Education And Debate

Commentary: We don't know; better to err on the safe side from mid-gestation

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7060.796 (Published 28 September 1996) Cite this as: BMJ 1996;313:796
  1. Vivette Glover, clinical scientist, department of paediatricsa,
  2. Nicholas Fisk, professor of obstetrics and gynaecologya
  1. a Royal Postgraduate Medical School, Institute of Obstetrics and Gynaecology, Queen Charlotte's and Chelsea Hospital, London W6 0XG
  1. Correspondence to: Dr Glover.

    Some scientists argue that fetuses cannot feel pain.1 Indeed, fetuses are currently treated as though they cannot. By contrast, it is generally agreed that preterm babies—often of the same gestational age as fetuses—should be given analgesia.2 3 In the public arena the pro-life and pro-choice lobbies often adopt opposed stances on the issue. However, attitudes to abortion should not influence our assessment of the evidence.

    Currently we have no direct way of assessing pain in fetuses. The most rational approach is to make an informed guess based on our knowledge of the development and function of the nervous system at different gestational ages.4 Studies indicate that cortical, subcortical, and peripheral centres necessary for pain perception begin developing early in the second trimester.2 4 From 14 weeks most of …

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