Prenatal Pain vs. "Nociception:" Psychological Construct?

LifeEthics.org ^ | August 24, 2005 | Beverly B. Nuckols, MD

[hocndoc]

The Journal of the American Medical Association (This link is to the abstract. Subscription is required for the full article) published an article this week claiming to definitively settle the problem of whether or not children feel pain before birth.

Some of you may have read that there are serious ethical questions about the authors, two of whom are involved in the abortion industry.

But, what you probably won't read in the popular press is that the definition of pain used by the authors is a little bit more convoluted that the one you and I might use. Specific and particular jargon is important for consistent communication within a profession, however it may complicate communication between specialties. And a difference in the understanding of the definition of "pain" is vital in this case, where the authors call pain a "psychological construct." I believe that their definition is constructed.

Here's the description of the definition of pain from the article:

What Is Pain?

"Pain is a subjective sensory and emotional experience that requires the presence of consciousness to permit recognition of a stimulus as unpleasant. Although pain is commonly associated with physical noxious stimuli, such as when one suffers a wound, pain is fundamentally a psychological construct that may exist even in the absence of physical stimuli, as seen in phantom limb pain. The psychological nature of pain also distinguishes it from nociception, which involves physical activation of nociceptive pathways without the subjective emotional experience of pain. For example, nociception without pain exists below the level of a spinal cord lesion, where reflex withdrawal from a noxious stimulus occurs without conscious perception of pain.

"Because pain is a psychological construct with emotional content, the experience of pain is modulated by changing emotional input and may need to be learned through life experience. Regardless of whether the emotional content of pain is acquired, the psychological nature of pain presupposes the presence of functional thalamocortical circuitry required for conscious perception, as discussed below."

In other words, does the child feel bad about being hurt?

The stimuli that the writers are describing are the same that you and I would describe as painful. The child's brain is stimulated, to varying degrees, depending on his stage of development. Using this definition, most children would not pass their test until they were over a year old.

Some have speculated that the children may experience *more* "nociception" than a child who is mature, since the nerve stimuli can't be processed.

In the case of prenatal surgery for a wanted child (which seems to be the definition far too many use for "human child") the fetal stress hormones (mentioned in the paper) and the stimulation of the nerves themselves will affected and will actually change the way those nerves and nerve pathways will develop. With consequences that we do not yet understand.

From an article on neurodevelopment and child trauma and the periodic sensitivity to stressors:

There is some evidence to suggest that prenatal or maternal traumatic stress has significant impact on neurodevelopment -- battering the pregnant mother is also battering the developing fetus (Amaro et al., 1980).

and

The abnormal pattern of stress-mediating neurotransmitter and hormone activations during development alters the brains of traumatized children. The specific nature of these fucntional alterations is seen in all of the brain functions which are directly or tangentially related to CNS catecholamine systems. Unfortunately, the CNS catecholamines (and likely other important neurotransmitter systems altered by these experiences) are involved in almost all core regulatory activities of the brain. The brainstem and midbrain catecholamines are involved in regulation of affect, anxiety, arousal/concentration, impulse control, sleep, startle, autonomic nervous system regulation, memory and cognition.

Of course, if the child is killed there is no more development, is there?

For those of us who love science, one of the attractions is the fact that our knowledge increases as we develop better tools to measure, record, and repeat our experiments. Neuroscience is one of the most exciting fields today, because of techniques such as functional MRI and ever more focused and reliable ways to measure development, physiology and function. Within the last two years we found out that we were wrong about the old idea that no one develops new brain cells after the age of two. We also learn more each day about the effects of stimuli and "use it or lose it" on the development and function of the brain. In the last year, it was reported that infants as young as fifteen months old are able to tell the difference between false beliefs and those that are true, a cognitive skill that went against previous evidence and testing methods.

In light of these facts, shouldn't humane medical research and treatments be cautious in order to "First, do no harm?"

As noted in this blog, since when do we allow people to kill other people just because that person can't feel pain? Would a surgeon take an unconscious person to the operating room without anesthesia? Terri Schiavo was even given IV morphine while she was being starved to death.

[hocndoc]

My latest effort to explain -

[hocndoc]

Ping!

I just thought I'd put it all down in one place.

[Coleus]

thanks doc, well done.  the demons on the left will stop at nothing to promote their evil agenda through deception or any other tactic..

