Reaction to fetal pain article

A thoughtful, informed response to the JAMA article about fetal pain is posted at OpinionJournal. Scroll down to Comfortably Numb? to see it. The JAMA article concluded that first and second trimester fetuses probably don’t feel pain. But according to the OpinionJournal authors,

It would be a mistake… to assume that because a fetus does not have the same cerebral capacity as an adult, he has no capacity to feel pain.

We just don’t know.

August 25, 2005

9 thoughts on “Reaction to fetal pain article”

  1. I have the relevant JAMA issue open in front of me as I write.

    From the introduction, this meta-analysis sounds more like political advocacy than scientific review. “Over the last several years, many states, including California, Kentucky, Minnesota, Montana, New York, Oregon, and Virginia, have considered legislation requireing physicians to inform women seeking abortions that the fetus feels pain and to offer fetal anesthesia…”

    That’s a shame, because the actual text of the article is a fairly good review of the subject. I’m not an expert in the literature so I cannot speak to it’s comprehensiveness.

    Those seeking to protect abortion rights, might, however, find their cause harmed by the JAMA piece. Defenders of dilatation and extraction (partial-birth abortion), are left having to defend what even Lee (a med student), and colleagues acknowledge is a painful procedure.

    All of the foregoing is irrelevant to the question of whether abortion is justified killing. In other words, the question of whether the fetus feels pain is irrelevant to the question of whether it is okay to kill it.

  2. It is very clear after reading Dr. Sanjay Gupta’s comments on fetal pain that this JAMA article was based on biased conclusions on old research. There is insufficient research at present to derive the conclusions reached in this article. The evidence if any points to the direction that it is likely that fetus feels pain.

    Dr. Sanjay Gupta’s comments can be read at American Pain Association website http://www.painassociation.org.

  3. Although I appreciate what the “American Pain Association” is trying to do, they are doing a bad job of it. First of all, Dr. Gupta’s article (at most 4 paragraphs) makes no such comment about old research, and provides no references. There is, however, an email link to contact Dr. Gupta.

    The “APA” is located in a residential neighborhood in Voorhees, NJ, not far from Woodcrest Country Club.

    see:

    http://www.mapquest.com/maps/map.adp?country=US&addtohistory=&formtype=address&searchtype=address&cat=&address=66%20Franklin%20Dr&city=Voorhees&state=NJ&zipcode=08043%2d2162&searchtab=home

  4. An article in the Philadelphia Inquirer adds a wrinkle about whether the Journal authors should have disclosed conflicts of interest. The editor of JAMA wishes the authors had disclosed their role in providing abortions.

    Excerpts below:

    The article did not disclose – because JAMA editor in chief Catherine DeAngelis did not know until The Inquirer asked about it – that two of the five authors from the University of California at San Francisco are abortion-rights advocates. Susan Lee, a medical student and lawyer, worked briefly for NARAL Pro-Choice America. Eleanor Drey, an obstetrician-gynecologist, is medical director of an abortion clinic.

    In a statement, a UCSF official denied any conflict of interest, saying that the JAMA article “represents… thoughtful and thorough scholarship” and that “no affiliations nor clinical practice information were withheld inappropriately.”

  5. Good points, David. UCSF was able to weasel out of this one since the body of the article does indeed reflect a fair amount of scholarship.

    It’s clear to me, however, that the introduction fairly exudes partisanship. Now that we know the author’s affiliations, the conclusions become tainted. Better that they should have revealed them.

    The question is therefore begged: why didn’t they disclose?

  6. Good question on the disclosure. I just sent this email to the corresponding author. Let’s see if he replies:

    Dr. Rosen,

    I’m the author of the Health business blog. We’ve been discussing your fetal pain article. See https://healthbusinessgroup.com/blog/2005/08/25/reaction-to-fetal-pain-article/ and https://healthbusinessgroup.com/blog/2005/08/24/politically-charged-journal-article-of-the-week/.

    One commenter asked why your co-authors did not disclose their current or prior affiliations with a pro-choice organization and with a clinic that provides abortions.

    I’d be interested in your perspective.

    Thank you,

    David Williams

  7. Its time to end the barbarism in medical care and enforce the prohibition against cruel and degrading treatment. Physicians are too quick to subject infants children and adults to painful procedures without analgesia-because as texas pain initiative indicates there no cost to them for poor pain care. Most physicians receive no education in pain care. For too many years physicians operated on infants and children without anesthesia-lets end the barbarism and the “gnostic denial of the human” by requiring adequate pain care for all

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