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Ethical issues

Science, smiling fetuses, and the abortion issue
By Ellie Lee
October 5, 2006

It is now three years since the debate provoked by Professor Stuart Campbell's 4-D ultrasound images of the 'smiling' fetus began (1). Over this time, these images have become ubiquitous. They have been referred to time and time again in media commentaries, especially those more or less overtly contending that abortion should banned in Britain at an earlier stage in pregnancy than is now the case. The claim made in almost all of this discussion has been that 4-D images provide 'new medical evidence' against legal abortion. These images, it has been argued, prove that the fetus from quite early stage exhibits human feelings and emotions, and so mean a law that permits abortion to 24 weeks of pregnancy is at best ethically dubious.

In the light of this it is very welcome to find that, at long last, those who have expertise in this area have entered the debate. Earlier this week experts on fetal development made comments about what the 4D images tell us at a meeting held at London's Science Media Centre (2,3,4). In particular, participants addressed the question of whether 4D tells us anything new, and also of what science does really tell us about the point at which fetus might feel emotion.

Speaking at the event was Donald Peebles of the Department of Obstetrics and Gynaecology at University College London. 'These images don't tell me anything I haven't known for 30 years', he noted. 'We know what it [the fetus] looks like, and that it moves continuously. I don't think in a scientific sense this sheds any new light on the debate', he added. Huseyin Mehmet, Reader in Developmental Neurobiology at Imperial College in London concurred. He also pointed out that much discussion of the 4-D images runs entirely contrary to what scientists know. In contrast to the notion that the developing fetus is biologically mature enough to possibly feel pain (cry) or feel pleasure (smile), he explained, 'Scans that look at the structure of the foetal brain at 23 to 24 weeks show that the human brain is extremely immature. It is the period between 24 and 40 weeks that is largely responsible for brain development'.

Notably, the third participant at the event also concurred with this assessment. This was Professor John Wyatt of University College Hospital London. Wyatt is one of Britain's most eminent and highly regarded neonatal paediatricians, but also an often vocal opponent of abortion. Yet he too, speaking as a scientist, agreed. 'It is clear that the vast amount of activity is happening mainly in the last three months of pregnancy', he stated. 'The link between cortex and the rest of the body doesn't come into play until 23 to 24 weeks'.

These doctors have made some very important points clear. First, there is nothing new at all, in a medical sense, about what 4-D ultrasonography shows us. Second, this technology does not and cannot contribute to helping us understand the development of consciousness and emotion; to the contrary discussion to date provoked by these ultrasound images has actively misrepresented understanding about this issue.

The absence of anything 'new' associated with 4-D is, especially, a well-made point. The scientific issue, of at what point a fetus become sentient, has been the subject of serious discussion for over a decade, the arguments are well worn, and contradict the sorts of claims surrounding 4-D images. Debate goes on about what true emotional experience constitutes, but there is no serious body of opinion that considers fetal imaging pertinent to this debate, or which considers there to be evidence of even the biological basis for emotional experience before very late gestational stages (5).

These points, have, in fact been made consistently in public arenas over the last three years. Ann Furedi, Chief Executive of bpas (British Pregnancy Advisory Service), for example, has argued time and again that while 4-D images give parents with wanted pregnancies something new experientially, since these parents can revel through use of this technology in seeing the pregnancy develop, from a scientific point of view the technology innovates nothing: 'It contributes little, if anything, to medical knowledge and nothing about the discussion that is relevant to late abortion'. As she points out, the Swedish photographer Lennart Nilsson's images published 15 years ago, tracking a pregnancy from ovulation to birth, showed clearly the human physical characteristics of the 'unborn child' as early as six weeks' gestation (6). Psychologist Dr Stuart Derbyshire, perhaps Britain's most prolific scientific commentator on these issues, has also explained the main point. Regardless of how astounding fetal development appears from 4D images, 'there can be no question that foetal development is limited…seeking an equivalence between foetus and baby…is bound to produce disappointment and exaggeration' he has written (7).

