No brain, no pain?
by Mary Kay Hastings
From the New York Times, February 10:
… [W]hen Kanwaljeet Anand was a medical resident in a neonatal intensive care unit, his tiny patients, many of them preterm infants, were often wheeled out of the ward and into an operating room. He soon learned what to expect on their return. The babies came back in terrible shape: their skin was gray, their breathing shallow, their pulses weak.
That is when I discovered that the babies were not getting anesthesia, he recalled recently.
Doctors were convinced that newborns nervous systems were too immature to sense pain, and that the dangers of anesthesia exceeded any potential benefits.
In a series of clinical trials, Anand demonstrated that operations performed under minimal or no anesthesia produced a massive stress response in newborn babies, releasing a flood of fight-or-flight hormones like adrenaline and cortisol….
The fetus is not a little adult, Anand says, and we should not expect it to look or act like one. Rather, it is a singular being with a life of the senses that is different, but no less real, than our own.
If the notion that newborns are incapable of feeling pain was once widespread among doctors, a comparable assumption about fetuses was even more entrenched:
Nicholas Fisk is a fetal-medicine specialist and director of the University of Queensland Center for Clinical Research in Australia, carried out a study that closely resembled Anands’ pioneering research, using fetuses rather than newborns as his subjects. He selected 45 fetuses that required a potentially painful blood transfusion, giving one-third of them an injection of the potent painkiller fentanyl. As with Anands’ experiments, the results were striking: in fetuses that received the analgesic, the production of stress hormones was halved, and the pattern of blood flow remained normal.
THE SAME MIGHT be said of the five children who were captured on video by a Swedish neuroscientist named Bjorn Merker on a trip to Disney World a few years ago:
The youngsters, ages 1 to 5, are shown smiling, laughing, fussing, crying; they appear alert and aware of what is going on around them. Yet each of these children was born essentially without a cerebral cortex. The condition is called hydranencephaly, in which the brain stem is preserved but the upper hemispheres are largely missing and replaced by fluid.
Merker (who has held positions at universities in Sweden and the United States but is currently unaffiliated) became interested in these children as the living embodiment of a scientific puzzle: where consciousness originates.
The tacit consensus concerning the cerebral cortex as the “organ of consciousness”, Merker wrote, may have been reached prematurely, and may in fact be seriously in error .
I urge you to please read the rest of the article here.
Jill Stanek is a nurse turned speaker, columnist and blogger, a national figure in the effort to protect both preborn and postborn innocent human life.
No anesthesia??? Unbelievable. At least one person cared enough to make a difference.
The guy clearly stated that these premies were in better condition if they received anathesia. That alone is a good argument for it.
When I had my boys circumcised as infants in the hospital, anasthesia was “optional”. In one case, the insurance didn’t cover it!
Jill, if you are there,
Is this how it was in your hospital too?
That is when I discovered that the babies were not getting anesthesia, he recalled recently.
I got to that part and then I started crying.
My daughter had to get a prick in her foot to test her bilirubin when she was like 5 days old..and she wailed like nobody’s business.
Poor babies…how can people do this?
Sweet, sweet cherubs.
It just amazes me – medical science has shown that the vestibular system, which is a part of the central nervous system, is fully fuctional at 7 gestation and is the ONLY part of the CNS that is fuctional at birth. Yet, people still want to say that the fetus doesn’t perceive pain.
There’s the catch. “perceive” meaning “to achieve understanding”. These newborns don’t perceive pain either – so why should we care if they get anesthestic or not?
Even though pulling away from pain is only reflexive – like the test scientist have done in utero -, that means the CNS is working. If the reflex is working then that means the body felt something. Otherwise, the fetus would not have moved. With every prick the baby is feeling the pain and learning what it is. But from the beginning the baby knew the sensation was something to move away from and stay away from because the CNS told the body it can be dangerous.
Just because the fetus doesn’t understand the pain it is getting, does that mean we should ignore the fact that the fetus IS feeling?
“Exhibiting his flair for the startling but apt expression, Stuart Derbyshire warns against “anthropomorphizing” the fetus, investing it with human qualities it has yet to develop. To do so, he suggests, would subtract some measure of our own humanity. And to concern ourselves only with the welfare of the fetus is to neglect the humanity of the pregnant woman, Mark Rosen notes.
Def.: anthropomorphism n.
Attribution of human motivation, characteristics, or behavior to inanimate objects, animals, or natural phenomena.
When considering whether to provide fetal anesthesia during an abortion, he says, it’s not “erring on the safe side”to endanger a woman’s health in order to prevent fetal pain that may not exist.”
It would follow that it is “erring on the safe side” to ignore fetal pain to prevent a problem with a woman’s health which may or may not occur??????
It is well worth reading this entire article. Even though it is about 10 pages long, it’s a quick read. You might want to print it out and mark it up because there are so many good talking points. Show it to everyone you know! Pro-lifers should discuss this issue of fetal pain with their OB/GYNs and other medical personnel. Pregnant women can raise the issue with friends and family.
Elizabeth, when I read that part about the anesthesia, I think my heart stopped beating for a second. How can people be so insensitive?
Elizabeth,
“My daughter had to get a prick in her foot to test her bilirubin when she was like 5 days old..and she wailed like nobody’s business.”
Same here, but they had to do it several times a day for 3 days, I felt so bad for her.
So would it be worse if they did have anesthesia? I know it can be dangerous.
