Dr. Carlo Bellieni, an expert pediatrician, states in Bioethics Today that “denying fetal pain in the second half of pregnancy can undermine preterm babies’ right to analgesia.”

According to Bellieni, in recent months there are some who argue against abortion saying that fetuses can feel pain in the first trimester of pregnancy, while others say the opposite (see more HERE).

In an article published in Nature Neuroscience, the authors point out that it cannot be said that the fetus feels pain between 12 and 14 weeks of gestation, a statement with which Bellieni agrees, and also that this sensation cannot be felt before 24 weeks, which, according to his criteria, is difficult to demonstrate.

According to the American College of Obstetricians and Gynecologists, the cerebral cortex, which is essential for feeling pain, develops after the 24th or 25th week, while in another article they argue that ” it is unlikely that fetal pain perception is possible before the 29th or 30th weeks of pregnancy”. According to Bellieni, ” This late pain threshold has been widely criticized, for its frail physiological bases, and because all the patients younger than that age, who are being taken care of, would not receive consequently any analgesic treatments.”

Since there are babies born very prematurely and some survive as late as 22 weeks gestation and fetuses less than 24 or 30 weeks gestation can undergo prenatal surgery to cure some congenital anomalies, these preterm infants and fetuses would not receive analgesia if the delayed pain threshold were applied.

Two aspects are worth highlighting:

The first is that according to an article, the maturation of the human brain begins in the third gestational week and rapidly grows and matures over the course of pregnancy, so it would be impossible to find a threshold that would establish the periods in which the fetus does or does not experience pain. Although, according to another article, the connections between peripheral receptors and the thalamus in the human fetal brain, which appear between 19 and 22 weeks of gestation, allow the perception of pain.

Bellieni recently published an article stating that fetal pain “is a neuroadaptive phenomenon that emerges in the middle of pregnancy, at about 20-22 weeks of gestation, and becomes more and more evident for bystanders and significant for the fetus, throughout the rest of the pregnancy”.

The second point to comment on is the consequences that can result from a strict fetal pain threshold, such as the fact that fetuses undergoing prenatal surgery and premature infants would not have access to analgesics during surgical interventions.

Currently, neonatologists and anesthetists administer analgesic drugs to fetuses or newborns during surgery, but will they continue to do so if the evidence for the possibility of pain in their patients is questioned? Faced with pain, we must always use the precautionary principle, of course backed by scientific evidence.

Bioethical assessment

The question of whether or not the fetus can experience pain, which, as has been stated, is very difficult to resolve, cannot obviate the need to act prudently in any intervention that could cause suffering. Not using analgesia before an intervention that admits its use, and justifying it in the belief that the patient does not experience pain, constitutes malpractice and a bioethically unacceptable maleficent act.

On the other hand, trying to use the argument that the fetus does not experience pain until late in the pregnancy to downplay the drama of the practice of abortion, constitutes intolerable manipulation.

Today there are those who defend that killing without pain (in euthanasia, in the death penalty or in induced abortion) is more humane, less reprehensible, more compassionate. An attempt against life is always reprehensible, regardless of whether it is done with analgesia or not.

In abortion, both the mother who aborts and the aborted fetus suffer, since, even if the fetus does not experience pain, he suffers the violence of the one who ends his life without further ado.

 

Ester Bosch and Julio Tudela

Bioethics Observatory – Institute of Life Sciences

Catholic University of Valencia

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