Clarification of the scientifically illiterate nature of the debate about 4D is welcome, and it is to be hoped that, in the future, more medical experts will take the lead of those who spoke out this week, contest bogus claims about science, and clarify these matters in public. This should not, however, be confused with the process of clarifying the abortion issue.

That this is the case was illustrated by Professor Campbell's riposte to the Science Media Centre discussion. Writing in the Daily Telegraph, he argues 'There is something deeply moving about the image of the baby cocooned inside the womb. When four-dimensional scans first became available three years ago, I sat with parents who trembled at the sight of their soon-to-be newborn……We have to draw the line [on legal access to abortion] somewhere, and 24 weeks is too late' (8). In other words, Campbell, working on a daily basis with prospective parents viewing 4D images of much wanted pregnancies, cannot reconcile this experience with allowing women legally to terminate pregnancies, certainly past 18 weeks.

Anyone who has been wantedly pregnant, seen the scan images, and so wondered at the amazing progression over 40 weeks of a pregnancy from ball of cells to waking baby, will likely also have felt deeply moved, just like Professor Campbell. Yet many of us also understand this experience is of no relevance for the abortion law. We separate our perceptions and emotions of our own pregnancies from this issue. It seems, however, that an inability to separate personal experience and emotion from the question of the abortion law is now central to the issue of abortion. A kind of emotional dissonance between personal experiences in regard to wanted pregnancies, and the legal provision of abortion, is now increasingly articulated in public. Indeed, if there is anything 'new' at all about the abortion debate as it currently exists, it is this.

It is, for example, just this sort of dissonance that is leading to criticism of legal abortion from unexpected quarters. Feminist commentators - including Naomi Wolf and Allison Pearson - have thus come out against the current abortion law, citing their own personal experience of pregnancy and that of their friends, as evidence. Politicians, not only those who are paid up members of Life and SPUC, also draw upon just this sort of sensibility born of the experience of pregnancy and parenthood, when they express their distaste and discomfort with the current abortion law.

The influence of this sensibility over the abortion debate can be considered symptomatic of moral and intellectual bankruptcy. It is an approach whose advocates certainly display a quite profound lack of respect for science, willing as they are to cite 'science'- be it 4-D technology, or exaggerated claims about survival rates for premature babies - to justify their position. It is perhaps unsurprising that such resort is made to 'science', however, since ultimately this way of 'thinking' about the moral issue of whether abortion should be permitted takes place through reference to little more than one's own feelings and experiences. It is an approach that thus studiously pays scant attention the experience of those women who seek abortion, the social problem of involuntary parenthood, and the moral issue of the right of women to decide about their lives and futures that the abortion issue centrally addresses.

But it is also a widespread approach and, unfortunately, rarely challenged head-on. It is important that those who are concerned about the abortion debate as it currently exists do not make the make the mistake of believing that science, even in its best and most robust variety, can be relied upon to address the key questions. Tempting as it may be to think that the debate about 4D can be resolved this way, this would be to miss the cultural problem of the growing acceptability of subjective claims and reference to personal experience in the abortion debate. As Dr Stuart Derbyshire has succinctly put it, 'The question of who should and should not continue a pregnancy is not one that science can resolve. Trying to do so is likely to produce both bad science and bad law'. A wider debate about morality, and its social basis is what is needed.

1. 'The Trouble with smiling fetuses'.

2. 'Doctors grapple with abortion debate'

3. 'Foetus scans fuel abortion debate'

4. New foetal scans 'clouded debate on abortion'

5. 'The science and politics of fetal pain'

'Late abortion: a review of the evidence'

6. 'Faith in the abortion debate'

7. Derbyshire, Stuart. 2005. 'Why I see no place for science in the abortion debate'.
Time Higher Educational Supplement January 21.

8. 'Don't tear a smiling foetus from the womb'

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