. David A. Grimes, a former head of abortion surveillance at the U.S. Centers for Disease Control and Prevention who now delivers babies and also performs abortions in Chapel Hill, N.C., told the Times, "This is an unknowable question."

"All we can do in medicine is to infer," he added.

Still, he said, the new research makes a compelling case that fetuses younger than 29 weeks have no perception of pain.



http://www.forbes.com/lifestyle/health/feeds/hscout/2005/08/24/hscout527596.html

I Certainly hope not. This will make the abortion debate more heated than what it already is.

Post subject: Re: Can fetuses feel pain?

Post subject: well wow, they got hate mail

I really don't like it when people take their beliefs too far. It's fine to be passionate, I am very passionate about a lot of things, but these anti-abortion people, some of them are extreme and down right mean, evil, and psychotic in my opinion.

---------------------------------------------

By LINDSEY TANNER, AP Medical Writer
Thu Aug 25, 8:12 PM ET



CHICAGO - Dr. Catherine DeAngelis is a staunch Roman Catholic, used to give communion to her patients and says she strongly opposes abortion.

So The Journal of the American Medical Association's editor-in-chief says she had to take a walk around the block after receiving dozens of "horrible, vindictive" e-mails condemning her for publishing an article that says fetuses likely don't feel pain until late pregnancy.

"One woman said she would pray for my soul," DeAngelis said Thursday. "I could use all the prayers I can get."

DeAngelis ticked off a list of other nasty e-mails she received: "Your license should be stripped. "You should get a real job." "Eternity will definitely bring justice for you."

The article in Wednesday's JAMA prompted especially harsh letters from abortion foes because one of the five authors is a University of California, San Francisco obstetrician who works at an abortion clinic. A second author — a UCSF medical student and lawyer — once did legal work for the NARAL Pro-Choice America advocacy group.

Critics, including the National Right to Life Committee, said the article was a politically motivated attack on proposed federal legislation dealing with fetal pain. The legislation would require doctors to provide fetal pain information to women seeking abortions when fetuses are at least 20 weeks old, and to offer women fetal anesthesia at that stage of the pregnancy. A handful of states have enacted similar measures.

DeAngelis said JAMA will publish properly submitted critics' comments in an upcoming edition and will give the authors a chance to respond. But she stood by her decision to publish the article.

"There's nothing wrong with this article," DeAngelis said. "This is not original research. This is a review article," based on data in dozens of medical articles by other researchers.

The article did not mention the two researchers' ties to the abortion clinic and the advocacy group. But the connections were later reported by news organizations.

DeAngelis said the obstetrician's experience is not a conflict because performing abortions is often part of that job. She said she would have published the medical student's NARAL connection as a potential conflict of interest had she known about it in advance, but that not mentioning it does not mean that the article or journal are biased.

"If there weren't four other authors and this wasn't a peer-reviewed journal, I'd worry ... but I don't," she said.

Dr. Mark Rosen, the review's senior author, is a University of California-San Francisco anesthesiologist and fetal surgery pioneer. He called the article an objective review of medical literature.

Dr. Philip Darney, a UCSF obstetrics-gynecology professor who is the obstetrician's boss, said the article represents "thoughtful and thorough scholarship. No conflicts of interests were present in conducting this work and no affiliations nor clinical practice information were withheld inappropriately."

DeAngelis said she attends Mass at least weekly and also is a Eucharistic minister, which allows her to administer communion to fellow Catholics. She said that while she opposes abortion, she also supports a woman's right to choose.

She said she attempts to set aside her personal biases in her role as editor of a reputable medical journal and that researchers who seek to publish in JAMA are expected to do the same.

Dr. Jerome Kassirer, a former New England Journal of Medicine editor and vocal critic of doctors' conflicts of interest, said he experienced a similar outcry in the 1990s when his journal published research concluding that a so-called abortion pill was safe and effective.

"I got a lot of hate mail and I also got in the mail some models of fetuses with knives in their heads," Kassirer said. He notified legal authorities and was given a bodyguard at his office.

Kassirer said JAMA probably could have avoided the criticism if the article had included a conflict of interest statement, but that the authors' connections don't mean the article is biased.

___

Post subject: Re: well wow, they got hate mail

Post subject:

yep, and how ironic that they murder or threaten someone else and they call themselves "pro Life."

Post subject:

venus wrote:

yep, and how ironic that they murder or threaten someone else and they call themselves "pro Life."

Post subject:

Now you should know how I've come to feel about religion, after looking into a bit of its violent and inhumane history!