PMCCPMCCPMCC

Search tips
Search criteria 

Advanced

 
Logo of bmjLink to Publisher's site
 
BMJ. 2006 April 29; 332(7548): 1036.
PMCID: PMC1450060

Fetuses can feel pain

Mark Tighe, paediatric specialist registrar

Editor—Derbyshire argues against the ability of fetuses to feel pain.1 He states: “Good evidence exists that the biological system necessary for pain is intact and functional from 26 weeks.” He then adopts a definition of pain from the International Association for the Study of Pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage” but concludes that pain is “a conscious experience” rather than “merely the response to noxious stimuli,” so a fetus cannot experience pain.

This is a specious argument. There are many examples of the ability of babies of this gestation to feel pain. In the first few moments after birth, even with extremely premature neonates (23-26 weeks), a noxious stimulus—for example, phlebotomy—can cause bradycardia, desaturation, and hypertension as a stress response. A neonatologist would seek to relieve this distress with analgesia, and a parent would seek to soothe. Also, as Derbyshire notes, fetal procedures (such as in utero chest drain placement) are increasingly being carried out with analgesia.22

Figure 1
Credit: JIM STEVENSON/SPL

The problem lies with his definition of pain and the subsequent development of his argument. If a pregnant woman asks whether the fetus feels pain a conscious rationalisation is not necessarily implied. The Oxford English Dictionary instead describes pain as “a strongly unpleasant bodily sensation such as is produced by illness, injury or other harmful physical contact.”3 There is thus a gap between the definition Derbyshire has adopted and his patients' understanding of pain, resulting in ill-informed counselling or, worse (as he encourages in his conclusion), “avoiding a discussion of fetal pain with women.” His argument that fetuses cannot feel pain needs correcting.

Notes

Competing interests: None declared.

References

1. Derbyshire SWG. Can fetuses feel pain? BMJ 2006;332: 909-12. (15 April.) [PMC free article] [PubMed]
2. Davis CF, Sabharwal AJ. Management of congenital diaphragmatic hernia. Arch Dis Child Fetal Neonatal Ed 1998;79: F1-3. (July.) [PMC free article] [PubMed]
3. Thompson D, ed. The concise Oxford dictionary of current English. 9th ed. Oxford: Clarendon Press, 1995: 432.

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Group