Abortion: What You Didn’t Need To See

The Channel 4 Dispatches documentary on late abortion and fetal pain was a gratuitous and confused mess.

Stuart Derbyshire

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Topics Politics

Last week, Dispatches – Channel 4’s investigative documentary series – examined Britain’s abortion law as we approach the fortieth anniversary of the 1967 Abortion Act (1). The programme, titled Abortion: What We Need to Know, featured several experts on the issue of fetal pain (including myself), surgeons who carry out abortion, clinic directors, women who have had an abortion, 4D ultrasound images and, most notoriously, pro-life footage showing the process of abortion and the fetal matter that is created by the procedure.

Presumably the idea was to provoke people into considering the morality of a procedure that kills a fetus even though it may be able to survive outside the womb and may experience pain during the abortion. Undoubtedly the Dispatches reporter, Deborah Davies, had decided that aborting a fetus at 24 weeks, when it has a marginal but real chance of survival if born, is immoral. And in case you didn’t get the point that the fetus has arms and legs and looks like a baby, Davies helpfully provided footage of the appropriate dismembered fetal parts and indulged London-based professor Stuart Campbell in his descriptions of fetal emotion based on their facial expressions.

The programme was a dreadful mess. Anyone who was hoping to be enlightened on the question of fetal pain will have been disappointed. If American researcher Sunny Anand has new evidence demonstrating that pain is possible due to activation in the brainstem, which fetuses possess, I would have liked to see it. But that evidence was not forthcoming in the programme. The brainstem causing pain is unlikely. For example, in living humans, destruction of the higher, cortical regions of the brain leaves an individual in a persistent vegetative state with conscious awareness abolished; reactions to noxious stimuli persist in such cases due to surviving activity in the lower levels of the central nervous system, including the brainstem, but such patients are not thought to feel pain (2, 3).

Similarly, if Vivette Glover has developed her position beyond saying ‘we should err on the side of caution’ and assume the fetus can feel pain from about 18 weeks, that didn’t come through in the programme (4). I didn’t fare any better in my appearance, being reduced to stating that nothing in the past 10 years changes the view that the biologically necessary components for pain are not in place until about 26 weeks’ gestation. My arguments about the importance of the cortex relative to the brainstem and the necessity to understand pain as a conceptually driven, rather than a biologically driven, experience were all cut (5). I don’t mind being cut; but I do mind that the three fetal pain experts were presented as islands of opinion rather than being engaged in active discussion. It’s hard to see how any viewer could draw a conclusion about fetal pain based on the lack of evidence being debated.

Anyone who might have been looking for enlightenment on the relationship between fetal viability and abortion will also have been disappointed. Currently the chances of survival if a baby is born prior to 24 weeks’ gestation are very low indeed; those babies who do survive often suffer from terrible disabilities. So it would seem that viability does not pose an argument for changing the current abortion law, which mandates against abortion after 24 weeks. Any possibility of a discussion about the relationship between viability and abortion – is abortion automatically wrong if the fetus reaches a gestation where it can survive outside the womb? – was bypassed in favour of Dr Trevor Stammers’ view that it is ‘totally barbaric’ to deliver one baby at 24 weeks but abort a fetus at the same gestation.

Stuck in the middle of this non-debate on fetal pain and viability were 4D ultrasound images narrated by Stuart Campbell and several abortion procedures narrated by Deborah Davies. The conclusion that Campbell and Davies drew is that fetuses start to look an awful lot like babies once pregnancy progresses past 12 weeks, and while suctioning out cells that don’t look like babies is morally acceptable, after 12 weeks it is all a bit icky.

There is an important debate to be had about the nature of abortion in the later stages, but this wasn’t it. There is no question that as a pregnancy advances, abortion becomes more difficult. It becomes more technically difficult, with greater physical dangers to the woman, and it becomes more emotionally difficult. A woman seeking an abortion after 18 weeks is very aware of her pregnancy and may have begun to show; a decision to abort at that stage is very difficult, which is why the vast majority of abortions are completed well before 18 weeks (6).

Making abortion illegal after 18 weeks, however, will not make those difficult decisions go away – it will just make them more difficult. Early abortion is better, definitely, but for those women seeking an abortion when they are past early, then late is all that is left. Late abortion is not pleasant and some women do end up regretting their decision to abort. A law to protect women from unpleasantness and tough decisions that they may later regret, however, is a rather dubious proposition. Everyone needs the autonomy to make tough decisions. Protecting women from the decision to abort because it will sometimes be difficult and sometimes regretted means denying women something that is fundamental to their personhood and humanity, namely their capacity for free will and agency and their ability to act as grown-up members of society (7).

Ultimately the Dispatches programme was flat-out biased. In the online forum discussion after the show, Davies claimed the show was not biased because all the comments were balanced by objections from the experts being interviewed (8). The problem, however, is that Davies’ voiceover controlled the show and she was evidently keen to get the law changed. Towards the end, Dr Evan Harris, a UK Liberal Democrat MP who is a member of the Science and Technology Committee currently considering abortion legislation, was berated by Davies for having already made his mind up about viability and fetal pain (9). Harris defended himself well, but in case you missed the point about him having already made his mind up, the programme makers helpfully cut in Sunny Anand to explain that there are ‘none so blind as he who refuses to see’.

You would have to be blind not to observe that Dispatches was driven by an agenda. As it happens I don’t mind agendas; there is much to be said for having principles and opinions and getting them out for others to chew on. In this instance, however, the agenda just got in the way, and a programme that might have been interesting ended up being a complete mess.

Stuart Derbyshire is a senior lecturer at the School of Psychology at the University of Birmingham, England. He is speaking at the session CAM: Junk science or genuine alternative? at the Battle of Ideas festival in London on 27-28 October.

Abortion law: 40 years on

Jennie Bristow said that, when it comes to abortion, politics and science should not mix. Ellie Lee took a look at the history of the abortion debate and made the case for Early Medical Abortion (EMA). Or read more at spiked issue Abortion.

(1) The programme is available to view online for a limited period, click here for details.

(2) Coma and other disorders of consciousness, M. Jouvet, Handbook of Clinical Neurology, Vol. 3, New York: Elsevier Science Publishers (1969) pp. 62–79.

(3) Coma and Impaired Consciousness, G.B. Young, A. H. Ropper, and C. F. Bolton, New York: McGraw-Hill (1998).

(4) Fetal pain: Implications for research and practice, V. Glover and NM. Fisk, Brit J Obstet Gynaecol 1999;106: 881-6.

(5) Can fetuses feel pain?, SWG. Derbyshire, British Medical Journal 2006;332:909-12.

(6) In 2005, there were 194,353 abortions in the UK. The vast majority of these were performed under 13 weeks gestation (89%) and more than half under 10 weeks (67%). Just 1.3% of abortions, or 2,500, were performed between 20-23 weeks gestation.

(7) The US Partial Birth Abortion Ban Act: a blow for women’s autonomy and clinical judgement, SWG Derbyshire, Abortion Review 2007;22:6-7.

(8) The forum discussion is archived here.

(9) Written evidence presented to the science and technology committee can be found here.

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