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Fetal pain, its existence, and its implications are debated politically and academically. Many researchers agree pain likely cannot be felt until around the seventh month of pregnancy, although some scientists disagree and a consensus has proven elusive. Developmental neurobiologists suspect that the establishment of thalamocortical connections" (at about 26 weeks) may be critical to fetal perception of pain. Nevertheless, because pain can involve sensory, emotional and cognitive factors, it is difficult to know when pain can exist.

Whether a fetus has the ability to feel pain and to suffer is part of the abortion debate. For example, legislation has been proposed by pro-life advocates requiring abortion providers to tell a woman that the fetus may feel pain during the abortion procedure, and that require her to accept or decline anesthesia for the fetus.

Medical studies and reviews

United Kingdom

In 2006, an opinion piece published in the British Medical Journal concluded that pain is dependent upon cognitive and emotional developments that occur after birth:

"Theories of development assume that the early human mind begins with minimal content and gradually evolves into the rich experience of older children and adults. Although the view of a neonate as a blank slate, or tabula rasa, is generally rejected, it is broadly accepted that psychological processes have content concerning people, objects, and symbols, which lay in the first instance outside the brain. If pain also depends on content derived from outside the brain, then fetal pain cannot be possible, regardless of neural development."

In 2001, a working group of the Medical Research Council (UK) in the United Kingdom suggested that doctors should consider the use of analgesia and sedation for fetuses over 24 weeks of age undergoing surgery. Eve Johnstone, the chair of that working group, told The Daily Telegraph that a fetus was aware of pain by 24 weeks, because "onnections from the thalamus to the cortex begin to form at about 20 weeks gestation." Dr. Susan Dudley of the National Abortion Federation in the U.S. responded: "The obvious and most important thing to say is most abortions take place before 20 weeks."

Also in 1997, a "Working Party" appointed by the Royal College of Obstetricians and Gynaecologists, a medical group in the United Kingdom, stated that "very early in pregnancy fetuses will react to stimuli, but that reaction does not in itself provide any evidence that the fetus experiences those stimuli." The Working Party further stated that, "Little sensory input" reaches the brain of the developing foetus before 26 weeks, and "therefore reactions to noxious stimuli cannot be interpreted as feeling or perceiving pain."

United States

In 2005, Mellor and colleagues reviewed several lines of evidence that suggested a fetus does not awaken during its time in the womb. If the fetus is asleep throughout gestation then the possibility of fetal pain is greatly minimized.

Later in 2005, a meta-analysis (or "review") of existing experiments published in the Journal of the American Medical Association (JAMA) concluded that the limited available evidence indicates fetal perception of pain is unlikely before the third trimester, and that electroencephalography suggests the capacity for functional pain perception in premature infants probably does not exist before 29 or 30 weeks; this study asserted that withdrawal reflexes and changes in heart rates and hormone levels in response to invasive procedures are reflexes that do not indicate fetal pain. The report has been highly criticized by pro-life activists, who claim that the results may have been biased by the undisclosed ties to pro-choice activism of 2 out of the 5 authors.

The National Right to Life Committee (NRLC) criticized the study, claiming that two of the five authors of the study had done abortion work or abortion related work. Catherine DeAngelis, editor-in chief of JAMA, said that the journal would have published the affiliations if they had known about them at the time of publishing. She also said any disclosure would not have prevented her from publishing the article. DeAngelis went on to say, "It is a peer-reviewed article. They are not reporting their own findings. It's a review article based on what's in the literature." Arthur Caplan, chair of the department of medical ethics at the University of Pennsylvania, said about the NRLC criticisms, "As a scientist, if you think I'm wrong, you probe my data, question my findings and do a critical study -- not point your finger and talk about my politics."

In 1980, Stanislav Reinis and Jerome M. Goldman wrote that, "The first detectable brain activity in response to noxious stimuli occurs in the thalamus between the ninth and tenth weeks."

Abortion Debate

United Kingdom

In 1996, physiologist Peter McCullagh spoke on behalf of a pro-life group to the British Parlament. He said, "At what stage of human prenatal development are those anatomical structures subserving the appreciation of pain present and functional? The balance of evidence at the present time indicates that these structures are present and functional before the tenth week of intrauterine life."

United States

In 1995, Dr. Robert J. White, director of the Division of Neurosurgery and Brain Research Laboratory at Case Western Reserve University School of Medicine and a member of the Vatican's Pontifical Academy of Sciences, gave testimony before the House Constitution Subcommittee of the Congress of the United States. He stated that, at 20 weeks' gestation, the fetus "is fully capable of experiencing pain...Without question, all of this is a dreadfully painful experience for any infant subjected to such a surgical procedure."

