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Fetuses may be able to feel pain as early as 20 weeks gestation.
August 30, 2001 7:24 PM   Subscribe

Fetuses may be able to feel pain as early as 20 weeks gestation. "Members of the Medical Research Council's (MRC) expert group on fetal pain, led by Professor Eve Johnstone of Edinburgh University, say the finding could have important implications for the treatment of thousands of very premature infants born every year." It frankly makes my pro-choice conscience squirm a little, too.
posted by RylandDotNet (42 comments total)

 
But without a developed higher nervous system, what is pain? It's simply a response to nerve stimulation. A worm can feel "pain" in the sense that its body is aware of a certain level of danger and damage, but is that pain the same (ethically) as the pain we feel, or even animals with developed brains feel? I suppose it relates to a sense of self, or consciousness. Can something without that actually feel pain?
posted by Doug at 7:40 PM on August 30, 2001


In 1995, 92% of abortions were performed at 20 weeks or earlier. The article you cite mentions nothing about abortion though, it merely raises the point to give doctors a better understanding of how to care for infants. Analgesic use needs to be balanced against pain's effects on a baby's long term development. I find that much more intriguing than a polarizing debate on abortion.
posted by machaus at 7:52 PM on August 30, 2001


And if so, should we stop all practices that cause pain to any living things? No more killing of animals, period? I know what you're going to say: how can I equate humans with animals, but we're talking about pain here, right?
posted by Poagao at 7:54 PM on August 30, 2001


Sometimes all it takes is a little bit of pain to make you realize what it is to be alive.
posted by dopamine at 8:11 PM on August 30, 2001


Poagao: The best answer to your question that I know comes from Stand to Reason.. Basically, it all comes down to humanity.

The abortion issue is not a difficult issue. It is not a confusing issue. It is a very simple issue when it comes to the facts themselves... If the unborn is not a human being, no justification for abortion is necessary. However, if the unborn is a human being, no justification for abortion is adequate.

Basically, you've touched on the core question: at what point do we grant the moral and legal rights that go along with being a member of the human race (as opposed to being an animal). The implication to this post (and what probably made Ryland uncomfortable) is this: maybe an fetus that can feel pain is less like a tumor and more like a baby.
posted by gd779 at 8:14 PM on August 30, 2001


In 1995, 92% of abortions were performed at 20 weeks or earlier.

8% of 1.21 million is almost 100,000
In 1892, the peak year of lynching, "only" 230 people were vicitmized.

Surely numbers don't matter, right?

Doug, Poagao & gd779 ask the right questions: How do we decide what gets protection and what doesn't, and to what degree?
posted by marknau at 8:17 PM on August 30, 2001


Whoops. I meant to link here. This version of the article is much more comprehensive, and it explains the core question of abortion much more clearly.
posted by gd779 at 8:24 PM on August 30, 2001


plants feel pain, too.
posted by o2b at 9:21 PM on August 30, 2001


GD, I value your opinion, and the way you back it up, but I've read your other posts on this issue here, and have to ask one thing:
In a strictly practical sense, what would you like your beliefs to accomplish? Answering with "an end to abortion in cases where the life of the mother is not in jeopardy or a victim of rape" is not an answer. Doing such would imply that your views of when life begins would be imposed on those that feel uncomfortable doing such without scientific data, even if the delta between beliefs was only two weeks. We have beaten our heads against the wall here on this, but have never in my recollection come to the much needed understanding that legislating abortion is a bad idea for both sides. Would you like others to understand where you come from in order to attempt to make a difference? You have done that, and very well.
posted by machaus at 9:25 PM on August 30, 2001


If a scientific definition of what constitutes a human being cannot be established, I don't think the legal system should touch it. While most people have an opinion on what it is, and we've adopted a(n often arbitrary) system of ethics, we've yet to learn much about the mechanisms of consciousness. Even if we do come to understand, some groups will refuse science and claim that unobservable (and thus inarguable) forces drive consciousness. It's such a mess.

