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2010/06/26 PM defies 'experts' who insist babies don't feel pain at 24 weeks
 
內容大意： 
英國皇家婦產學院提出研究報告指出，新生兒於妊娠24週內，由於腦部未成熟，致使無痛覺反應。儘管如此，英國首相(PM=Prime Minister) David Cameron堅持將合法墮胎歲齡縮短至20-22週。
 
 
 
 
 
 
 
一. 新聞內容：
 
 
 
 
 
 
 
 
PM defies 'experts' who insist babies don't feel pain at 24 weeks
 
 
By Jenny Hope and Kirsty Walker
Last updated at 12:30 AM on 26th June 2010
 
David Cameron last night re-affirmed his backing for a cut in the abortion time limit  -  hours after a report called for it to remain unchanged.
 
The Prime Minister confirmed he would support a moderate reduction in the 24-week limit in a free Commons vote. He has previously said the limit should be reduced to 20 or 22 weeks.
 
His declaration came after a report yesterday delivered the controversial finding that unborn babies cannot feel pain before the age of 24 weeks.
 
It found nerve connections in the brain are not sufficiently formed for pain to be experienced until after that age.
The authors of the study said this means there is no reason to change the abortion limit.
 
The Government-commissioned report from the Royal College of Obstetricians and Gynaecologists concluded that, in any case, foetuses are 'undeveloped and sedated' in the womb.
 
Abortions for serious abnormalities allowed right up to birth may not, therefore, result in suffering.

A foetus at 20 weeks. Nerve connections in the brain are not sufficiently formed to allow pain perception until after 24-weeks, according to an official report
 
But pro-life campaigners were outraged by what they condemned as a 'nakedly political' verdict. They pointed out that some of the leading experts on foetal pain - who may disagree with the conclusions - were not consulted, and nor were there any leading pro-life representatives on the Royal College panel.
Among those who were on the panel, however, was Toni Belfield, formerly of the Family Planning Association and author of The Contraceptive Handbook.
Jane Fisher, director of the charity Antenatal Results and Choices, a support charity for pregnant women, was also in the team.
Campaigners added that, while possible suffering is among the arguments for reducing the abortion limit, survivability of the foetus is a more important ethical issue.
The latest report follows a recommendation by MPs from the Commons Science and Technology committee, which led the Department of Health to commission a review of foetal pain.
Among the conclusions from the 12-strong working party are that the foetus exists in a state of ' continuous sleep-like unconsciousness or sedation' even after 24 weeks.
The nerve connections in the cortex, the area which processes responses to pain in the brain, does not form properly before 24 weeks, according to the report. 'It can be concluded that the foetus cannot experience pain in any sense prior to this gestation,' it added. In addition, the report said anaesthetics, which can be risky, would not be needed if the baby had surgery while in the womb.
The chairman, Professor Allan Templeton, president of the Royal College, said: 'There's nothing in the report that suggests any need to review the upper limit.' A second report, also carried out by the Royal College, looked into what mental and physical abnormalities could result in a 'serious handicap'.
Around 1 per cent of abortions are carried out on these grounds after the 24-week limit.
But there has been an outcry over reports of late abortions for conditions such as cleft palate, which can be corrected by surgery. The inquiry found it was 'impractical' to produce a list of conditions for serious handicap because it was too difficult to predict the long-term impact of an abnormality.
Vivette Glover, professor of perinatal psychobiology at Imperial College London, argued the evidence was inconclusive about whether a foetus could feel pain.
She said: 'No one knows. I'm concerned the report is so certain they don't when we can't be sure.'
She added: 'I would not be happy to carry out surgery on a 23-week-old baby that needed it without anaesthetic.'
A spokesman for the ProLife Alliance said the report was a 'nakedly political' attempt to defend the status quo.
Josephine Quintavalle, of Comment on Reproductive Ethics, said foetal pain was not the only issue, pointing out that medical advances mean some babies can survive as young as 22 weeks old.
'Performing abortion humanely does not justify the fact that you are terminating a human life,' she added.

Ann Furedi, chief executive of the British Pregnancy Advisory Service, which provides abortions, said: 'Women and doctors need to be able to make informed decisions based on what science says, not what advocates - whether prochoice or anti-choice - wish it said.'

二. RCOG(the Royal College of Obstetricians and Gynaecologists)研究報告
 
2010/06/25 RCOG release: RCOG updates its guidance

The Royal College of Obstetricians and Gynaecologists (RCOG) releases two Working Party reports today: Fetal Awareness and Termination of Pregnancy for Fetal Abnormality.  The first updates the previous report published in 1997, while the latter replaces the 1996 report.  Both documents were commissioned by the Department of Health, following recommendations by the House of Commons Science and Technology Committee in 2008.

A wide range of stakeholders including scientists, doctors, midwives and lay representatives were involved in producing these reports.  Relevant international scientific studies published since the 1990s were considered by the respective working parties as was evidence submitted to the Science and Technology Committee.  An online public consultation followed and the public were invited to submit their views.  Both documents went through rigorous peer-review which included academics, ethicists and lawyers.

To reflect new research findings and the advances in clinical practice, both original documents have been completely rewritten.  These two new reports contain information for clinicians, researchers and healthcare professionals and the report on Fetal Awareness includes a new chapter with practical information and advice to women and parents.

The main findings from each document are listed below.

Fetal Awareness

  • The fetus cannot feel pain before 24 weeks because the connections in the fetal brain are not fully formed
  • Evidence examined by the Working Party showed that the fetus, while in the chemical environment of the womb, is in a state of induced sleep and is unconscious
  • The Working Party concluded that because the 24 week-old fetus has no awareness nor can it feel pain, the use of analgesia is of no benefit
  • More research is needed into the short and long-term effects of the use of fetal analgesia post-24 weeks.

Termination of Pregnancy for Fetal Abnormality

  • The Working Party concluded that it is unrealistic to produce a definitive list of conditions that constitute ‘serious’ handicap since accurate diagnostic techniques are as yet unavailable.  Likewise, the consequences of abnormality are difficult to predict
  • The Working Party recommends that the NHS Fetal Anomaly Screening Programme is centrally linked so that the outcome of pregnancies with specific congenital abnormalities are monitored over time.
  • Appropriate information and support should be offered to all women undergoing antenatal screening
  • In the case of a possible termination of pregnancy, all staff caring for the mother must adopt a non-directive, non-judgemental and supportive approach.

These two reports are meant to be read together as both subject matters are closely related.

Professor Allan Templeton, chair of the Fetal Awareness Working Party said, “These two reports represent an extensive review of the scientific and clinical literature, and I am grateful to the many people who contributed and in particular to the members of the two working parties.

“I believe we now have robust and updated guidance for healthcare professionals.”

Ends

三.  國內相關規定
98.07.08 優生保健法 (民國 98 年 07 月 08 日修正)
 
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