[HN Gopher] Infants' sense of pain is recognized, finally (1987)
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Infants' sense of pain is recognized, finally (1987)
Author : akakievich
Score : 53 points
Date : 2022-06-14 19:37 UTC (3 hours ago)
(HTM) web link (www.nytimes.com)
(TXT) w3m dump (www.nytimes.com)
| BitwiseFool wrote:
| This is, I believe, one of the downsides of empiricism and the
| fixation on citation rather than observation and reason. The idea
| that a whole profession came to reject the idea that infants are
| able to feel pain is astonishing, especially considering anyone
| who has ever taken care of infants knows that these little human
| beings react to things which are known to be painful. Babies
| feeling pain is something that should be self-evident, shouldn't
| it? It may not be empirically evident, but decisions can still be
| made without such metrics.
|
| Don't get me wrong, empiricism and citation is valuable. However,
| a myopic focus on it enables some very twisted conclusions.
| anonu wrote:
| True. Lobotomies used to be common practice as well. Even a
| surgery performed recently, UPPP, for treating sleep apnea is
| "no longer recommended"... It was only five or ten years ago
| where they would perform this incredibly invasive surgery, but
| enough research shows they're not that effective.
| diob wrote:
| Grateful I turned that shit down in 2012. Even then the
| evidence against it was overwhelming (basically, it makes
| sleep apnea worse because scar tissue comes back fierce).
| [deleted]
| RobertRoberts wrote:
| You are proving the OP's point. Cutting off your uvula? It
| sounds insane to me, and I wouldn't have the procedure even
| if a doctor recommended it to me.
|
| There are so many totally insane medical practices that it's
| shocking we don't question the medical industry as a rule of
| thumb.
|
| Another one:
| https://en.wikipedia.org/wiki/Focal_infection_theory
| saurik wrote:
| > You are proving the OP's point.
|
| That would seem to be why they left the comment, so:
| mission successful.
| kif wrote:
| What is considered to be the best treatment for apnea these
| days? Is it ESP, or something else? Besides CPAP of course.
| [deleted]
| Spoom wrote:
| I get the impression that a lot of gynecological care is in
| the same realm, but I don't have the equipment to have first
| hand anecdotal evidence. Heard many a horror story about IUD
| placement / removal, where folks were told that a Tylenol
| would be enough.
| bad416f1f5a2 wrote:
| Medical racism and sexism are very real.
|
| One in four residents believe blacks have thicker skin than
| whites:
| https://www.pnas.org/doi/abs/10.1073/pnas.1516047113
| kzrdude wrote:
| I absolutely agree. I think there are many factors that make
| people look aside. We "believe" what's convenient to us. What
| immediately comes to mind - and I'm a meat-eater - is eating
| meat and harming animals. For animals, we tell ourselves what
| we need so that we can continue eating meat.
| lisper wrote:
| > Babies feeling pain is something that should be self-evident,
| shouldn't it?
|
| We need to be careful here. Just because a system responds to
| painful stimulus does not necessarily mean that it "feels
| pain".
|
| Consider this:
|
| https://arstechnica.com/science/2022/06/google-places-engine...
|
| Or this:
|
| https://spectrum.ieee.org/why-people-demanded-privacy-to-con...
|
| Or this:
|
| https://junkerhq.net/MGS2/MarkIII.html
|
| People tend to instinctively anthropomorphize, and this
| instinct is particularly strong when it comes to our offspring.
| Just because it seems conscious doesn't necessarily mean that
| it is.
| BitwiseFool wrote:
| >"People tend to instinctively anthropomorphize, and this
| instinct is particularly strong when it comes to our
| offspring."
|
| I don't want to come across as snide when I ask this, but why
| would it be wrong to anthropomorphize a fellow human being?
| ibejoeb wrote:
| It doesn't even make sense. What would it mean to
| anthropomorphize a human? It is a given and can't be fairly
| characterized like that. The only way to characterize it
| otherwise is to dehumanize.