So, we look to the related problems, which can usually be decided more easily.
posted by skyline at 9:27 PM on August 30, 2001


Doug, Poagao & gd779 ask the right questions: How do we decide what gets protection and what doesn't, and to what degree?

My test has always been viability, but I don't know that, that is the right question. Where society can't decide (as in this case it clearly cannot) the individuals should be left to decide for themselves.

Laws by their nature deprive an individual of rights for the good of society. Individuals agree to give up these rights because society offers more benefits that burdens, but where society can't come to a consensus, there is no justification for a law that would take away individual freedoms.

Certainly those who believe the fetus is a child are free to, and in fact should, try to compel others to believe as they do, but until there's a consensus, the state and the protections/restrictions it conveys shouldn't be brought into it.
posted by willnot at 9:37 PM on August 30, 2001


Abortion will always be a controversial issue. We could go around and around in circles on this folks.

But this brings to mind a famous essay which brings some interesting analogies on the issue. This was mandatory reading in my moral issues philosophy class years ago (and probably still in most moral issues/ethics classes). It is not necessarily about when a fetus becomes a person, but it is still a very interesting and very well studied essay (and controversial too).

I don't have a link to the full article online, but there are lots of excerpts available. Here's the google search link:

A Defense of Abortion by Judith Jarvis Thomson

If anyone wants, I can scan my paper copy of it and email it to you if you'd like.
posted by misanthropy at 9:37 PM on August 30, 2001


Abortion issue aside, isn't the beginning of human life when the DNA is fused? You have a complete map of an individual human there, and the cell divides that's life. That's why viruses aren't "alive"... they're fragments of RNA and don't divide.
posted by geoff. at 10:02 PM on August 30, 2001


It frankly makes my pro-choice conscience squirm a little, too.

My fiance is a respiratory therapist at a neonatal intensive care unit. So she works mainly with premature babies.

Tonight, while visiting, she showed me a baby who was 21 weeks. He was fully formed, all toes and fingers, was very restless, and started crying during the ten minutes I was watching her.

In other words, I couldn't tell the difference between this baby and a full term baby, other than this one was born at 14 oz. and would fit in my hand.

If the question of 'pain' causes you to question your beliefs then this experience would certainly shake the foundation.
posted by justgary at 10:08 PM on August 30, 2001


a baby who was 21 weeks. He was fully formed, all toes and fingers

He also likely had transparent skin, a typical survival rate of 0-10%, and hadn't yet developed a brain capable of handling sound of visual input. A week later, he'd start a period of rapid brain growth that lasts until the age of 5. If a cutoff point for abortion was esablished, this would be it.
posted by skyline at 10:29 PM on August 30, 2001


Skyline,

First of all, his skin was not transparent.

If you read what I said there was NO visual difference other than size. I'm not telling you this because I read it, I'm telling you this because I saw it.

As far as your other comments, I never said otherwise, and they have nothing at all to do with what I posted.

My point was that it's very easy to talk about a 21 week baby, as you are doing, without actually having to deal with one. It's very easy to quote stats and numbers you find on a web page and quite another to see a 21 week baby in the flesh.

By the way, I'm VERY pro-choice. I do think though it's important for those contemplating that difficult decision to see both sides. Your numbers and stats, and my observation of a beautiful baby that can, regardless of the percentage, survive.
posted by justgary at 10:55 PM on August 30, 2001


If I misinterpreted your post, I apologize; but you seemed to imply that the baby, at 21 weeks, was substantially human. This is not the case. I've observed two such babies (22 weeks, 25 weeks), not just book learn'n, so I understand that it leaves one with a terrible feeling. Laws, however, shouldn't be based on a superficial definition of human-ness.
posted by skyline at 1:06 AM on August 31, 2001


o2b--I was taught in psych classes, convincingly, that pain is an interpretation. One of the supports cited was that 50% of soldiers receiving bullet wounds report that getting shot didn't hurt. The experience was so far out of their sensory context that they could not interpret it as pain (which doesn't that the later recovery period didn't hurt, just getting shot).

Many things can sense damage, including animals, plants and machines. That does not indicate that they can all feel pain.

