Discounting fetal pain.

ITEM: A widely published Associated Press story reported on August 23: "A review of medical evidence by a group of researchers in California concludes that fetuses likely don't feel pain until the final months of pregnancy, a powerful challenge to abortion opponents who hope that discussions about fetal pain will make women think twice about ending pregnancies."

ITEM: Shortly thereafter, it was disclosed that two authors of the review were abortion promoters and providers. However, as reported by the Philadelphia Inquirer for August 27: "The UCSF [University of California at San Francisco] researchers have not conceded any failings. 'The research team does not believe that being an abortion provider is a conflict of interest, nor that such information should be disclosed as part of the publication,' declared a statement released by Philip D. Darn<v, chief of obstetrics, gynecology and reproductive sciences at San Francisco General Hospital, which includes the abortion clinic."

CORRECTION: Not only are the conclusions of this medical review suspect, so are the motivations of its authors and promoters. Yet, when these conflicts of interest were made public, Dr. Catherine DeAngelis, editor-in-chief of the Journal of the American Medical Association (JAMA), denied that the publishing decision was "politically motivated." The utter dubiousness of that contention is reflected in the review's very first sentence, which states that proposed legislation would require physicians to tell pregnant women considering abortions that fetuses feel pain and to offer anesthesia for the unborn.

Does not legislation fall squarely into the realm of "politics"? Of course it does, which is why the review is being pushed by opponents of the proposed legislation.

The lead author of the JAMA review, Susan Lee, has been a lawyer for the pro-abortion group NARAL; she is now a medical student. One coauthor, Dr. Eleanor Drey, is the director of the largest abortion clinic in San Francisco. Drey has acknowledged that her clinic performs about 600 abortions per year during the fifth and sixth months (weeks 21 through 23 of pregnancy), as recounted by the National Right to Life organization.

JAMA's editor subsequently said that she had been unaware of any potential conflict of interest with the reviewers, but that she would have disclosed their affiliations if she had known about them. Obviously distraught that her professionalism had been challenged, the editor maintained to USA Today that the reviewers' pro-abortion affiliations "aren't relevant"--begging the question about why she would have published that supposedly irrelevant information.

Does one really believe that JAMA would publish the work of pro-life medical personnel supportive of the Unborn Child Pain Awareness Act without mentioning their affiliations? To ask the question is to answer it.

Dr. K.S. Anand, a former Rhodes Scholar who is a tenured Professor of Pediatrics, Anesthesiology, Pharmacology, and Neurobiology in the College of Medicine at the University of Arkansas for Medical Sciences, and who has studied the issue of fetal pain for two decades, is among those sharply disagreeing with the conclusions of the clinical review. He says that the authors excluded or minimized evidence indicating that fetal pain sensation begins in the second trimester. Keep in mind that while Dr. Anand has testified as an expert against some late-term abortions, he is not opposed to legalized abortions.

Nevertheless, consider his court testimony: "It is my opinion that the human fetus possesses the ability to experience pain from 20 weeks of gestation, if not earlier, and that pain perceived by a fetus is possibly more intense than that perceived by newborns or older children." As Anand told the New York Times after the JAMA controversy broke: "By the second trimester, all bets are off and I would argue that in the absence of absolute proof we should give the fetus the benefit of the doubt if we are going to call ourselves compassionate and humane physicians."

When one of Anand's papers appeared in the New England Journal of Medicine in 1987, documenting the doctor's contention that fetuses as early as 20 weeks feel pain (citing 201 sources), the publication ran an accompanying editorial saying how "important" these findings were. The observations, said the editorial, "should dispel the now outmoded notion that newborns are insensitive to or immune to pain." What is more, the data in this study has been borne out over time--it is becoming increasingly common for infants born at only 23 weeks of gestation to survive.

If neonates feel pain by 20 weeks, it certainly hurts the case of abortion advocates who claim unborn babies in utero up to 29 weeks feel no pain.

That point has not been lost on Dr. Paul Ranalli, a neurologist at the University of Toronto who has served as the head of the de Veber Institute for Bioethics and Social Research and as an officer of Canadian Physicians for Life. He has marshaled evidence that fetuses feel pain into three general areas--anatomical, physiological/hormonal, and behavioral. The doctor describes in detail pain receptors, stress hormones, withdrawal from pain, and changes in vital signs.

Commenting on the JAMA review (as cited on the National Right to Life website nrlc.org), Ranalli points out that neonatal intensive care units are filled with infants born prematurely who are bravely struggling. "The only difference between a child in the womb at this stage, or one born and cared for in an incubator, is how they receive oxygen--either through the umbilical cord or through the lungs," says Ranalli. "There is no difference in their nervous systems. Their article sets back humane pediatric medicine 20 years, back to a time when doctors still believed babies could not feel pain."