The pain of the fetus

In France, the new studies demonstrate that the fetus can suffer. The question is to find the treatment to fight this pain.
On June 5th in Paris, Palais du Luxembourg, the PremUp foundation organizes a colloquium to discuss it. This Fondation works on prematurity, average prematurity and extreme prematurity.
The premature births increased by 15 % these last ten years in France. The fetus perceives the pain from the second quarter of the pregnancy, it is important to treat her.

What is the best means to avoid the suffering of the foetus?
Besides the contact with the mother, the environment of the fetus is essential. Some medical staffs can give painkillers for 20 % of case. But all hospitals cannot afford it. Unfortunately, the French hospitals miss means.

This colloquium will be the opportunity to speak about solutions the most adapted to treat the pain of fetus.

The PremUp Foundation Website, english pages: http://www.premup.org/en/

Pain and personhood

Yesterday's NYT Magazine ran a long article about whether fetuses feel pain. The author, Annie Murphy Paul, is working on a book about how our early experiences shape development, and she asks some interesting questions about what effects pain and stress might have on fetuses. The pain question is an interesting one, and experts disagree about whether, to what degree, and at what point in time fetuses can experience pain.

If fetuses can experience pain, it seems not only reasonable but morally necessary that they receive sufficient anesthesia when they undergo painful procedures (such as blood transfusions or surgical interventions--which, believe it or not, can actually be done in utero in certain specialized centers in the U.S.). Such a claim doesn't rest on assertions of personhood, only of sentience. I would never let a veterinarian do surgery on my dog without anesthesia, but that doesn't make him a person.

As Paul notes, some anti-abortion activists have seized on research that shows fetuses displaying a physiological response to painful stimuli. They want to use this information as an emotional weapon, making sure that women know that if they have an abortion, the fetus will feel pain. Therefore, the argument goes, they should not abort. But while such a statement might make a woman feel worse, I have a hard time imagining that it would really change the mind of a person who'd made a firm decision to abort. It might cause her to ask that anesthesia be provided, though, which seems like a good thing.

Setting aside the abortion debate, pain is awfully tricky. We tend to understand pain as a subjective phenomenon: two people exposed to the same painful stimulus might well have different responses. So what does it mean to talk about pain for the fetus, who can't rate pain on a scale from 1 to 10, or even point at a frowny face? What do measures of cortisol or other stress hormones, or changes in blood flow, tell us about what the fetus is experiencing?

If we say that increases in certain metrics or decreases in others correlate with pain, what would it mean if we saw similar indications in a person in a persistent vegetative state? Paul comments that it might cause one to reconsider active euthanasia in such a situation, as a means of sparing suffering. But the connection between pain and suffering, between objective physiological measures and life as experienced, forces us to think about consciousness, about personhood, about respect for living beings (human and not), and about mercy. I can't do the article justice here, but it's definitely worth a read.

A Painful Issue...

The Washington Post describes a controversial article published in JAMA; researchers at University of California San Francisco reviewed dozens of studies and medical reports and said the data indicate that fetuses likely are incapable of feeling pain until around the seventh month of pregnancy, when they are about 28 weeks old. Other researchers have claimed that evidence indicates that the capability of feeling pain can occur as early as 20 weeks. The reason this is of significance is that there has been proposed federal legislation that 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; apparently several states have enacted similar legislation. One thing is for sure: We will hear more about this as neuroimaging and neuroscanning techniques improve. For the link to the article at JAMA (Journal of the American Medical Association click here.