Separate from that, I'd think this ought to influence people's perspective on circumcision, too.
posted by NortonDC at 3:43 AM on August 31, 2001


I say outlaw ban tatoos! they cause pain to living humans.
If an attempt is at suicide is illegal, then the state tells us that we do not have choices in what we do but only the state does. If abrotion is outlawed, as it once was, then suicide and abortion will still take place though it is illegal.
posted by Postroad at 4:55 AM on August 31, 2001


I'm 100% adamantly ANTI-abortion, and 100% pro-choice. Society and science cannot make this distinction as to where life begins to the satisfaction of the majority.

If we could only get rid of the "legal" issue we might be able to make more of a case against abortion. Now, if you talk about being against abortion the VAST majority of people freak out about you "taking away their rights". I'm not interested in making abortion illegal or even difficult to procure. I am against it being performed without a serious consideration of the issue though.
posted by revbrian at 7:29 AM on August 31, 2001


Misanthropy: I was just about to summarize the Thomson article when I saw your post. After flip-flopping on the abortion issue during my reading of several papers on the subject, since reading Thomson's piece I am solidly pro-choice. I strongly recommend that anyone interested in the issue read "A Defense of Abortion".

One of the most interesting things she talks about is the difference between what is "morally decent" and what is "just". If a boy has a box of chocolates, but he is allergic to them, and his friend would absolutely adore the Crunchy Frog, well, to not give the candy would be morally reprehensible - or, at least, cruel. It would not, however, be unjust.

Thomson argues convincingly that in some cases, abortion is morally indecent, but it is never unjust.
posted by Marquis at 7:46 AM on August 31, 2001


[I strongly recommend that anyone interested in the issue read "A Defense of Abortion". ]

That analogy is about as strong as wet kleenex.
posted by revbrian at 8:21 AM on August 31, 2001


It's my analogy, not hers, and the argument behind it is not the core of her argument in favour of abortion but rather a final note that I found particularly noteworthy.

But thanks.
posted by Marquis at 8:44 AM on August 31, 2001


Basically, it all comes down to humanity.

gd, let us know when you manage to define humanity to the satisfaction to the majority. Then we can talk about whether or not it's a confusing or complicated issue.
posted by Hildegarde at 9:54 AM on August 31, 2001


[But thanks.]

It was her analogy I was speaking of.
posted by revbrian at 10:31 AM on August 31, 2001


Ah, apologies for my curtness, then. :)

It was her analogy I was speaking of.

Which one do you mean? The baby in the house? The violinist? Henry Fonda? The burglar? People seeds? Google seems to most frequently turn up references to the Violinist, but it was the weight of her many different analogies, coupled with a cohesive thread of logic, that made her article so convincing. Unfortunately, the piece does not appear to be reproduced (in full) on the Web.
posted by Marquis at 11:16 AM on August 31, 2001


[Unfortunately, the piece does not appear to be reproduced (in full) on the Web.]

That indeed is a shame. The violinist was pathetic, perhaps however taking in the proper context it isn't as weak as it appears.
posted by revbrian at 11:31 AM on August 31, 2001


she showed me a baby who was 21 weeks

i'm confused. twenty-one weeks what? old? 21 weeks from conception?
posted by tolkhan at 12:14 PM on August 31, 2001


Well, back to the pain issue, most newborn circumcisions are performed without anaesthetic, compounding the idiocy of the practice.
posted by whatnot at 12:19 PM on August 31, 2001


but you seemed to imply that the baby, at 21 weeks, was substantially human. This is not the case. I've observed two such babies (22 weeks, 25 weeks), not just book learn'n, so I understand that it leaves one with a terrible feeling. Laws, however, shouldn't be based on a superficial definition of human-ness.

Yes, I understand that a 21 week old baby is quite different than a full term baby. Most don't survive and those that do have a very hard road ahead of them. I was speaking (as you know now) to those who have never seen a baby that young.