| drpyser22 wrote:
| I guess the word "anthropomorphise" here is conflating
| many understanding of "human" and humanity. In the same
| way, is a bunch of cells, an embryon or just a tissue
| sample, a human? Is an organ a human? Is a developing
| fetus a human? How many properties do each share with a
| typical example of a human? There's a spectrum of
| biological complexity and other attributes we associate
| with the idea of "human". The question then is where does
| a baby fit on that spectrum.
|
| The general idea of anthropomorphising, here, is to
| attribute characteristics and experience that we only
| know from our own experience as conscious, self-aware
| creatures capable of complex cognition and complex
| communication of that experience.
| lisper wrote:
| That's a fair question. And I'm not saying it _is_ wrong,
| only that it _might_ be. Let me give a slightly less
| fraught example: we have an instinct to "honor our dead"
| and not to "desecrate their bodies." Does that make sense?
| The dead person doesn't care. Does it even make sense to
| talk about a dead "person"? One might argue that no dead
| thing can be a person, it's just a (dead) thing that was
| once a person and still happens to look like a person but
| isn't actually a person any more.
|
| Likewise, a baby may look like a person, may even behave in
| some ways like a person, but not yet actually be one.
|
| Again I have to emphasize: I am not saying this is the
| case, only that it is a possibility that needs to be taken
| into account when doing the moral calculus.
| Dylan16807 wrote:
| > Again I have to emphasize: I am not saying this is the
| case, only that it is a possibility that needs to be
| taken into account when doing the moral calculus.
|
| An important thing to note about babies is that at some
| point in the past few months they _objectively_ couldn 't
| feel anything, despite having a human body.
|
| So the question is _when_ those various things switch
| over, not if.
| prometheus76 wrote:
| The identity of someone is not just their body, and,
| while they may not be aware of how their body is being
| treated, an assault on their body can still be quite
| traumatic for those who do remember the person and in
| whom their identity still lives.
| bobthechef wrote:
| treis wrote:
| >little human beings react to things which are known to be
| painful. Babies feeling pain is something that should be self-
| evident, shouldn't it
|
| Perhaps this is just semantics, but I think "feeling pain"
| implies a higher level of cognition than simply reacting to
| things which are known to be painful. Like the classic toddler
| move of painting with their feces. They're obviously physically
| capable of smell but it just doesn't seem to register the same
| way.
| asiachick wrote:
| smell being good/bad seems to me to be learned? Go to Taiwan
| and smell stinky tofu Chou Dou Fu . To most non-Taiwanese it
| smells like cat poop or sewer water. Eating it as a non-fan
| feels like I'm eating in a dirty public restroom where the
| food itself doesn't taste bad but the smell from the over
| full toilet next to me is off putting. Similarly shrimp
| paste. Many cheeses also smell pretty bad.
|
| All of them stop smelling so bad once you train yourself to
| enjoy them. Is the smell of poop any different?
| happytoexplain wrote:
| I feel like it's the opposite - that, historically, many people
| (regardless of profession) _always_ generally assumed that
| certain living things did not feel pain or otherwise suffer for
| some definition of suffering. This status quo naturally
| persisted into the era of science _until science demonstrated
| it to be wrong in this case_. Should they have known better,
| sooner? Obviously - I don 't fully comprehend what could lead
| to such a bizarre and terrible assumption. But the problem
| seems to predate the age of empiricism and medical science.
| rodgerd wrote:
| "You shouldn't feel bad about eating an octopus alive or
| boiling a lobster alive. It's tastier and they don't feel
| pain anyway."
| Dylan16807 wrote:
| If someone is making it up, that's terrible, but if they're
| basing it on some evidence it's not crazy. Not everything,
| not even all _humans_ , have the same types of pain.
| yieldcrv wrote:
| That's a great example because I disagreed with them and
| have no problem consuming anything based on its nervous
| system or perceptive capabilities
|
| but then these same people, themselves, will suddenly have
| a cognitive maturity enough to notice things the same way I
| could my whole life, and _then_ freak out about consuming
| them!?
|
| I'm dumfounded! When was _that_ the line!? It was only the
| line because in some cultures the humans were cognitively
| stunted the whole time!? Can I trust a single thing they
| say and perceive? Can they even pass the turing test?
