Fetal Pain: The Science Behind Why It Is the Medical Standard of Care

Robin Pierucci

doi:10.1177/0024363920924877

Fetal Pain: The Science Behind Why It Is the Medical Standard of Care

Linacre Q. 2020 Aug;87(3):311-316. doi: 10.1177/0024363920924877. Epub 2020 May 21.

Author

Robin Pierucci^{1

2

3}

Affiliations

¹ Southwest Michigan Neonatology, PC, Bronson Children's Hospital, Kalamazoo, MI, USA.
² Homer Stryker Medical School, Western Michigan University, Kalamazoo, MI, USA.
³ NICU, Bronson Children's Hospital, Kalamazoo, MI, USA.

Abstract

Despite pain as the fifth vital sign in adult and pediatric care, many still dismiss the fact that immature human beings (whether a fetus, a preterm, or term baby) are capable of being affected by pain. Studies have demonstrated that avoiding, minimizing, and treating pain in babies, particularly when premature, improves their outcomes. Informed by the evidence, treating neonatal pain has become the medical standard of care for physicians in neonatology and anesthesiology. This article provides a brief overview of relevant publications that explain the clinical evolution that has led to the treatment of neonatal pain. This article also examines three arguments against the existence of fetal pain and presents evidence that refutes them. Informed by the research, a revised definition of pain is offered.

Keywords: Abortion; Applied ethics; Difficult moral questions; Ethics at the lower limit of neonatal viability; Maternal–fetal medicine; Medical research; Neonatology; Neuroscience; Patient care; Personhood at the beginning and end of life.