Where I do disagree with you however is your certainty about the age these babies become 'human'. Research in these areas is still going on. 21 weeks? 25 weeks? I wouldn't be comfortable sounding so confident about the number.

she showed me a baby who was 21 weeks

It was delivered after 21 weeks. In other words, long before she should have been born.
posted by justgary at 12:59 PM on August 31, 2001


Where I do disagree with you however is your certainty about the age these babies become 'human'. Research in these areas is still going on. 21 weeks? 25 weeks? I wouldn't be comfortable sounding so confident about the number.

I was using 'human' in the sense of being comparable to a fully developed infant. Normal infants develop brainwave patterns comparable to fully developed infant at 26 weeks.
posted by skyline at 4:14 PM on August 31, 2001


Gotcha.
posted by justgary at 4:16 PM on August 31, 2001


Doing such would imply that your views of when life begins would be imposed on those that feel uncomfortable doing such without scientific data

Your argument sounds familiar. If I'm not mistaken, in the years prior to the civil war some southerners attempted to justify slavery by arguing that African American's were not, scientifically speaking, human beings. If they're not full human beings, then they're not worthy of protection under the law.

In fact, your argument actually cuts against you. You're saying that the science is unclear about whether or not we are legalizing the murder of thousands of human beings a year. Given the uncertainty, which value should we act to protect: the value of convenience for the woman, or the value of life for the (potential) child? Better safe than sorry, as they say.

Individuals agree to give up these rights because society offers more benefits that burdens, but where society can't come to a consensus, there is no justification for a law that would take away individual freedoms

So what about women's suffrage? There was a time when society hadn't reached consensus on that issue, yet we felt comfortable giving women the right to vote anyway. Protecting minorities from the tyranny of the majority was one of the reasons that this country was set up as a republic rather than a true democracy. Protecting individual rights even in the face of public opposition is a tradition that has served this country well. If you believe that there is a reasonable chance (not certainty, but chance) that a fetus is a person, then I would strongly urge you to consider opposing abortion. If you don't believe that there is a reasonable chance that the fetus is a person some time prior to birth, then you don't understand the scientific evidence sufficiently well... go back and study the issue some more.

It seems to me that there are two main arguments against the humanity of a fetus: viability, and gradual development.

Viability argues that an organism which isn't viable outside the mother's womb isn't a separate human being. What people rarely realize is that this view also indicts partial-birth abortion (thousands of which occurr per year) as infanticide, since the fetus could survive outside the womb at the moment of birth. Also, this view is illogical: parasites often cannot survive without the assistance of their host, yet no one claims that they are not separate creatures.

The gradual development theory holds that a fetus gains increasing levels of human worth as it develops. This view seems to be only reasonable absent a belief in the soul. Aside from the difficulty inherent in weighing the partial value of this human life against a woman's right to choose, the best rebuttal I know is this:

The argument that an acorn isn't an oak but a potential oak isn't true. An acorn is an oak just as a mature oak tree is an oak, both are oaks but they are at different stages of development. It is entirely what an oak was meant to be. No nascent form of a being is the same as the mature form. Is an infant an adult? Of course not. Is a little sprig of an oak tree coming out of the ground a mature tree? No. An infant form is not an adult form, that's all you're saying when you say that an acorn isn't an oak. An acorn is an oak but it's not the adult form. In the same way, a brand new human being formed by the fertilization of a human egg and sperm is everything that a human being is in its substance or essence.
posted by gd779 at 1:39 PM on September 1, 2001


So, based on everything that's been said, can we all agree that partial birth abortion (aka intact D&X) should be banned except to preserve the health of the mother? The Journal of the American Medical Association describes intact D&X like this:

The intact D&X procedure involves literally delivering the fetus so that only the head remains within the cervix. At this juncture, the fetus is merely inches from being delivered and obtaining full legal rights of personhood under the US Constitution. What happens when, as must occasionally occur during the performance of an intact D&X, the fetal head inadvertently slips out of the mother and a live infant is fully delivered? For this reason, many otherwise prochoice individuals have found intact D&X too close to infanticide to ethically justify its continued use."

In partial birth abortion, the doctor terminates a child that would have been fully viable had it been allowed to move a few inches outside of the womb of the mother. Surely those few inches cannot be the basis of personhood? The AMA also recommends banning the procedure.

