OPEN LETTER FROM DOCTORS ON FETAL PAIN
[NOTE TO POTENTIAL SIGNERS: Documentation of the statements in this letter is available at www.doctorsonfetalpain.com/fetal-pain-the-evidence ]
As physicians and other health care professionals, we are convinced that there is substantial medical evidence for the following statements, which together support the conclusion that an unborn child is capable of experiencing pain by 20 weeks after fertilization.
(1) Pain receptors (nociceptors) are present throughout the unborn child’s entire body and nerves link these receptors to the brain’s thalamus and subcortical plate by no later than 20 weeks after fertilization.
(2) By eight (8) weeks after fertilization, the unborn child reacts to touch. After twenty (20) weeks, the unborn child reacts to stimuli that would be recognized as painful if applied to an adult human, for example, by recoiling.
(3) In the unborn child, application of such painful stimuli is associated with significant increases in stress hormones known as the stress response.
(4) Subjection to such painful stimuli is associated with long-term harmful neurodevelopmental effects, such as altered pain sensitivity and, possibly, emotional, behavioral, and learning disabilities later in life.
(5) For the purposes of surgery on unborn children, fetal anesthesia is routinely administered and is associated with a decrease in stress hormones compared to their level when painful stimuli are applied without such anesthesia.
(6) The position, asserted by some medical experts, that the unborn child is incapable of experiencing pain until a point later in pregnancy than 20 weeks after fertilization predominately rests on the assumption that the ability to experience pain depends on the cerebral cortex and requires nerve connections between the thalamus and the cortex. However, recent medical research and analysis, especially since 2007, provides strong evidence for the conclusion that a functioning cortex is not necessary to experience pain.
(7) Substantial evidence indicates that children born missing the bulk of the cerebral cortex, those with hydranencephaly, nevertheless experience pain.
(8) In adults, stimulation or ablation of the cerebral cortex does not alter pain perception, while stimulation or ablation of the thalamus does.
(9) Substantial evidence indicates that structures used for pain processing in early development differ from those of adults, using different neural elements available at specific times during development, such as the subcortical plate, to fulfill the role of pain processing.
(10) The position, asserted by some medical experts, that the unborn child remains in a coma-like sleep state that precludes the unborn child experiencing pain is inconsistent with the documented reaction of unborn children to painful stimuli and with the experience of fetal surgeons who have found it necessary to sedate the unborn child with anesthesia to prevent the unborn child from thrashing about in reaction to invasive surgery.
(11) Consequently, there is substantial medical evidence that an unborn child is capable of experiencing pain by 20 weeks after fertilization.
- The Christian Medical & Dental Association, CMDA representing 16,500 members, www.cmda.org
- Emidio Michael Novembre DO AOA DO Member , AOA Board Certified, Emidio Novembre, DO, Revival Pain Management, clinical faculty of the Virginia College of Osteopathic Medicine.
- Sean P. Kenney, MD, FACOG, Director Maternal Fetal Medicine, Saint Elizabeth Regional Medical Center
- Mark L. Rosenthal, M.D., Department of Anesthesiology, Lakewood Ranch Anesthesia, Manatee Memorial Hospital
- Anita Showalter, D.O., FACOOG (D), Chair, Department of Obstetrics and Gynecology, Pacific Northwest University of Health Sciences
- William J. Polzin, M.D., Director, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Good Samaritan Hospital
- Peter M. Horvath, M.D., FACOG, Founder, Albany IVF (Private Reproductive Endocrinology and Infertility Practice) and Clinical Associate Professor of Obstetrics and Gynecology, Albany Medical College, Albany, NY
[Institutions with which signers are affiliated are listed for identification only; no representation is made that they have endorsed this letter.]
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