EPTOn March 16 2019 02:17 JimmiC wrote:
It's so at odds with all your other beliefs that because of this extraordinarily small % that the doctors get wrong. People try to argue about the rights of people to not get shot but no in that case the rights of the individual to won the gun matters more than others. Or the bunch of issues involving hate hate speech and so on.
But when it comes to a women's/ parents right to choose, on a extraordinarily difficult and complex issue you want to take that choice away with blanket legislation. I guess this also lets you talk down to and look down on people. Which from your long history of posting is clearly one of your favorite pass times.
edit: + Show Spoiler +
It's so at odds with all your other beliefs that because of this extraordinarily small % that the doctors get wrong. People try to argue about the rights of people to not get shot but no in that case the rights of the individual to won the gun matters more than others. Or the bunch of issues involving hate hate speech and so on.
But when it comes to a women's/ parents right to choose, on a extraordinarily difficult and complex issue you want to take that choice away with blanket legislation. I guess this also lets you talk down to and look down on people. Which from your long history of posting is clearly one of your favorite pass times.
edit: + Show Spoiler +
Logical Problems
These laws are logically flawed. If we as a society believed we should not be doing procedures that may cause pain (the argument used by proponents of fetal pain legislation), all invasive procedures and surgeries would be banned [4]. It would appear, rather, that the widely recognized ethical obligation is to limit pain to the best of our abilities, not to ban anything that may be painful.
If the goal is (as it is in most invasive medical interventions) to prevent or limit possible pain, rather than to prevent terminations, a more robust and defendable position would be to require fetal analgesia during terminations after the gestational age at which scientific evidence suggests the fetus has developed the ability to feel pain. That, rather than banning terminations, would represent an attempt to prevent fetal pain. Even that position, however, is suspect. If these laws are justified by concern about fetal pain, that concern should extend to situations other than terminations: proponents of fetal pain laws should also be advocating for, for example, mandated general anesthesia during fetal surgery and vaginal deliveries. That they are not indicates that concern about fetal pain may not, in fact, be the priority underlying these bills.
Ethical Problems
These laws are unethical on two counts: they undermine the scientific accuracy of the information physicians give patients that is crucial to high-quality patient care and they trample the respect for patient autonomy central to medical ethics.
One would hope that there would be substantial rigorous medical evidence to justify the passage of this kind of fact-dependent legislation, but this has not been the case. These laws are based on scientifically ungrounded ideas: they conflate nociception, the triggering of autonomic responses to harmful stimuli, with pain. While the neural pathways that send nociceptive signals have completed development by 23 weeks, a comprehensive, nonpartisan, multidisciplinary review of almost 2,000 fetal pain studies concluded that “the capacity for functional pain perception in preterm neonates probably does not exist before 29 or 30 weeks” [5]. Until the conscious ability to process nociceptive signals develops, it is definitionally and physically impossible to register pain [6]. Allowing a nonmedical third party (e.g., the government) to dictate that counseling and treatment be based on sources other than evidence, clinical judgment, and the patient’s wishes undermines the scientific accuracy and patient-centeredness of the counseling process.
Secondly, these laws run afoul of medical ethics by mandating the privileging of nonmaleficence towards the fetus over maternal autonomy. The implication is that the capacity for fetal pain changes its moral status sufficiently to trump the rights to bodily integrity and privacy of the woman carrying it. This is in direct opposition to Roe v. Wade [7] and the widespread perception that, in medical ethics, respect for autonomy is “first among equals” [8].
Conclusion
The scientific, legal, and philosophical communities have grappled with the large body of available neurobiological and clinical evidence available in order to establish a scientific understanding of fetal pain [6]. Gonzalez v. Carhart set a precedent requiring the nearly impossible standard of “medical certainty” to overturn state gestational-age-based restrictions on abortion [9]. Given this hurdle, it is unlikely that these laws will be overturned on the basis of science alone, despite the preponderance of evidence stating that a 20-week fetus is unable to feel pain [10].