Researcher Stands by Fetal Pain Findings [Abortionist Did the Report]

Study Finds 29-Week Fetuses Probably Feel No Pain and Need No Abortion Anesthesia

FETALPAIN;

and just don't tell any of your patients they're obese. It could cost you your license.

Woman Files Complaint After Doctor Tells Her She's Obese

[Chaguito]

Neither my cat nor my dog have consciousness, nor do they have an emotional involvement, but their responses to "noxious stimuli" are the same as mine (and I am semi-conscious). These researchers have defined down pain to fit their results, 'pears to me.

[TASMANIANRED]

Looks like they have confused "thinking about pain" with feeling it.

[hocndoc]

Thanks for the bump, y'all.

Admin, how about moving this to one of the news pages if you don't like it on the editorial page?

This is breaking news, since the NYT and several others reported on the story. The St. Louis Times has the article about the biases of the authors.

Please do not assign it to the Blogs page, since I posted the whole thing, gave links to all sorts of other references, and lots of people will be discussing the (disingenuous) JAMA article.

[cpforlife.org]

The fetus at 20 weeks gestation "is fully capable of experiencing pain. … Without question, all of this is a dreadfully painful experience for any infant subjected to such a surgical procedure." — Robert J. White, M.D.,PhD., professor of neurosurgery at Case Western University, Cleveland, Ohio, in testimony before the Subcommittee on the Constitution, Committee on the Judiciary, U.S. House of Representatives, March 21, 1996

"Ultrasonographic findings report specific fetal movements in response to needle punctures in utero. When neonates are born prematurely at 23 weeks gestation, they demonstrate highly specific and well-coordinated physiologic and behavioral responses to pain … validating outside the uterus what they were capable of manifesting inside the uterus." —, Jean A. Wright, M.D., M.B.A., Clinical Associate Professor of Pediatrics, Emory School of Medicine, White Paper: Advances in the Understanding of Fetal Pain, Christian Medical Association
http://www.mccl.org/fp_news/fetal_pain.htm

Kelly Thorman was born prematurely in 1971 at 21½ weeks after conception. This picture was taken three weeks later.

Photo of 20 week old UNBORN BABY. From http://www.priestsforlife.org/resources/abortionimages/fetaldevelopment.htm

[Tribune7]

Thanks

[Coleus]

It looks as though they used anesthesia on Baby Samuel Armas, could it be he would have felt pain?  

Mike doesn't take pictures anymore, it seems the surgeon went on record stating that he posed the picture and said that the baby was under anesthesia and could not possibly reach out of the womb.  Mike provides pictures to back up his story and has them posted on his webpage, who knows what really happened? We only know that a baby in utero does feel pain and is human and is not just a blob of protoplasm.

Samuel's Spinal Bifida Surgery In Utero

Notice the freerepublic link at the end of Mike Clancy's Web Page.

[little jeremiah]

Moral Absolutes Ping.

All in one place - the disgusting defense of killing the unborn - "they don't feel anything". I'm so sickened I can't even read these articles. Maybe later when my stomach is empty/settled.

I don't know. If people can justify slaughtering unborn humans and claim "they feel no pain", then they can justify slaughtering Jews, gypsies, Christians, Hindus, and anyone else they don't like. It happened before, it will happen again. It's happening now.

Freepmail me if you want on/off this pinglist.

[Sun]

Laura Ingraham said on her radio show this morning that one of the authors of the pain study used to work for NARAL, and another author is an executive at an abortion clinic.

[hocndoc]

There's a link to the St. Louis Times article about the authors.

Jeremiah, I hope you will look at my post, since it explains the jargon that is used in the article.

If you tell me you're wheezing, and I say that you aren't really "wheezing," because you have "rales," it's not going to make you feel better that I know a different, more precise definition of "wheezing." ( http://health.allrefer.com/health/breath-sounds-info.html ) And it won't change your shortness of breath.

[little jeremiah]

I will read it later. Must back away from keyboard now and do some other things for a while.

I will read it, and the link, I promise! I just really need to be two people, I could get more done.

[cpforlife.org]

"Notice the freerepublic link at the end of Mike Clancy's Web Page."

That is an excellent FR link. Simply excellent--LOL.

[TASMANIANRED]

btt

[TASMANIANRED]

btt