Fetal Pain

Abstract

Debate about fetal pain is dominated by approaches from neuroscience that ask when the minimally necessary neural circuitry for pain might be existent. In general, it is accepted that the minimum necessary neural circuitry for pain involves a connection from the periphery to the central nervous system. That connection is available from 8- to 12-week gestation, which sets a lower limit for the possibility of fetal pain at 8-week gestation. Most neuroscientists, however, believe that the cortex is also necessary for pain, and connections from the periphery to the cortex are not available before 24-week gestation, which sets a lower limit for the possibility of fetal pain at 24 weeks. There is, however, considerable dissent over the necessity of the cortex for pain and that dissent stems, in large part, from uncertainty as to how neural activity translates into psychological experience. Some argue that fetal pain is possible before 24 weeks on the basis that the fetus has a mechanism to detect noxious events and will respond to noxious events by withdrawing and grimacing. These observations lead to an intuitive claim that the fetus can feel pain. That intuition breaks down, however, because pain is a subjective, reflective, state with content. Thus pain requires knowledge and conceptual organization that cannot be plausibly attributed to the fetus. Ultimately, the question of fetal pain is vexed and, as such, cannot be usefully used to decide clinical or legal policy. Fetal pain is an immensely provocative and thought-provoking issue that, for all practical purposes, should be ignored.