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Friday,

Octob~r

7,2005

A painful presumption note that infants around this age In the practice of medicine and medical ethics, we routinely do appear t6 feel pain and respond to noxious stimuli. Yet make certain presumptions in the authors of the JAMA article favor of patients and their wellattempt to argue that because being. When we see somebody bleeding, we presume we should certain connections in the developing brain of the unborn' stop the bleeding. When we see infant have not yet been estabsomebody in pain, we presume lished by 20 weeks of age, pain we should remedy the pain. When we see somebody sick, we presume we should heal the ailment. Medicine presumes to operate this way all the time. You might say that medicine is defined by By Father Tad a general presumption Pacholczyk of acting in favor of the goods of healing, comforting, and saving perception by the infant may not life. be possible. The authors also Sometimes these commonmake an concerted attempt to sense presumptions come to be discount or discredit a number challenged in unexpected and of the standard lines of evidence even disturbing ways within the suggesting that infants in utero medical field: Recently the may feel pain quite early during Journal of the American a pregnancy. . Medical Association published What are some examples of an article discussing whether this evidence suggesting that infants in the womb can feel fetuses feel pain early on? Those pain early in their development. who work full-time in neonatal The article ignited considerable intensive care units dedicated to controversy, as the question came to be discussed in terms of helping premature infants recognize how these "preemies" abortion procedures carried out readily respond to painful after 20 weeks of gestation. stimuli. Surgeons routinely Many neonatal specialists

Making Sense Out of Bioethics

their article to the editor of the Journal. The lead author is a former NARAL employee, and another is the director of an anaesthetize premature, babies abortion clinic in San Francisco before they undergo operations. Children delivered as early as 21 and also on the staff of the Center for Reproductive Health weeks can have an audible cry. Research and Policy, a prbSome doctors believe that such abortion advocacy center at the distress can be felt even as early University of California-San , as 12 weeks. If you stick a pin Francisco. into the palm. of a baby in utero The conclusions of the paper who is eight w€!eks old, she will are indeed troubling: "Because withdraw from this pain perception probably does painful stimulus. In not function before the third fact, such a baby will trimester, discussions of fetal open her mouth in pain for abortions petformed utero as though she before the end of the second were crying and carry trimester should be nonout initial exhalation compulsory. Fetal anesthesia or movements and other analgesia should not be recombreath-type movemended or routinely offered for ments. Recent imaging abortion because current studies have corroboexperimental techniques provide rated this "fetal unknown fetal benefit and may homologue" of an infant crying increase risks for the woman." in the womb following painful Pain,has traditionally been or noxious stimuli. understood a's an unpleasant What is perhaps most telling sensory and emotional experiabout the JAMA article is that ence associated with actual or the authors recommend that 'potential tissue damage. So mothers contemplating an although the infant may be abortion should not be given undergoing physical dismemberinformation about the pain that ment during a termination their child may experience during the procedure, because of procedure, the presumption somehow ends up being made uncertainty about when that by the authors that she is not child actually begins to experiexperiencing discomfort until ence pain. Two of the article's such· time as it can be absolutely authors, interestingly, failed to proven that she is. This amounts reveal important conflicts of ' to a "painful presumption" in interest when they submitte? the wrong direction. If there is uncertainty about when the infant in utero can begin to feel

Rooting for a three-legged frog Let's see if I remember how to As the late, great George Harrison once sang, "All things do this. It's been so very long, must pass." and I don't think it's quite like riding a bicycle when that skill It certainly was fun while it lasted, this dynasty thing. It's just comes back almost instantly providing one had the skill to that the word "dynasty," conjures begin with. up long-term images, and this In fact, I've had to make two vain attempts already in the past three weeks, and it's NOT coming back. As difficult as this task will be, it must succeed. Arid by the look of things, it best happen By Dave Jolivet soon. I'm willing to accept any and all recommendaride was but a mere four years. tions to help me accept the fact that the New England Patriots are Gone. Please don't get me wrong. I once again an average football, still, and always will, love my team. New England Patriots, but I think There, I've said it, and that's the glory days are through for a half the battle. But I really don't while. feel much better. How can they notbe?,No Now I must become reacteam can lose the likes of Tedy quainted with watching a team Bruschi, Ted Johnson, Ty Law, that may not be able to muster a Rodney Harrison, Kevin Faulk, miracle comeback in the fourth Charlie Weis and Romeo Crennel quarter. and not be affected. That's like It's time to learn that the entering a three-legged frog in Patriots' defense may not come the JUIl)ping Contest of up with a backbreaking touchCalaveras County and expect to down against a team with all the win. momentum. There will be more wins this A game at The Razor? Not a season and hopefully a playoff given any more. I had better get used to finding spot, but I don't know if I can bear watching Peyton Manning the Patriots out of the top 10 in ride into town on his Colts and the weekly power rankings on cut us down, at home, and on the ESPN, FoxSports and Sports national television. Illustrated Websites.

My View From the Stands

But I think the largest adjustment I'll face this season will be hopping over the railing to my neighbor's house for his annual Super Bowl party without a care who wins or loses. So this is what football fans in the rest of the country felt like for most of this millennium. Yuck. But as a Pats fan from the mid 60s, I know I must accept the good 'with the bad. It's just that the good is much more fun. And the Red Sox? I don't dare touch that one in this column. By the time this Anchor graces your mailboxes, the Home Towne Team may be barely clinging to life. And I didn't have the courage to ask the pastor of Notre Dame for his take on the Battle of the Sox. Not only did he predict the Yanks would win the Eastern Division, but he had the darn score of the clinching game dead on! I surely don't want to know what he knows about the division series. The Patriots are enough of a horror story right now.

Dave Jolivet is a former , sports editor/writer who frequently gives his view ofthe unique world ofsports. Comments are welcome at dave;olivet@anchornews.org.

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pain, should we not err on the side of caution and presume that she is entitled to pain medication when being subjected to typically painful or noxious stimuli? If we had any inkling that a young dolphin or puppy might suffer because of the way we were euthanizing them, we would seek to redress their pain, rather than carry on an academic argument aimed at preventing pain management for these young animals. Yet a deeper concern remains. By offering pain control during.an abortion, we still would not succeed in redeeming or sanitizing the act itself. Painfree killing is still killing. But at least by encouraging abortion doctors and their pregnant patien~ to consider the pain the infant may experience, they may be prompted to consider a deeper dimension of what they are'doing. By challenging their highly suspect presumptions about fetal pain, they may ultimately be pushed to look not only at the discomfort implicit in the procedure, but to revisit the more basic question about the practice itself which brings the life of an innocent human being to an untimely and unjust end.

Father Tadeusz Pacholcl,Yk, Ph.D. earned his doctorate in neuroscience from Yale and did post-doctoral work at Harvard. He is a priest ofthe Diocese of Fall River, and serves as the director ofeducation at The National Catholic Bioethics Center in Philadelphia.

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