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Preterm infant pain seemed like a problem after all. The half that had no pain meds during surgery had “substantial stress responses” and endured “significant intra- and post-operative morbidity” including hemorrhaging. Half were given the very strong pain medication fentanyl and half weren’t given pain medication.
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In the study, 16 preterm infants were paralyzed prior to cardiac surgery. The paper goes on to explain this standard changed due to a combination of “humanitarian concerns and parental activism” (imagine being a parent to a baby going through this!) along with a revolutionary study in 1987. (I note this concern doesn’t have an analog in the abortion debate, where the fetus who may receive anesthesia is about to be killed anyway.) In fairness there was also hesitation about using anesthesia because at the time there was no standard medical practice established and medical professionals weren’t certain if anesthesia could cause further harm to the fetus. In other words, these children were given medications to paralyze them but not to manage pain. Analgesia was considered unnecessary during surgery due to lack of higher cortical function and the infant’s inability to remember the pain. Anesthesia, if administered to infants, was utilized for the benefit of the surgeon in order to suppress movement during surgical procedures, by means of paralytic medications. The assumption that newborns were insensitive to pain due to an undeveloped cortex was widely adopted by the scientific and medical communities until the late 1980s, despite dissenting views. On the history of neonatal pain management I’m pretty skeptical that many people would find this definition persuasive even at face value, but if this were the definition, it would mean that even newborns don’t have morally meaningful pain, because newborns aren’t yet capable of self-reflection. is not morally meaningful) unless the entity experiencing it is consciously aware they are experiencing it. There is a lot of debate over what constitutes “feeling” pain, and one suggestion is that pain doesn’t really count (i.e. Neurodevelopmentally, the self-reflective experience of pain does not emerge until cortical synapses develop during the first 2 years of postnatal life. In contrast, internal awareness represents a self-reflective experience of knowing that one is in pain, such as a 4-year-old who remembers and fears the pain of an immunization. If you can read the entire article, do, but for those who aren’t able to, here are some notes from my reading.Įxternal awareness of pain represents an unreflected experience of “being in pain,” such as a neonate who experiences, but will not remember, pain from a heel lance. Bridget Thill’s dissertation “ Fetal Pain in the First Trimester.” The article is written for a medical audience, with over 100 references to research in medical journals published from 1936 through 2021.
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On December 6, 2021, The Linacre Quarterly published Dr. The author’s daughter in utero, 22 weeks gestation.