Foetal pain and the abortion debate: believing what you want to believe

By Janet Radcliffe-Richards

Last Friday’s BBC morning news headlines included a report of two reviews by the Royal College of Obstetricians and Gynaecologists of evidence about foetal pain. The reviews concluded that foetuses under 24 weeks could not feel pain, because “nerve connections in the cortex, the area which processes responses to pain in the brain, does not form properly before 24 weeks”, and that even after that stage “a foetus is naturally sedated and unconscious in the womb”.

The corresponding article on the BBC website added the comment that “anti-abortion campaigners challenged the reports”. There were no details about the form these challenges took or who they came from, but as the reports were reviews of scientific evidence, it sounds as though a challenge to the reports must have been a challenge to the scientific claims. Of course scientific claims are always potentially open to challenge, so if the article had reported that scientists had come forward to challenge the methodology of key studies, for instance, or the way the reviews represented the data, we would just have known there was an ongoing scientific debate on the subject. But the implication of the BBC article was that people who were against abortion were challenging the scientific claims about foetal pain. And if this is true, it is interesting. Why should people with particular moral views (about the wrongness of abortion) or political ambitions (to prevent it) issue challenges to scientific claims? Most of these people are not scientists, and there is no reason to think they have special knowledge of nerve connections in the foetal cortex. So why are the challenging what the scientists say?

Intuitively the answer may seem obvious: they don’t want to believe the reports, and people believe what they want to believe. But it is worth looking in more detail at what underlies such familiar platitudes.

If opponents of abortion feel they must challenge the claim that the foetus does not feel pain, that suggests that they are afraid that the truth of the RGOG’s reports would undermine their case in some way, and because they don’t want their case undermined they resist the claims of the report. But most people who are against all abortion are against it on grounds that have nothing to do with pain. As a spokeswoman for Life was reported as saying, "We believe that the issue of whether or not an unborn child feels pain is highly peripheral to the ethical debate over abortion. Our intrinsic dignity as human beings does not in any way depend on the extent of our ability to feel pain". Nearly all opponents of abortion as such regard human life as in some way sacred, and they think that deliberately ending innocent human life is just wrong. That case is not the least undermined by claims about whether pain is felt or not. Such people have no obvious reason to want to believe the the foetus can feel pain.  Indeed, since abortion happens, it would be horrible if they did want to believe pain was involved.

Might there be other reasons for wanting to prohibit all abortions? In principle there might be infinitely many, most are unlikely to appear in practice. There might in theory be people who thought that there should be no abortions because we needed a much larger population. There might be others who thought that the only way to keep women in order was to keep them perpetually pregnant. And there might be yet others who opposed abortion because they were against all preventable pain, and believed that as a matter of fact an embryo could feel pain from the moment of conception.

But even if there are opponents of abortion who come into categories like these, they still have no reason to be afraid that their position would be undermined by the RCOG reports. If they are against abortion for reasons entirely unconnected with pain, like the first two, their opposition will be completely unaffected by the reports. If on the other hand they are against all abortion because of their beliefs that even early embryos feel pain, they still have no reason to oppose the reviews. Their opposition to abortion is rooted in opposition to pain, and if it turns out that that there is no pain, they should simply reverse their opposition to abortion. Their political position would change, but there would be no undermining of their concern with the preventing of pain, which is what matters to them.

Anyone who genuinely holds any particular set of values – opposition to pain, or values of any other kind – needs to know as much as possible about the way the world works in order to implement those values. If you think abortion is morally acceptable until the foetus is viable, you need scientific evidence about when viability occurs. If you think it is morally acceptable between conception and implantation, you need to know when implantation occurs. And so on.

In other words, there seems to be no reason for anyone – other than possibly critical fellow scientists ¬– to oppose the RCOG reviews about the evidence for foetal pain. The conclusions don’t in the least affect the position of people whose opposition is rooted in matters that have nothing to do with pain, and for anyone whose opposition is based entirely on beliefs about pain, they should simply want to know the truth so that they can apply their pain-opposing principles on the basis of knowledge. Why, then, should people opposed to abortion challenge the purely scientific claims of the RCOG reviews? Why should anyone, with any political aim, challenge the claims of people who have investigated the facts?