Dougster,
I thought you’d be all over this post…
Cat got your tongue ;)
Jess,
Not according to this study:
‘IF THE NOTION that newborns are incapable of feeling pain was once widespread among doctors, a comparable assumption about fetuses was even more entrenched. Nicholas Fisk is a fetal-medicine specialist and director of the University of Queensland Center for Clinical Research in Australia. For years, he says, “I would be doing a procedure to a fetus, and the mother would ask me, “Does my baby feel pain?” The traditional, knee-jerk reaction was, “No, of course not.” “But research in Fisk’s laboratory (then at Imperial College in London) was making him uneasy about that answer. It showed that fetuses as young as 18 weeks react to an invasive procedure with a spike in stress hormones and a shunting of blood flow toward the brain – a strategy, also seen in infants and adults, to protect a vital organ from threat. Then Fisk carried out a study that closely resembled Anand’s pioneering research, using fetuses rather than newborns as his subjects. He selected 45 fetuses that required a potentially painful blood transfusion, giving one-third of them an injection of the potent painkiller fentanyl. As with Anand’s experiments, the results were striking: in fetuses that received the analgesic, the production of stress hormones was halved, and the pattern of blood flow remained normal.”
MMK: Dougster, I thought you’d be all over this post… Cat got your tongue ;)
Sis, we’ve done been pretty well all over it already, eh? However, now that you mention it….
Anand has put out many obfuscatory and IMO deliberately misleading things, as with his testimony to Congress. However, if the hormones are there they are there, no debate on that. Yet, seeing bright lights and hearing loud noises can cause their secretion, without any mental anguish or suffering occurring.
……
the potent painkiller fentanyl Heh – there’s an understatement. Fentanyl is like 80 times stronger than morphine. Less response from the subjects? Well Hello! When ol’ man Fentanyl comes a-callin, then lil’ ol’ Festus the Fetus gonna be sleepin.’
……
Anyway, is there an argument here?
essentially without a cerebral cortex Well, is there one or not? A greatly reduced cortex, in size and/or volume, could still account for reduced function and response, rendering the point moot.
……
the upper hemispheres are largely missing and replaced
“largely missing”? Same deal. To me, this sounds like much of Anand’s stuff – carefully worded so if questioned the speaker can avoid being shown to be false, i.e. “Well, I didn’t say there wasn’t any cortex, period.” Meanwhile, the desired response for readers is to think, “Wow, you don’t have to have a cerebral cortex to think, have emotions, feel pain, etc,” yet the article doesn’t prove that.
I’d be interested to see brainwave scans of those kids, and to compare them with other kids.
As for premature babies feeling pain, no debate there. Jill said her grandson felt pain after being born at 25 weeks, and I certainly believe her. For fetuses and preemies in that zone, it’s certainly not impossible.
For fetuses that stage or for any stage, IMO, let anesthesia be adminstered if it’s a concern – I certainly have no problem with it.
Seems to me a lot of the thrust of all this is that the presence of stress hormones “proves” something here, even though the article itself says:
stress hormones are also elevated, for example, in the bodies of brain-dead patients during organ harvesting.
Obviously, with brain-dead patients the effect would just be physilogical stimulus, rather than any “anguish” or “feeling pain” going on.
Doug
Janet, the alarming thing is that he’s saying not to “anthropomorphize” the unborn — to literally “stop attributing humanity to them”.
They ARE human. They’re not hamsters. You can’t anthropomorphize a fetus any more than you can anthropomorphize an elderly woman or a toddler or a high school football player. They ARE human. You can’t falsely attribute to them an attribute they inherently have.
Doug,
Everything you wanted to know and more…
http://rad.usuhs.edu/medpix/tf_case.html?mode=answer&quiz=no&pt_id=11246#treatment
My 7 year old daughter wandered over to the computer and looked at the photos of all of the children. She said, “They are so cute!” I shall instill in all of my children that life is precious. All life.
Christina, 4:17 AM,
Agreed. These doctors also talk about pregnancy like it’s a zero sum game. There’s only so much humanity to go around and giving the fetus a higher status than it deserves takes away from our humanity. Lord have mercy on us all.
Anand & Hickey wrote their paper in 1987 – published in the JAMA in November. This is more current – from 2005.
CLINICIAN
TR:
If you read the complete article above (see link at bottom of post) your 2005 study was addressed, and this is what followed:
“Sunny Anand reacted strongly, even angrily, to the article’s conclusions. Rosen and his colleagues have -stuck their hands into a hornet’s nest,” Anand said at the time. “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. This is not the last word – definitely not.” Anand acknowledges that the cerebral cortex is not fully developed in the fetus until late in gestation. What is up and running, he points out, is a structure called the subplate zone, which some scientists believe may be capable of processing pain signals. A kind of holding station for developing nerve cells, which eventually melds into the mature brain, the subplate zone becomes operational at about 17 weeks. The fetus’s undeveloped state, in other words, may not preclude it from feeling pain. In fact, its immature physiology may well make it more sensitive to pain, not less: the body’s mechanisms for inhibiting pain and making it more bearable do not become active until after birth.
The fetus is not a little adult, Anand says, and we shouldn’t expect it to look or act like one. Rather, it’s a singular being with a life of the senses that is different, but no less real, than our own.
Janet, the alarming thing is that he’s saying not to “anthropomorphize” the unborn — to literally “stop attributing humanity to them”.
Christina, there is a lot of personificatiion that goes on, well beyond the actual physical reality of the unborn in this argument. “Humanity” can mean quite a bit beyond merely “human.”
Doug
Humanity:
humanness: the quality of being human;
Humans considered as a group; the human race.
a: the quality or state of being human
Bethany, I certainly know those definitions, but there is also the sense of being humane, of having characteristics which are not present in the unborn, or not there until a point in gestation.
That human DNA is there in the unborn we’re talking about is not in doubt. I do see people attribute characteristics to the unborn where they really don’t apply or are at the least very arguable, though.
Doug