| bobthechef wrote:
| [deleted]
| Enginerrrd wrote:
| You can see this all the time right now. People always talk
| about dogs as though they are philosophical zombies that
| merely learned to imitate the emotional displays we see from
| them. I see people talking about animals frequently caveat
| their intuition by saying things like "I'm sure he's just
| learned that if he does that he'll get food" or the like.
|
| But the notion that fellow mammals which evolved to live in
| social groups don't experience any of the same emotions we do
| despite using the same brain structures in the same contexts
| is absolutely insane to me. They clearly experience even
| fairly complex emotions like jealousy of their peers. I can
| give my child a snack that my dog likes and it's no big deal.
| But if I were to give the cat that same treat and not my dog,
| she will flip her shit. Another dog would be similarly. In
| fact, my dog will jealously guard a treat she doesn't even
| like from the cat or another dog. Like she won't even eat it
| in a neutral context. But in the jealousy eliciting context,
| she will take it and bring it somewhere and guard it.
|
| Like it's insane to me that people think the entire range of
| our emotions and thoughts evolved solely in humans. There are
| other social mammals and have been for a long time.
| QuadmasterXLII wrote:
| We should find sympathy for the doctors here. Administering
| general anesthesia to a newborn was a terrifying and deadly
| prospect at the time, so it was much easier to find a way to
| pretend it was unnecessary - certainly many of these surgeries
| had to happen one way or another for the baby to survive.
| mike00632 wrote:
| I'm afraid it's the case that most all surgeries on infants
| (circumcision) are elective and performed for aesthetic
| reasons. For males it's likely they only time they will go
| into shock from pain during their lives.
| FredPret wrote:
| Absolute barbarism
| dmurray wrote:
| I miss the version of the NY Times that could write this article
| without a single social justice angle.
| sydd wrote:
| It's fucking scary, that this was recognized in 1987. In the 80s
| and even in the 90s most places did complex operations on
| newborns without any kind of painkillers -- imagine a heart
| surgery without painkillers. Not to mention "simple" stuff like
| circumcision.
|
| Also by this time they knew this about animals too. I think
| people will look at us as barbarians that we ate them when we
| knew that they feel pain, can sense the world similar to us, and
| it would be just a minor inconvenience to eat something else.
| dane-pgp wrote:
| > Not to mention "simple" stuff like circumcision.
|
| You might have stumbled upon the real reason for this seemingly
| inexplicable delay in accepting that infants can feel pain: The
| circumcision industry. Presumably some doctors feared that
| parents would think twice about it if they knew that their son
| would be in agony (or need expensive painkillers) when
| undergoing that elective surgery.
|
| https://www.endalldisease.com/baby-foreskin-in-cosmetics-the...
| someweirdperson wrote:
| German law, BGB SS1631d (last updated 2012) allows
| circumcision by qualified non-medical religious
| practitioners. Non-medical implies that they do not have
| access to proper painkillers. edit: within first 6 month of
| birth.
| usrn wrote:
| throw_m239339 wrote:
| > German law, BGB SS1631d (last updated 2012) allows
| circumcision by qualified non-medical religious
| practitioners. Non-medical implies that they do not have
| access to proper painkillers. edit: within first 6 month of
| birth.
|
| Now imagine getting circumcized at 6 or 8, with scissors,
| without anesthesia by someone that isn't a doctor... this
| is the fate of many young boys in Africa.
|
| It's as bad as FGM.
| jl6 wrote:
| Some days I think humans are pretty gosh darned
| sophisticated. Then I remember that it's still controversial
| as to whether we should slice off healthy parts from children
| who cannot possibly consent.
| lotsofpulp wrote:
| And with all the regulation around healthcare in the US,
| male genital mutilation is not only perfectly legal, but
| also legal to be done by some with no medical
| certifications, outside of a medical setting, and it is
| legal for them to suck the blood from the mutilated area
| with their mouth, increasing risk of disease for the
| infant.
|
| https://en.wikipedia.org/wiki/Mohel
|
| Can you imagine a new cult starting today that behaved that
| way? How fast would everyone jump on them for child abuse?
