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A Question of Empathy

By Austen Ivereigh

How science is rehsaping the abortion debate

Posted 2/5/08 at 2:58 PM

 

It was an MP, Julian Brazier, who drew the analogy at a public meeting in London’s Parliament recently.

He had been reading up on the eighteenth-century anti-slave trade campaigner Wilberforce. What struck him was that so few could identify with the condition of slaves they had never met – and who were so different in so many ways – until the first accounts of what they endured were published, and the first line-drawings of slave ships began to circulate. And all of a sudden there was a wave of empathy which over time eroded the notion that Africans were not like us and therefore not entitled to human treatment. 

Brazier had seen the analogy with unborn children, otherwise known as a fetuses or “neonates” – their many names at once evoking our difficulty with these odd, sublime creatures – following two remarkable presentations: one by the British global pioneer of 4D fetal imaging, Professor Stuart Campbell, and Professor Sunny Anand, an American pioneer in neo-natal pain research.

The MP’s analogy was incisive. Professor Campbell’s “walking-in-the-womb” pictures have had a similar impact on the national debate on abortion in Britain as those late eighteenth-century slave accounts had on the campaign to abolish the slave trade.

I had seen the stills in the newspapers when they were first published in 2004, but Campbell had the whole journey of the unborn packed away in his laptop in short films.

Up on the screen he projected these little windows onto the womb. At 12 weeks, look: breathing movements, yawning, reflex actions, a developing spatial awareness. At 17 weeks, it seems pretty cramped in there, clinging onto his feet in an amniotic universe, practicing the reflexes for a life he has as yet no notion of. At 20 weeks, he is very definitely a baby-in-being – eyelids open, yawning. And at 23 weeks, a crying face, a smiling face.

“To me it’s barbaric,” Campbell said, his grandfatherly bedside manner suddenly stern. “To pull this fetus out, limb by limb. It’s barbaric.”

As a junior doctor, he performed such “terminations” at this point, the still-legal 20-24 week stage at which 3,000 abortions are still carried out – almost uniquely among European Union nations – in Britain each year: 2,000 of them for “social reasons”, 700 because of “abnormalities”.

In spite of his impeccable credentials and ground-breaking work, Professor Campbell’s evidence to Parliament’s Science & Technology Committee was not accepted. That Committee, it is no secret, is made up of pro-abortion lobbyists determined to resist any attempt to resist a reduction in the legal upper limit down to the 12-week European norm. They have reason to be concerned: pro-life MPs are hoping to drive the reduction through on the back of the new fertilization and embryology Bill.

Campbell is a scientist, not a pro-lifer. Yet his images are considered too emotive, not “scientific” enough, for the Committee. So they refused his evidence. 

The purpose of Monday night’s meeting was to give his science an airing. It was convened by Nadine Dorries MP, a former nurse who was shocked at the Committee’s bias. Joining Professor Campbell was Professor Sunny Anand, the world’s pioneer on fetal and neonatal pain at the University of Arkansas, whose presentation was rather harder to follow if you were not up to speed on why the precondition for conscious pain was not, as had long been thought, developed cortical neurons and thalamortical inputs.

But the bottom line was that at 16 weeks there are clear reflex responses to pain and after 18 a “robust hormonal response”. In other words, what would be considered physical evidence of pain in a human being is present in a foetus. “When you couple hormonal and every other response,” said the turbaned doctor, “it is no different from any other pain.”

Professor Anand is not a pro-life campaigner either. Yet his research was also excluded from the Committee because it was deemed too “controversial”.

The controversy comes down to this. How do we know that what looks pain really is pain? As one of his critics, Dr Stuart Derbyshire, whose evidence was welcomed by the Committee, put it, how can we tell if the reflex response to pain at 16 weeks and the hormonal response at 20 weeks added up to a “subjective, conscious experience”?

Derbyshire had refused Nadine Dorries’s invitation to sit on the panel with Campbell and Anand because, he said, he thought the panel would be “stacked against him”. But he had come to the hearing, and it is good that he did, for his objection to Anand gave a little snapshot of the state of the debate.

And it really is as simple as this. While Anand says he cannot “hide behind the subjective screen” - there has to be a presumption, surely, that what corresponds, by every scientific measurement, to the definition of pain is, indeed, pain? - Derbyshire, and the parliamentary committee which excluded Anand, believe that just isn’t good enough.

The MP, Brazier, had another good analogy up his sleeve.

In the nineteenth century there was a considered view that animals did not have minds and therefore could not feel pain or be mistreated. A dog may yelp when you thwacked him, but that only looks like pain, said the experts. But then empathy took over. Perhaps if it looks like pain it is? “In the case of a subject that cannot speak,” the MP said, “you cannot get that final reassurance. But the precautionary principle would dictate that if all the responses are those of pain then it is pain.”

Or put it another way: no dog has yet articulated the subjective emotional response of being bashed on the nose by a wooden spoon; no dog has yet described, in an interview, what it is like to have an injection at the vet’s. But it’s rather nice to think we live in a society where most people give the dog a cuddle when it’s whimpering, rather than simply kick it on the grounds that no one has verified that the whimpers indicate a “subjective emotional response”.         

Anand’s evidence does not in itself argue the case to reduce the abortion upper limit. One can imagine his science – backed by the leaders in the field – taking hold over time, and leading to the foetus being anaesthetised before being removed, piece by piece, to make the procedure more “humanitarian”.

But it was fascinating, nonetheless, to see science on the side of the pro-lifers, and to see that science being dismissed as dangerous and unreliable by those with an ideological commitment to keeping abortion readily available. Just as the famous picture from space in the 1960s sparked the environmental movement – the globe looked so vulnerable, so delicate – and now has the scientific establishment behind it, so, too, the world of the unborn is now opening itself to us, empathy sparking new frontiers of scientific discovery.

They are not little adults, what I saw moving on that screen; they are not really babies either. Dancing in their watery universe, they are in many ways not really like us at all. But they are a wonder to behold. If a woman on the threshold of an abortion were allowed to see and know what we saw on Monday night, would she – could she – see it through?

Could there be a reason why doctors on both sides of the Atlantic are increasingly refusing to perform abortions after 20 weeks? That in the U.S. the task has to be given to people who are not medically trained? Could it be that empathy is beginning to take a hold, and reshaping the abortion debate?