Presumably the answer must be along these lines. People whose values lead them to support a particular political aim, such as making abortion illegal, will want to find effective ways to achieve that aim. If you are against abortion because you regard human life as sacred you probably want to prevent as many abortions as possible. If you and your supporters on your own lack the political clout to stop abortions, you will probably look out for people who might be persuaded to join in your political aims to at least to some extent, even if for different moral reasons. If there are people who do not oppose abortion as such, but would oppose any abortions that involved pain to the foetus, and you can persuade them to doubt the RCOG's claims about foetal pain, you may be able to get them to join you in opposing at least some abortions. If you can persuade them, for instance, that a 20-week foetus can feel pain, you may get their support in lowering the gestation limit for abortions to 20 weeks.

In other words, if anti-abortionists challenge the scientific claims of the RCOG the report it is not because it constitutes any challenge to their own position, but to influence the political position of people with different moral values. This is, of course, from the point of view of those people who hold those values, a cheat. And this is why people are often right to be suspicious of the claims of fact made by their political opponents.

Of course fact fudging can work in any direction. Perhaps that is what was being implied by Josephine Quintavalle, of the campaign group Comment on Reproductive Ethics, who was reported by the BBC as saying "I think both reports tell us more about the RCOG's willing acceptance of late abortion than the reality of the scientific and ethical issues at stake."  It’s not entirely clear what this means, but the implication seems to be that you can’t trust the report because the RCOG has motives of its own. If the RCOG is determined to support abortion, even late abortion, it may have a political interest in manipulating evidence about foetal pain so that it can keep on its political side anyone whose attitude to the permissibility of abortion is determined by the issue of foetal pain.

There is a much wider point here. Nobody has any interest in inventing facts – ‘believing what they want to believe’ – when their real values are involved in making practical and political decisions. They do it only when deception of some sort is involved – either of others or of self. But that needs a lot of argument and clarification.

In the meantime, how should we respond to all this, given that – as everyone knows – people with political ends are always playing with claims about facts – often unconsciously – by straightforward invention of what is convenient, or suppressing evidence that goes against their interests?  When something that claims to be a straightforwardly scientific report appears, how can we know whether the evidence is really as it seems, or whether the people putting it forward or are trying to manipulate us into supporting their political conclusions on the basis of our own, different, values?

The full answer is that we need to find out the facts, which means either investigating them in detail ourselves or, usually, finding experts we have reason to believe reliable. But in contexts where the problems centre on questions about what we should do – either as individuals, as organizations, or as states – there are some short cuts to be found, as the foregoing arguments illustrate.

When in such contexts people make claims about the facts – about what the world is like and how it works – the important thing to remember is that until you are clear about the values you want to accept you can’t tell whether the evidence being offered is even relevant to your political and practical questions. In the abortion debate, if your value is the preservation of human life, you don’t need to know about foetal pain to reach your opposition to abortion. If your concern is with pain, you would presumably be interested in the question of whether a foetus could feel pain.  It is the values that determine which facts you need to know, and how to set about using your knowledge.

That is why, in any debates about what we ought to do, we should concentrate on working out the values issues before getting into questions about the facts and the evidence.  This is just the opposite of the way public debates tend to work, where people often seem to think they need to start by establishing as many facts as possible – and then never get beyond the wrangles about the facts to the value issues that are at the root of all questions about what we should do.

There is endless confusion in this area, as the BBC story illustrated in various ways.
The broadcast referring to the RCOG reviews referred to “two reports that say there's no scientific evidence that should prompt a change to current abortion law”.  But in the absence of an understanding of the values at issue – the question of what matters – scientific evidence can never ‘prompt’ any conclusions whatever about what the law should be. It can only do so only in conjunction with particular values, and current law abortion law is certainly not rooted in concerns about foetal pain.

Then Ann Furedi, chief executive of the British Pregnancy Advisory Service (BPAS), was reported as saying that the two reports “would provide a clear basis for difficult decisions”; and that "women and doctors need to be able to make informed decisions based on what science says, not what advocates, whether pro-choice or anti-choice, wish it said."   But although many women and doctors are likely to need scientific evidence when they are making abortion decisions, most of the difficulty of their decisions is likely come in problems of value that arise before particular facts become relevant.

And a Downing Street spokeswoman was reported as saying "The Prime Minister's view is that he will be led by the science." Well, we hope his practical decisions will always be fully informed by the relevant scientific evidence – but in the absence of knowledge about his values, we have no idea where the  science will lead him.

Public debate about law and ethics will continue in its current state of perpetual confusion until these matters are clearer to the editors and journalists and broadcasters and political activists who tend to guide that debate.