| TedDoesntTalk wrote:
| > imagine a heart surgery without painkillers.
|
| I'm not aware of heart surgeries done on infants without
| painkillers. Do you have any links discussing that?
| rootusrootus wrote:
| Having had surgery as an infant in the mid 1970s, I guess I'm
| glad that I can't remember back that far.
| incanus77 wrote:
| Same.
| thriftwy wrote:
| subjectsigma wrote:
| akakievich wrote:
| http://web.archive.org/web/20211224010002/https://www.nytime...
| hirundo wrote:
| > Newborns do feel pain.
|
| Presumably it doesn't switch on from nothing at birth, and pre-
| borns feel pain too. I'm pro-choice on abortion, but perhaps we
| should at least anaesthetise the fetus before late term
| abortions. Is that done? Or is their pain denied? Or is
| compassion toward that pain too difficult in the circumstances?
| kybernetyk wrote:
| thehappypm wrote:
| What makes you think it's murder? Are you also against IVF?
| [deleted]
| qgin wrote:
| It's thought that the structures required for consciousness
| haven't developed until around 20 weeks. I'm not sure how based
| in evidence that position is.
| rootusrootus wrote:
| IIRC the consensus is that a fetus likely starts to experience
| pain in the second trimester. Over 90% of all abortions happen
| in the first trimester.
| anon291 wrote:
| Do they anesthesize the child in the other 10%?
|
| EDIT: Answered my own question: apparently only in Utah as of
| 2016: http://www.healthlawpolicy.org/fetal-anesthesia/`
| nonameiguess wrote:
| Anyone getting an abortion (at least an invasive late term
| abortion that isn't just induced miscarriage) is going to
| have some form of anesthesia administered. Since they share
| a bloodstream, giving general anesthetic to the mother also
| anesthetizes the fetus. Whether local shares an effect or
| not I think depends on the type, but it is usually
| administered along with a sedative. It appears from this
| that most sedatives other than muscle relaxers will also
| sedate the fetus, but whether local anesthetic crosses the
| placenta depends on a lot of things: https://www.openanesth
| esia.org/placental_transfer_anesth_dru...
|
| Here is a study of how effective various forms of
| anesthesia are for abortions, but it's not going to tell
| you the prevalence with which each form is actually used:
| https://www.ncbi.nlm.nih.gov/books/NBK561096/
|
| Unfortunately, for various reasons, there is quite a bit of
| need for privacy on both the patients and the providers
| parts as the act of getting or performing an abortion will
| make you a target in a lot of places.
| RobertRoberts wrote:
| Maybe they can't mandate it? There could be legal
| precedence that anything that can feel pain must be a
| living being and therefore to end it's life could be
| considered a criminal act.
| anon291 wrote:
| Then perhaps we should reconsider the act?
|
| But really, states have broad authority to do whatever.
| They can legalize murder if they really wanted.
| rootusrootus wrote:
| I can't answer that. I know the basic statistics, as it was
| not long ago a question my wife and I sought out the
| answers to, but I don't know anything deeper about medical
| policies.
|
| I suspect that answer is probably some version of no.
| Aren't most abortions just induced miscarriages anyway?
| anon291 wrote:
| I was asking about the minority that aren't. Typically,
| exceptions to the rule are the most interesting.
| rootusrootus wrote:
| Sure, but when it comes to macro policy they should be
| weighted appropriately.
| anon291 wrote:
| I typically agree, but not when it comes to this. Very
| few percentage of Americans are executed, but we all
| agree that the way in which they are ought to be humane,
| for some definition of humane. Most people today seem to
| agree that 'painless' is a desirable property.
|
| So if it's true fetuses feel pain past some time in
| pregnancy, then I think it's imperative than anesthesia
| is used, and that medicine create such a thing, lest we
| betray our own convictions.
| rootusrootus wrote:
| At the risk of running way off into a tangent...
|
| > we all agree that the way in which they are ought to be
| humane
|
| Do we? As far as I can tell, the currently accepted
| execution protocol (for lethal injection) is more about
| ensuring that the execution _looks_ painless, and only
| secondarily about whether or not it is in _fact_
| painless.
