Ruling on foetal pain reignites abortion law debate

THE authors of a government-commissioned report were challenged to a debate last night over their findings that a foetus cannot feel pain before the age of 24 weeks.

The study by the Royal College of Obstetricians and Gynaecologists concluded there was no need to alter the current official 24-week limit for terminations.

But the findings have reignited the abortion debate with critics accusing scientists of "dangerous arrogance" in setting such a definite limit which is then used as the basis of government policy.

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The research, released yesterday, also said the foetus was in a state of "continuous sleep-like unconsciousness or sedation" even after 24 weeks.

This could mean that late abortions, which are permitted for serious abnormalities or risks to the mother's health, may not result in foetal suffering.

The landmark findings come amid efforts by some MPs – including Prime Minister David Cameron – to lower the current abortion limit.

Mr Cameron said in April this year that the time limit for abortions should be cut to "20 or 22 weeks".

A fresh analysis of evidence for foetal pain was recommended by MPs from the Commons Science and Technology committee during the previous parliament.

Professor Richard Anderson of the department of reproductive medicine at the University of Edinburgh, who is a member of the working group, admitted that "there is a complex philosophical issue about the nature of pain… we didn't want to go too far down there, because that is very difficult…"

Explaining the findings, Prof Anderson said: "The key thing is to distinguish between a sort of reflex action and a more serious, more complex perception of pain. You and I, when we stand on a nail, immediately move our foot away because there is a nervous reflex that tells you 'this isn't the right thing to be doing' and pulls your leg away.

"There's a separate signal that goes to the brain, which says, 'this is going to hurt'. The two can be there separately.

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"The nervous reflex which causes you to move develops much earlier in life and that is before 24 weeks, whereas the pathway that goes up to the brain, which tells you, 'Ouch, this is going to hurt', develops later."

On the issue of pain perception, the Royal College report concluded: "It was apparent that connections from the periphery to the cortex are not intact before 24 weeks of gestation and, as most neuroscientists believe that the cortex is necessary for pain perception, it can be concluded that the foetus cannot experience pain in any sense prior to this gestation."

It added: "There is increasing evidence that the foetus never experiences a state of true wakefulness in utero and is kept, by the presence of its chemical environment, in a continuous sleep-like unconsciousness or sedation."

But Peter Kearney, director of the Scottish Catholic Media Office, said: "The issue of pain or pain levels is utterly secondary.

"When Amnesty International campaign against the death penalty they don't distinguish between someone who has been given sedation before being beheaded and someone who has not.

"I don't think anyone campaigning against the death penalty would change their minds if sedation was involved.

"But in some respects this whole debate is a red herring. When scientists are being as conclusive as this, as they are over the 24 weeks, it is clearly very arrogant and dangerous to make settled policy on such a definitive statement.

"We should accept that we don't have definitive answers. By shying away from public discussion about the 24-week limit for pain, Prof Anderson and his colleagues are opening up a debate and then refusing to follow it to its logical conclusions.

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"An individual like that and a body like that clearly are naive if they think their findings are just going to be accepted without a murmur," Mr Kearney said.

"We need to have an open, explicit debate on this subject. The working group needs to stop hiding behind semantics and scientific half-truths."

Josephine Quintavalle, of Comment on Reproductive Ethics, said: "Performing abortion humanely does not justify the fact that you are terminating a human life."

But Professor Ken Mason, a pathologist and professor of medical law at the University of Edinburgh, said that while he questioned the ability to set a date for when a foetus could feel pain, it was important to distinguish this from the debate over the morality of abortions.

"To attempt to make a date when a foetus could feel pain is quite impossible," he said. "There may be a limit before something could not happen, but that doesn't mean there is not variation between individual foetuses.

"The point is that you can't say because the child is 23 weeks it cannot feel pain unless you have an absolute bottom limit of when a child can feel pain.

"I personally don't think the foetus is given enough notice in this debate. But ultimately I believe that whether or not a foetus can feel pain can only be discussed in terms of scientific fact and that has nothing to do with the morality of abortion."

However, the 24-week findings has been welcomed by groups campaigning for women's rights to control their fertility.

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Ann Furedi, chief executive of the British Pregnancy Advisory Service (BPAS), which provides abortions, said: "This guidance on the state of the evidence is extremely welcome.

"The issue of foetal pain experience has been politicised by campaigners in a way that has inhibited a sensible discussion.

"Women and doctors need to be able to make informed decisions based on what science says, not what advocates (whether pro-choice or anti-choice) wish it said."

Ms Furedi added: "This report makes it possible for choices about treatment to be properly informed."

Anne Quesney, international policy and parliamentary adviser at Marie Stopes, said: "The RCOG's findings should give comfort and reassurance to any woman who finds herself in the extremely distressing position of having to make the decision to terminate a pregnancy at a later gestation.

"Later abortions are carried out for the most compelling reasons, such as severe foetal abnormality, risk to the health or life of the mother, or following a drastic change in the personal circumstances of the woman involved."

We want to make abortion rarer not harder

THE Royal College of Obstetricians and Gynaecologists has reported that foetuses up to 24 weeks do not feel pain because they are "sedated" in the womb and pain cannot be felt at this stage.

This raises important ethical questions. Should this new understanding change the way we think about abortions? Life is a gift of God and the Church must show unconditional love to those who struggle with such difficult questions and find themselves making decisions of whether or not an abortion is appropriate.

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Women have the right to be in control of their own bodies thus women who choose to have an abortion need care and understanding. The decision-making processes with regard to the termination are complex, the welfare of the mother is an essential part of the equation.

However it is important the Church remains true to its principles and articulates its concerns. I do not think the new research should change fundamentally how we view abortions or the status of the unborn human. Too many abortions happen each year. They must never be granted "on demand", or as an alternative to contraception.

The Church would like the upper time limit for abortions reduced from 24 weeks to 20. The new research offers an opportunity for society to say that we want to make abortion rarer – not by making it harder for women who feel they have no choice but by changing our world so that fewer ever have to make that choice in the first place.

• The Rt Rev John Christie is Moderator of the General Assembly of the Church of Scotland

I don't think that a number can define life

I HAD a miscarriage when I was 18 weeks pregnant, but before that I had been feeling the baby move.

The fact that someone is alive in you – you feel them kicking – makes you think it must feel something.

I had to go into Simpsons maternity hospital to have it delivered.

They showed us our wee girl and she seemed like a person even at that age, and you just feel that she must have been able to feel pain and know what was going on around her.

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If my little girl had been born alive I'm sure the NHS would have swung into action to give her first-class treatment.

I have a friend who had twins at 25 weeks – one lived, one died. But had they been born two weeks earlier, according to this report, then they would have not been real babies. That is madness. My same friend had a baby at 27 weeks and that child has more problems than the one born at 25 weeks. There really isn't much of a difference in these timescales after they are born, so I'm not convinced it is so very different before birth.

If a baby is born at 23 and a half weeks, is it less worth the effort than one born at 24 weeks? I don't think scientists can say there's a number which defines life.

They might say a baby feels no pain before 24 weeks but I don't think they know that for certain. They are also not taking into account the bond between a mother and her child from the moment of conception.

Every now and then, despite this happening to me 11 years ago, I feel a twinge when I hear a new-born baby crying. I can't be the only one to feel this way.

• Lynn Murray, 49, is a mother of four children and lives in Edinburgh.