When Can Fetuses Feel Pain? Utah Abortion Law and Doctors Are at Odds

May 5, 2016

By Jack Healy

Starting later this month, women in Utah seeking an abortion 20 weeks or more into a pregnancy will first have to be given anesthesia or painkillers — drugs that are intended not for them, but for the fetus.

Those are the terms of a new law that has made Utah the first state in the country to require what doctors here are calling “fetal anesthesia” for the small percentage of abortions that occur at this point in a pregnancy. The law, passed by the Republican-controlled State Legislature and signed in late March by Gov. Gary R. Herbert, a Republican, has opened a new front in the heated debate over fetal pain.

The science examining when a fetus begins to feel pain is complex. Most scientists who have expressed views on the issue have said they do not think the neurological wiring to feel pain is in place until a fetus is further along in a pregnancy, past the point when nearly all abortions occur.

But in recent years the issue has become political fodder in legislative battles over restricting abortions later in a pregnancy.

Anti-abortion groups and lawmakers in Utah said they were acting out of concern for the fetus. But abortion rights activists and some obstetricians and maternal care doctors in Utah said the law was bafflingly vague and scientifically unsound. They said that it intruded into confidential decisions between doctors and patients, and that it could put women’s health at risk by creating a broad requirement for them to take unspecified painkillers.

“You’re asking me to invent a procedure that doesn’t have any research to back it up,” said Dr. Leah Torres, an obstetrician-gynecologist who spends half of a Saturday each month working in Salt Lake City at one of Utah’s two licensed abortion clinics. “You want me to experiment on my patients.”


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13 comments on “When Can Fetuses Feel Pain? Utah Abortion Law and Doctors Are at Odds

  • A rule of thumb may be if they wriggle when poked with a needle. It may be nutty to require anaesthesia for abortions, but it not that much of an impediment, and it disarms one of the big objections to abortion. Mankind has always underestimated the ability of creatures to feel pain.



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  • Seems to me to be a decent prophylactic measure. In case it does, viability is becoming earlier and earlier, about 23 weeks now I believe. It strikes me that most late term abortions are going to be due to profound disability which may not be able to be detected until fairly late in the piece, thus what harm does it do even if they cannot feel pain, there must be some elasticity in the figures.



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  • Stafford Gordon
    #3
    May 6, 2016 at 3:28 am

    Even when essential, no matter when or how they are carried out, all terminations by means of human intervention are a minor tragedy.

    This statement struck me as a declaration of absolute authoritarian truth delivered with the force of righteousness that would make any right to lifer proud. However, I was pleased to see that at the end of the statement you gave a concession to the idea that there might be “minor” tragedies and therefore implying that there might be major tragedies out there as well.

    I wonder if we could move this even further to acknowledge that there are not just two types of tragedies. Could we see it more as a continuum and less of a dichotomy? Isn’t it true that good and bad exist in a multitude of degrees? On this issue of abortion which is one possible outcome in the whole larger picture of human reproduction, in my view of things, this is not even to be classified as a tragedy at all. I even propose for your consideration that in many cases, a child brought into this world that is unwanted and faces a lifetime of poverty, misery and neglect would suffer much more in the long run than if their “life” as a collection of cells was to end very early on in the whole picture. All of this has to do with the life of the embryo/fetus but the larger picture must include harms to the siblings, parents and extended family because every child that is born causes a ripple effect of good and bad that extends out far in their domain.



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  • LaurieB @ # 5.

    I thought that comment might land me in hot water; I am no right to lifer LaurieB, and I apologize if I’ve angered you.

    I always feel very uncomfortable venturing into the affairs of women, but that’s how I’ve felt about terminations ever since I became a father; the very thought of either of our daughters having not been born fills me with a weird kind of dread; what would we have missed had my wife lost them or had her pregnancy ended prematurely.

    The right should always be that of the woman’s to choose, but surely, it’s never an easy choice to make, and it’s one that saddens prospective fathers too.

    I suppose there are some healthy momen who are glad to end their pregnancy, but I suspect there are very few.

    I hope I’ve managed to explain myself sufficiently well.



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  • It is a fool’s errand to determine with any amount of certainty if and/or when a fetus (or as LaurieB noted a ‘collection of cells’ in an earlier state) can feel pain (it will eventually at which point it may no longer be a fetus). And how does pain in this case differ from sensation or reflex (poke anyone’s foot or tap their knee and see the expected movement)? We can tell the difference because we’re sentient beings with a lifetime of experience dealing with various sensations. No one remembers the womb and I call BS on anyone who says they can.

    When people with profound brain injuries lapse into a persistent vegetative state (PVS; verbiage differs somewhat in the UK where they seem to prefer continuous vegetative state) they are said to be in a state of partial arousal, not actual awareness. It seems to me that a fetus, especially in that early stage of development, would be far more likely to be considered in a state of arousal rather than awareness. Because the very definition of awareness is knowledge or perception of a situation. Certainly a fetus is not capable of such thought. Where I’m going with this is that by law people in a PVS can have their feeding tubes removed and allowed to die, primarily due to dehydration (where there is also debate about the possible discomfort involved, though studies have shown that most have peaceful deaths). I think some kind of moral connection can be made with these very disparate situations. I do not believe, particularly in the early stages, that any type of anesthesia should be required for the fetus. This is yet another slippery slope.



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  • Stafford Gordon #6
    May 6, 2016 at 9:23 am

    I apologize if I’ve angered you.

    You never anger me. The Westboro “church” angers me! The frothing at the mouth right to lifers who hang around outside of abortion clinics just waiting for a patient to pass them by so they can harass them, they anger me! Pedophile priests who make women feel bad about not wanting to go through with their sixth unwanted pregnancy, they anger me!

