Tag: syndicated

Blog Posts (3055)

May 23, 2016

The Politics of Fetal Pain

Earlier this year, Utah passed a fetal pain bill that requires the use of general anesthesia on women seeking abortions at 20 weeks gestation or later.  This bill, which relies on a controversial claim that fetuses may feel pain as early as 20 weeks, has been heavily criticized as an attempt to abrogate abortion rights rather than serving a legitimate protective purpose. 

The issue of fetal pain has long been a source of contention in the scientific community, and the dispute has led to several states restricting or prohibiting abortions 20 weeks or later on the basis of potential fetal pain.  While many argue that this law is just one of many across the country aimed not at protecting health, but at restricting or eliminating abortion rights, this law, in fact, seems to be justified in its goal of minimizing the possible experience of suffering by the fetus. 

While studies have not proven that a fetus can feel pain prior to the third trimester, reasonable doubt about the possibility of fetal experience of pain exists.  As E. Christian Brugger argues in his article entitled “The Problem of Fetal Pain and Abortion: Toward an Ethical Consensus for Appropriate Behavior,” there is no moral certitude that fetuses do not feel pain after 20 weeks, and “a preponderance of evidence supports the conclusion that fetal-pain experience beginning in the second trimester of pregnancy is a real possibility.”  Brugger makes the argument, drawing from several researchers of fetal neuroanatomy that all the neural structures for both pain perception and consciousness are in place by 18-20 weeks.  Furthermore, he argues that those who deny fetal consciousness until much later in pregnancy may be relying on outdated assumptions which place the seat of consciousness in the cerebral cortex, despite growing evidence that the upper brainstem and subcortical tissues may actually play a greater role.

If it is reasonable to believe that the fetal experience of pain is possible after 20 weeks, it seems equally reasonable to consider requiring anesthetic or analgesia for such fetuses to prevent unnecessary suffering.  Despite statements from ACOG and others supporting the assertion that fetal pain is not likely before the third trimester, even the possibility that the fetus may experience significant pain and distress supports the notion that, in the face of uncertainty, we should err on the side of preventing such pain.

Opponents of such requirements argue that anesthesia can pose significant and disproportionate risks to the woman with no corresponding benefit, and that the use of anesthesia will increase the cost of abortion significantly, potentially limiting access to the procedure for many women for financial reasons.  While mandating anesthesia or analgesia is not without risks, these risks are not disproportionate if the benefit is eliminating possible pain experienced by the fetus. 

Whether or not the primary purpose of this law is to curtail abortion rights, its effect is, in fact humane; that is, it is an attempt, in light of scientific and moral uncertainty, to prevent unnecessary fetal pain if, in fact, the fetus can and does experience it.  This compassionate approach seems eminently reasonable, and should be supported.

 

The Alden March Bioethics Institute offers a Master of Science in Bioethics, a Doctorate of Professional Studies in Bioethics, and Graduate Certificates in Clinical Ethics and Clinical Ethics Consultation. For more information on AMBI's online graduate programs, please visit our website.

May 23, 2016

Brain Cancer Awareness Month

Watching “60 Minutes” last week reminded me of why I pursued a degree in bioethics. The segment was on Duke University’s experimental treatment of glioblastoma patients and its surprising success treating this deadly cancer. There is a cautious optimism associated with this new treatment, which was granted “breakthrough status” by the FDA earlier this month. Immediately I was thrown back to 2010 when my wife’s... // Read More »
May 23, 2016

Making End-of-Life Care More Scientific

The Philadelphia Inquirer has an important story covering the FIELDS (Fostering Improvement in End-of-life Decision Science) program at PENN. Scott Halpern observes: "Everyone recognizes the problems that pervade end-of-life care and, because of ...
May 22, 2016

British Court of Protection Decides Another Medical Futility Case

Perhaps nowhere in the world other than the UK is there a more developed body of published, reasoned jurisprudence on when clinicians can stop life-sustaining treatment over family objections. In In re O, the 58-year old patient suffered a severe hyp...
May 21, 2016

Ninth Circuit Cautious about Brain Death Stay

In the Aden Hailu case in Nevada, the hospital kept a dead body in its ICU for seven months.  Seven months!  This was the result of numerous stays from the trial and supreme court pending the outcome of litigation. In contrast, in the ong...
May 21, 2016

4% to 5% of Patients Are Incapacitated and Unrepresented

Available US estimates are that 5% of critically ill patients in the hospital are incapacitated and unrepresented.  A new audit of UK hospitals finds that the rate there is similar, 4%.  
May 20, 2016

Roundup Ready® Humans

Everyone is familiar with Roundup®, arguably the most well-known of any herbicide in the world and my favorite gardening tool. What may be less well known is that Monsanto has created a line of genetically modified organisms (GMOs), which are resistant to their famous herbicide. Called Roundup Ready®, soybeans in this product line can essentially take a bath in Roundup and still grow up to... // Read More »
May 20, 2016

New Case - Lawson v. VCU Medical Center

A Virginia court has issued a temporary injunction ordering VCU Medical Center to continue life-sustaining medical treatment for Miranda Grace Lawson.  Virginia law is relatively unique in the United States in terms of empowering clinicians to re...
May 20, 2016

Fonseca v. Kaiser - Briefing on Stay from Ninth Circuit

Since the district court's stay expires tomorrow, the parties in the Fonseca v. Kaiser brain death dispute have submitted briefing on an "Emergency Motion under Circuit Rule 27-3."  I have posted the briefs filed on May 19. The Ninth Circuit s...
May 20, 2016

Fabricating Man

It has been reported that last week, a group of scientists met in a closed-door session at Harvard Medical School to discuss concrete steps and industry involvement to achieve the goal of synthesizing—creating in the laboratory—an entire human genome, and putting it into a cell, within 10 years.  Reportedly led by Harvard’s George Church, a leader and chief enthusiast of the technical prospects of genetic... // Read More »

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