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Fetal Pain Unlikely Until After 28 Weeks' Gestation, Review Says; Critics Claim Authors Have Politically Motivated Bias

A fetus's neurological pathways in its brain that allow for the "conscious perception of pain" do not function until after 28 weeks' gestation, according to a review of previous data and evidence published on Wednesday in the... Journal of the American Medical Association, the Pittsburgh Post-Gazette reports (Linn, Pittsburgh Post-Gazette, 8/24). Susan Lee and colleagues from the University of California-San Francisco conducted a review of existing medical evidence on topics including fetal pain, the use of anesthesia and facial expressions of fetuses in reaction to a stimulus. The review -- which cited studies suggesting that the neurological pathways develop after about 22 to 24 weeks' gestation and might take another five to seven weeks to start functioning -- defined pain as a "sensory and emotional experience that requires the presence of consciousness to permit recongnition of stimulus as unpleasant" (Hall, San Francisco Chronicle, 8/24). The researchers concluded that women seeking abortions before the third trimester of pregnancy should not be subjected to the risks of administering anesthesia to the fetus, which could cause bleeding, breathing problems and other complications -- including death -- for the woman, the Chicago Tribune reports. "Fetal anesthesia or analgesia should not be recommended or routinely offered for abortion because current experimental techniques provide unknown fetal benefit and may increase risks for women," the authors wrote (Kotulak/Graham, Chicago Tribune, 8/24). Findings Disputed
The review was disputed by critics who claimed the authors were biased in reaching their conclusions, the AP/Yahoo! News reports (Tanner, AP/Yahoo! News, 8/23). The article does not mention that study co-author Eleanor Drey, a UCSF OB/GYN, is the medical director of the abortion clinic at San Francisco General Hospital and that another author previously worked for NARAL Pro-Choice America, the Knight Ridder/Newark Star-Ledger reports (McCullough, Knight Ridder/Newark Star-Ledger, 8/24). In addition, the definition of pain used in the study is "markedly different" from the ability to take in a noxious stimulus, which is known medically as "nociception," according to the San Francisco Chronicle. Pain also can occur without a physical stimulus, as in certain chronic pain syndromes, the Chronicle reports (San Francisco Chronicle, 8/24). Reaction
Douglas Johnson, legislative director for the National Right to Life Committee, said the researchers' aim was to create information that would persuade physicians not to discuss fetal pain with their patients (Pittsburgh Post Gazette, 8/24). "[The authors] have literally stuck their hand into a hornet's nest," Kanwaljeet Anand -- a fetal pain researcher at the University of Arkansas for Medical Sciences, who believes fetuses can feel pain at 20 weeks' gestation -- said. He added, "This is going to inflame a lot of scientists who are very, very concerned and are far more knowledgeable in this area than the authors appear to be" (AP/Yahoo! News, 8/23). However, the review's conclusions are similar to the findings of a British panel released eight years ago. In addition, a panel commissioned by Physicians for Reproductive Choice and Health has been researching the issue over the past two years and "reached the exact same conclusions," according to PRCH Chair Wendy Chavkin (Maugh, Los Angeles Times, 8/24). David Grimes, an OB/GYN in Chapel Hill, N.C., and former head of abortion surveillance at CDC, said the issue of when a fetus can feel pain "is an unknowable question," adding, "All we can do in medicine is infer." Federal, State Legislation
Bills requiring that women seeking abortions be warned that their fetuses might feel pain have been introduced in Congress and 19 states, with such measures recently approved in Georgia, Arkansas and Minnesota, the New York Times reports. Legislation in Congress, known as the Unborn Child Pain Awareness Act (S 51, HR 356), would require abortion providers to tell women seeking abortion at 20 weeks' gestation or later that there is "substantial evidence" that fetuses can feel "substantial pain" during abortion procedures (Grady, New York Times, 8/24). The measure -- which was introduced by Rep. Chris Smith (R-N.J.) in the House and Sen. Sam Brownback (R-Kan.) in the Senate -- also would require doctors to offer a woman the option of providing anesthesia to her fetus before undergoing abortion (Kaiser Daily Reproductive Health Report, 5/21). The script that physicians would be required to read includes the statement, "The Congress of the United States has determined that at this stage of development, an unborn child has the physical structures necessary to experience pain" (New York Times, 8/24). Abortion providers found to be in violation of the legislation would be subject to fines and could lose their medical licenses if they repeatedly violated the provision (Kaiser Daily Reproductive Health Report, 5/21). Brownback said he hopes Congress will act on the bill next year, adding that it is "one of the top priorities of the pro-life movement to address this issue" (New York Times, 8/24).

ABCNews' "World News Tonight" on Tuesday reported on the review. The segment includes comments from Brownback; Andrew Harris, an obstetric anesthesiologist; Ian Holzman, chief of neonatal medicine at Mt. Sinai Medical Center in New York; and Sarah Stoesz, CEO of Planned Parenthood of Minnesota, North Dakota and South Dakota (Weiner, "World News Tonight," ABCNews, 8/23). A video excerpt of the segment is available online in RealPlayer.

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.





Fetale Pain Improbabil decât dupã 28 sãptãmâni de gestaþie, spune examinare; Criticii Revendicaþi autori au motivat politic în diagonalã - Fetal Pain Unlikely Until After 28 Weeks' Gestation, Review Says; Critics Claim Authors Have Politically Motivated Bias - articole medicale engleza - startsanatate