    Your admirable sentiments about being a father are touching. The world would be a better place if all men thought like you do. Alas, this is not our reality.

    I do realize that I have a limited view of how men feel about these things. It’s valuable for men to express these feelings to us women. Male bashing is easy for us to fall into and these negative generalizations are unacceptable just as misogynistic statements are also unacceptable. So you see, you are not in hot water at all.

    I will always be a (second wave) feminist and proud to say so but I never lose sight of the fact that while I advocate strongly for two daughters, nieces and now a new granddaughter, I also advocate for a son, nephews, brother and many other men in my life. Reproductive rights support their wellbeing and happiness in this life and this needs saying more often.

    I suppose there are some healthy women who are glad to end their pregnancy, but I suspect there are very few.

    There may be some data out there to clarify this and I will look for it later. It’s important to present the truth of the matter with these things even if it is unpleasant. My (anecdotal) sense of this is not in line with your suspicions so I think the truth that will be presented by any data out there is valuable – not because I want to win. I just want to know the truth of these feelings because if women are generally not sad and upset when they exit an abortion clinic but instead, mostly relieved and optimistic, then it would be an interesting state of affairs that must say something important about our reproductive strategy.



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  • LaurieB @ # 8.

    Phew! That’s a relief.

    Thanks for your kind comments.

    Thanks also for sharing some of the female perspective with me.

    Incidentally, I hung around with a lot of first wavers, until my guilt metre exploded.

    Most women I know now are second wave and wonderful; especially my wife.

    Going off-piste a tad; our twin daughters are now twenty five, and one of them, unprompted, told me how grateful she is not to have been burdened with any religious stuff; and I told her sister that I didn’t care in the least what her sexual proclivities are, but if she ever got religion that would really hack me off; her response was most reasuring.

    We’re all great friends, and enjoy discussing science and politics!



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  • S.G.

    Yes, my daughters are 25 and 26 and for the past few years they have become increasingly aware of the effects of being raised by two science major parents, one of them an ex-methodist atheist and the other a checked out Muslim who is as secular as he possibly can be without getting his head chopped off. 😉

    It’s amusing to see their reaction when flipping through the tv channels when they come across a show with those televangelists ranting about the end of times and burning in hell and give money for Jesus! They turn around with an expression of fright on their faces and find us laughing (jeering laughter) at the rabid lunatic on the tv. I guess I take it for granted having grown up in the church so I can just role my eyes but to them it’s shocking to see so many straight up brainwashed people all sitting there nodding their heads with eyes glazed over. A truly bizarre phenomenon indeed! They also see some of their friends waffling around trying to move into a more secular mindset but pulled back into religion by their families and they do see how lucky they are to not waste brain space on all of this psychological drama.



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  • My wife’s a “checked out” Catholic; thankfully, my parents left me to make up my own mind, and I never checked in in the first place.

    One of our daughters is a Biophysics research assistant at the Sir William Dunn School of Pathology in Oxford; as you can imagine, I am somewhat proud of that fact.

    I think we’ve exhausted this thread now, don’t you?



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  • Steven007 #7
    May 6, 2016 at 10:24 am

    It is a fool’s errand to determine with any amount of certainty if and/or when a fetus (or as LaurieB noted a ‘collection of cells’ in an earlier state) can feel pain.

    While the point at which development enables pain to become a function, is unclear, it should be clear that pain is not possible before nerves and a sensory system have developed.

    @OPAnti-abortion groups and lawmakers in Utah said they were acting out of concern for the fetus. But abortion rights activists and some obstetricians and maternal care doctors in Utah said the law was bafflingly vague and scientifically unsound.

    While AGW deniers, will happily ignore inconvenient truths, god-deluded dogmatists, have no problem with using “faith-thinking” to invent “inconvenient untruths or pseudo-truths”, which can be used to obstruct anti-dogma activities supporting the interests of others against dogmatic interference in their lives.



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  • @OP – But abortion rights activists and some obstetricians and maternal care doctors in Utah said the law was bafflingly vague and scientifically unsound. They said that it intruded into confidential decisions between doctors and patients, and that it could put women’s health at risk by creating a broad requirement for them to take unspecified painkillers.

    “You’re asking me to invent a procedure that doesn’t have any research to back it up,” said Dr. Leah Torres, an obstetrician-gynecologist who spends half of a Saturday each month working in Salt Lake City at one of Utah’s two licensed abortion clinics. “You want me to experiment on my patients.”

    We should bear in mind that early stage abortions are often medical, rather than surgical procedures.
    That is the abortion is induced by the woman taking medicine without any surgical intervention.

    https://www.nlm.nih.gov/medlineplus/ency/article/007382.htm

    Abortion – medical

    A medical, or nonsurgical, abortion can be done within 7 weeks from the first day of the woman’s last period. A combination of prescription hormone medicines are used to help the body remove the fetus and placenta tissue. Your health care provider may give you the medicines after performing a physical exam and asking questions about your medical history.

    Medicines used include mifepristone, methotrexate, misoprostol, prostaglandins, or a combination of these medicines. Your provider will prescribe the medicine, and you will take it at home.

    After you take the medicine, your body will expel the pregnancy tissue. Most women have moderate to heavy bleeding and cramping for several hours. Your provider may prescribe medicine for pain and possible nausea to make you more comfortable during this process.

    Medical abortion might be considered when:

    The woman may not wish to be pregnant (elective abortion).
    The developing baby has a birth defect or genetic problem.
    The pregnancy is harmful to the woman’s health (therapeutic abortion).
    The pregnancy resulted after a traumatic event such as rape or incest.




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