Abtreibung - Pro-Life vs. Pro-Choice
21.11.2013 um 12:04@Etta
Schmerzempfindung setzt das Vorhandensein entsprechende Neuronen und Neuronenverbindungen voraus (insbesondere zwischen Thalamus und Cortex) die aber wohl erst nach der 22 Woche gebildet werden.
Der grösste Teil der Abtreibungen findet meines Wissens früher statt, Spätabbrüche wohl nur bei medizinischer Indikation.
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Fetal PainA Systematic Multidisciplinary Review of the Evidence FREEDie entscheidenden Sätze hab ich dir fett hervorgehoben.
Susan J. Lee, JD; Henry J. Peter Ralston, MD; Eleanor A. Drey, MD, EdM; John Colin Partridge, MD, MPH; Mark A. Rosen, MD
ABSTRACT
ABSTRACT | EVIDENCE ACQUISITION | EVIDENCE SYNTHESIS | CONCLUSIONS | ARTICLE INFORMATION | REFERENCES
Context Proposed federal legislation would require physicians to inform women seeking abortions at 20 or more weeks after fertilization that the fetus feels pain and to offer anesthesia administered directly to the fetus. This article examines whether a fetus feels pain and if so, whether safe and effective techniques exist for providing direct fetal anesthesia or analgesia in the context of therapeutic procedures or abortion.
Evidence
Acquisition Systematic search of PubMed for English-language articles focusing on human studies related to fetal pain, anesthesia, and analgesia. Included articles studied fetuses of less than 30 weeks’ gestational age or specifically addressed fetal pain perception or nociception. Articles were reviewed for additional references. The search was performed without date limitations and was current as of June 6, 2005.
Evidence Synthesis
Pain perception requires conscious recognition or awareness of a noxious stimulus. Neither withdrawal reflexes nor hormonal stress responses to invasive procedures prove the existence of fetal pain, because they can be elicited by nonpainful stimuli and occur without conscious cortical processing. Fetal awareness of noxious stimuli requires functional thalamocortical connections. Thalamocortical fibers begin appearing between 23 to 30 weeks’ gestational age, while electroencephalography suggests the capacity for functional pain perception in preterm neonates probably does not exist before 29 or 30 weeks. For fetal surgery, women may receive general anesthesia and/or analgesics intended for placental transfer, and parenteral opioids may be administered to the fetus under direct or sonographic visualization. In these circumstances, administration of anesthesia and analgesia serves purposes unrelated to reduction of fetal pain, including inhibition of fetal movement, prevention of fetal hormonal stress responses, and induction of uterine atony.
Conclusions Evidence regarding the capacity for fetal pain is limited but indicates that fetal perception of pain is unlikely before the third trimester. Little or no evidence addresses the effectiveness of direct fetal anesthetic or analgesic techniques. Similarly, limited or no data exist on the safety of such techniques for pregnant women in the context of abortion. Anesthetic techniques currently used during fetal surgery are not directly applicable to abortion procedures.
Over the last several years, many states, including California, Kentucky, Minnesota, Montana, New York, Oregon, and Virginia, have considered legislation requiring physicians to inform women seeking abortions that the fetus feels pain and to offer fetal anesthesia. This year, Arkansas and Georgia enacted such statutes.1,2 Currently, Congress is considering legislation requiring physicians to inform women seeking abortions 20 or more weeks after fertilization (ie, 22 weeks’ gestational age) that the fetus has “physical structures necessary to experience pain,” as evidenced by “draw[ing] away from surgical instruments.” The physician must also offer anesthesia or analgesia “administered directly” to the fetus. Physicians who do not comply may be subject to substantial fines, license revocation, and civil suits for punitive damages.3
Although this legislation would not affect most US abortions because only 1.4% are performed at or after 21 weeks’ gestational age,4 this legislation raises important scientific, clinical, ethical, and policy issues. When does a fetus have the functional capacity to feel pain? If that capacity exists, what forms of anesthesia or analgesia are safe and effective for treating fetal pain? As a first step in answering these questions, we reviewed the literature on fetal pain and fetal anesthesia and analgesia.
Schmerzempfindung setzt das Vorhandensein entsprechende Neuronen und Neuronenverbindungen voraus (insbesondere zwischen Thalamus und Cortex) die aber wohl erst nach der 22 Woche gebildet werden.
Der grösste Teil der Abtreibungen findet meines Wissens früher statt, Spätabbrüche wohl nur bei medizinischer Indikation.