It is crucial that the balancing of maternal autonomy with nonmaleficence toward the fetus be based on the highest quality of evidence and contravene neither accepted principles of medical ethics nor federal law. As currently written, fetal pain legislation attempts to subvert the careful balance required by Casey at the expense of ethical practice and women’s health.
These laws are logically flawed. If we as a society believed we should not be doing procedures that may cause pain (the argument used by proponents of fetal pain legislation), all invasive procedures and surgeries would be banned [4]. It would appear, rather, that the widely recognized ethical obligation is to limit pain to the best of our abilities, not to ban anything that may be painful.
If the goal is (as it is in most invasive medical interventions) to prevent or limit possible pain, rather than to prevent terminations, a more robust and defendable position would be to require fetal analgesia during terminations after the gestational age at which scientific evidence suggests the fetus has developed the ability to feel pain. That, rather than banning terminations, would represent an attempt to prevent fetal pain. Even that position, however, is suspect. If these laws are justified by concern about fetal pain, that concern should extend to situations other than terminations: proponents of fetal pain laws should also be advocating for, for example, mandated general anesthesia during fetal surgery and vaginal deliveries. That they are not indicates that concern about fetal pain may not, in fact, be the priority underlying these bills.
Ethical Problems
These laws are unethical on two counts: they undermine the scientific accuracy of the information physicians give patients that is crucial to high-quality patient care and they trample the respect for patient autonomy central to medical ethics.
One would hope that there would be substantial rigorous medical evidence to justify the passage of this kind of fact-dependent legislation, but this has not been the case. These laws are based on scientifically ungrounded ideas: they conflate nociception, the triggering of autonomic responses to harmful stimuli, with pain. While the neural pathways that send nociceptive signals have completed development by 23 weeks, a comprehensive, nonpartisan, multidisciplinary review of almost 2,000 fetal pain studies concluded that “the capacity for functional pain perception in preterm neonates probably does not exist before 29 or 30 weeks” [5]. Until the conscious ability to process nociceptive signals develops, it is definitionally and physically impossible to register pain [6]. Allowing a nonmedical third party (e.g., the government) to dictate that counseling and treatment be based on sources other than evidence, clinical judgment, and the patient’s wishes undermines the scientific accuracy and patient-centeredness of the counseling process.
Secondly, these laws run afoul of medical ethics by mandating the privileging of nonmaleficence towards the fetus over maternal autonomy. The implication is that the capacity for fetal pain changes its moral status sufficiently to trump the rights to bodily integrity and privacy of the woman carrying it. This is in direct opposition to Roe v. Wade [7] and the widespread perception that, in medical ethics, respect for autonomy is “first among equals” [8].
Conclusion
The scientific, legal, and philosophical communities have grappled with the large body of available neurobiological and clinical evidence available in order to establish a scientific understanding of fetal pain [6]. Gonzalez v. Carhart set a precedent requiring the nearly impossible standard of “medical certainty” to overturn state gestational-age-based restrictions on abortion [9]. Given this hurdle, it is unlikely that these laws will be overturned on the basis of science alone, despite the preponderance of evidence stating that a 20-week fetus is unable to feel pain [10].
It is crucial that the balancing of maternal autonomy with nonmaleficence toward the fetus be based on the highest quality of evidence and contravene neither accepted principles of medical ethics nor federal law. As currently written, fetal pain legislation attempts to subvert the careful balance required by Casey at the expense of ethical practice and women’s health.
People use the percentage-rare cases of incest, life of the mother, and rape for abortion defenses all the time. How about misdiagnosis of viable fetusea? Are moral considerations subject to looking at this percent versus that percent and how rare is too rare to deserve to live? If I borrow from your language, the right of the unborn child not to get aborted.
Now we’re in the citation and argument stage of the debate, in a website feedback thread, on a topic started by one user that lied about another’s posting history. Time to take it to the main thread if you think your dead baby story matters and my 30 year old former unviable fetus does not.