According to the American College of Obstetricians and Gynecologists, there are "no circumstances under which this procedure would be the only option to save the life of the mother or preserve the health of the woman." The ACOG adds, however, that partial birth abortion "may be the best or most appropriate procedure in a particular circumstance to save the life or preserve the health of a woman".

According to reports (same link as above), about 9% of partial birth abortion procedures are due to maternal health concerns, the most common of which is depression. Roughly 80% are purely elective: at least one woman has chosen to terminate due to the fetus's cleft lip.
posted by gd779 at 1:51 PM on September 1, 2001


Machaus: Thanks for the complimentary tone. For the record, I generally post to Metafilter as a means of clarifying and improving my own positions. Iron sharpening iron through debate, so to speak. Secondarily, I post to share with others information or paradigms that I find particularly useful. The first and often hardest step in forming any policy is clarifying the real issue. The facts generally speak for themselves.
posted by gd779 at 2:03 PM on September 1, 2001


If you don't believe that there is a reasonable chance that the fetus is a person some time prior to birth, then you don't understand the scientific evidence sufficiently well

Sorry, about the multitude of posts, but I want to head off a potential point of contention. That statement of mine (above) was very unclear. I'm trying to convey that the science clearly leaves room for the personhood of the fetus at some point prior to birth (see my arguments about partial birth abortion). Anyone who is completely certain that a fetus cannot be a person at any time prior to birth is, in my opinion, operating off of ideological rather than scientific grounds.
posted by gd779 at 2:07 PM on September 1, 2001


Anyone who is completely certain that a fetus cannot be a person at any time prior to birth is, in my opinion, operating off of ideological rather than scientific grounds.

Absolutely, and well put, but I think it's unlikely that science can answer such a question. When we say person, we mean a package of form, consciousness, and (for some,) an external soul. Science can't touch the soul, and we know practically nothing about consciousness. As an atheist, I believe that consciousness arises after conception (obvious, but many disagree) and that destroying an unconscious but potential human is immoral but not unjust (it's just matter, after all).

If I'm not mistaken, in the years prior to the civil war some southerners attempted to justify slavery by arguing that African American's were not, scientifically speaking, human beings.

More than a few thinkers protested this claim on its lack of scientific rigor, from Jefferson to DuBois. This comes too close to the old Nazi/Hitler-comparison tactic.
posted by skyline at 2:45 PM on September 1, 2001


>>Basically, you've touched on the core question: at what point do we grant the moral and legal rights that go along with being a member of the human race (as opposed to being an animal).

Presumptuous "we"....

Funny how the debate changes when you drop the highminded air of reverence towards "the human race". A grown chimp is far more sophisticated -- physically, mentally, culturally -- than a few month old human fetus, and yet you don't see too many "pro-lifers" protesting HLS.

Also, just to clarify: the arguments in Judith Jarvis Thomson's essay don't depend at all on disqualifying fetuses from personhood. Therein lies the subtlety and innovation: she grants the other side's answer to the "core question", and goes from there.
posted by johnb at 7:52 PM on September 1, 2001


This comes too close to the old Nazi/Hitler-comparison tactic.

You're right. It was a poorly chosen analogy, and I withdraw it. However it does illustrate my point: morality is not determined by a consensus of the majority, certainly not when one group (women, slave owners) has a personal stake in overriding the rights of another group.

Besides, I would argue that while we lack social consensus, in cases of partial birth abortion (at least) the scientific evidence is clear. That's why the American Medical Association recommends a ban on the procedure.
posted by gd779 at 8:19 PM on September 1, 2001


I was curious if any of you know what the baby does during an abortion. It tries to get away from the vacuum, it does not want to die. If you want to read what the different methods of aborting a baby are, go to this website.
posted by Uncle Joe's Brother at 8:26 PM on September 1, 2001


Oops, here is the website
posted by Uncle Joe's Brother at 8:27 PM on September 1, 2001


And onions don't want to get cut, either. so they emit hydrogen sulfide when they are.
posted by Hildegarde at 11:56 AM on September 2, 2001


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