In 1984, anesthesiologist Vincent J. Collins wrote: "because the requisite neurological structures are present at that time and because they are functioning, as evidenced by the aversive response of the human fetus, it may be concluded with reasonable medical certainty that the fetus can sense pain at least by 13 ½ weeks." Dr. Collins was one of several scientists who wrote an open letter to President Reagan, asserting that, "The ability to feel pain and respond to it is clearly not a phenomenon that develops de novo at birth....by the close of the first trimester the fetus is a sentient, moving being."

References

1. "Study: Fetus feels no pain until third trimester" MSNBC
2. ^ Lee, Susan J., Ralston, Henry J. Peter, Drey, Eleanor A., Partridge, John Colin, & Rosen, Mark A. (2005). Fetal Pain: A Systematic Multidisciplinary Review of the Evidence. Journal of the American Medical Association, 294 (8), 947-954. Retrieved 2007-02-26.
3. ^ Grady, Denise Study Authors Didn't Report Abortion Ties New York Times August 26, 2005 Retrieved March 15, 2008.
4. ^ Johnson, Martin and Everitt, Barry. Essential reproduction (Blackwell 2000): "The multidimensionality of pain perception, involving sensory, emotional, and cognitive factors may in itself be the basis of conscious, painful experience, but it will remain difficult to attribute this to a fetus at any particular developmental age." Retrieved 2007-02-21.
5. White, R. Frank. "Are We Overlooking Fetal Pain and Suffering During Abortion?", American Society of Anesthesiologists Newsletter (October 2001). Retrieved 2007-03-10.
6. David, Barry & and Goldberg, Barth. "Recovering Damages for Fetal Pain and Suffering", Illinois Bar Journal (December 2002). Retrieved 2007-03-10.
7. Weisman, Jonathan. "House to Consider Abortion Anesthesia Bill", Washington Post 2006-12-05. Retrieved 2007-02-06.
8. Derbyshire, S.W.G. (2006). Can fetuses feel pain?. British Medical Journal, 332 (7546), 909-12. Retrieved 2006-12-23.
9. Medical Research Council, Fetal Pain - Research Review (2001-08-24). Retrieved 2007-03-10.
10. Highfield, Roger. "Very premature babies may need pain relieving drugs," The Telegraph (2001-08-27). Retrieved 2007-03-10.
11. Medical Research Council, Fetal Pain - Research Review (2001-08-24). Retrieved 2007-03-10.
12. Beaucar, Kelley. Fetal Study Adds Fuel to Late-Term Abortion Debate, Fox News (2001-08-31). Retrieved 2007-03-10.
13. Fetal Awareness Report of a Working Party RCOG Press. October 1997.
14. 'Abortion causes foetal pain' BBC.co.uk. 29 August, 2000. Accessed 2007-03-09. A British government report said in 2007 (shortly before the RCOG report) that signals from the thalamus begin to reach the cortex between "22-34 weeks" after conception. See Parliamentary Office of Science and Technology,Fetal Awareness (February 1997). Retrieved 2007-03-15.
15. Mellor D.J., Diesch T.J., Gunn A.J., & Bennet L. (2005). The importance of ‘awareness’ for understanding fetal pain. Brain Research Reviews, 49(3), 455-71. Retrieved December 23, 2006.
16. "Study Authors Didn't Report Abortion Ties". New York Times. Retrieved 2008-04-03.
17. ^ Fetal Pain Analysis Ignites Passions on Disclosure Issue
18. Reinis, Stanislav and Goldman, Jerome. The Development of the Brain (Charles C. Thomas 1980).
19. McCullagh Peter. "Fetal sentience. London: All-Party Parliamentary Pro-Life Group (1996). Dr. McCullagh is a Senior fellow in developmental physiology at the John Curtin School of Medical Research, Australian National University. This report was reprinted in the Catholic Medical Quarterly, XLV11 no 2, November 1996, p6. Retrieved 2007-03-10.
20. White, Robert. Testimony to U.S. House Judiciary Committee, Subcommittee on the Constitution (1995-06-15). Quoted in this congressional report. Retrieved 2007-03-10.
21. Collins, Vincent et al."Fetal Pain and Abortion: the Medical Evidence", Studies in Law and Medicine, No 18 (1984).
22. Schmidt, Richard et al., "Open Letter to President Reagan" (1984-01-31). Retrieved 2007-03-14.

• Abortion debate
• Medical ethics