|
| We don't use drugs to paralyze muscles and stop the heart
| when we humanely euthanize someone, why do we do this for
| executions?
| mc32 wrote:
| That's a good question. Why couldn't they use the
| cocktail given to assisted source subjects in
| Switzerland? Or any variety of cocktails (OD) known to be
| lethal to people?
|
| This still leaves an open question though. Why are people
| more concerned about the mode of execution of an adult vs
| the mode of termination of a foetus that could survive
| ex-utero in and neo-natal ICU?
| loeg wrote:
| Yeah, and miscarriage itself is just the lay terminology
| for a spontaneous abortion.
| anon291 wrote:
| A miscarriage / stillbirth isn't the same occurence as an
| intentional abortion, because if you intend to end a
| fetal life, you must also take care to make sure the
| ending is humane.
|
| People die naturally in ways we would never allow a
| person to do intentionally (assisted suicide does not
| mean you get to assist someone to die in any way
| possible)
| mike00632 wrote:
| Abortions are not defined by ending a fetal life but
| rather by terminating a pregnancy. Many women in the US
| are about to lose their rights to end a pregnancy EVEN
| WHEN THE FETUS IS DEAD.
| jjulius wrote:
| >Do they anesthesize the child in the other 10%?
|
| That answer is heavily nuanced and is likely difficult to
| answer. First, there's the likelihood that some of that 10%
| occurred very early in the second trimester but prior to
| the development of the ability to feel pain. One should
| also consider the circumstances of each specific abortion
| relative to whether or not they would feel pain.
|
| >EDIT: Answered my own question: apparently only in Utah as
| of 2016: http://www.healthlawpolicy.org/fetal-anesthesia/
|
| Your link very clearly states that Utah is the only state,
| as of 2016, that legally requires the use of anesthesia.
| Lack of legal requirement does not mean a lack of
| anesthesia whatsoever in other states.
|
| Edit: This sort of thing is never as black-and-white as one
| would like it to be, which complicates these discussions
| given the high level of emotions involved.
| anon291 wrote:
| > Lack of legal requirement does not mean a lack of
| anesthesia whatsoever in other states.
|
| I guess I was asking if anyone knew, because that article
| is the only thing I could find on it.
| jjulius wrote:
| This doesn't answer your question, but I thought it was
| worth sharing in the broader context and actually changes
| the figures we're looking at just a bit.
|
| >The problem? Thorough reviews of medical evidence reject
| the idea that fetuses can actually feel pain at 20 weeks.
| They don't fully develop the proper neurological
| structures to feel pain until later, around 29 to 30
| weeks in the third trimester.[1]
|
| >The bigger problem? There's really no such thing as
| "fetal anesthesia" in standard medical practice. And the
| law doesn't specify how doctors are supposed to make it
| happen.[1]
|
| So now, goalposts have shifted to pain not being present
| until 29+ weeks, which is the third trimester.
|
| >Abortions at or after 21 weeks are uncommon, and
| represent 1% of all abortions in the US.[2]
|
| Which means that the question you're asking pertains to
| likely less than 1% of abortions in the US, rather than
| 10%.
|
| [1]https://www.vox.com/2016/3/30/11331414/utah-abortion-
| anesthe...
|
| [2]https://www.kff.org/womens-health-policy/fact-
| sheet/abortion...
| scarmig wrote:
| Makes me wonder how painful going through birth is for the
| infant. I can't imagine it's pleasant.
| [deleted]
| anon291 wrote:
| Given that we are actively attempting to deny the fact that
| fetuses feel pain, are we really that much more civilized?
|
| Citation on my claim that there are those who deny that fetuses
| feel pain: http://www.healthlawpolicy.org/fetal-anesthesia/
| PretzelPirate wrote:
| > Given that we are actively attempting to deny the fact that
| fetuses feel pain, are we really that much more civilized?
|
| I don't believe the discussion has been around whether a fetus
| feels pain or not, but around whether the fetus takes priority
| over the woman it is in.
| mbg721 wrote:
| oneoff786 wrote:
| You're acting as if the post you responded to denied
| fetuses feel pain. They did not. It just doesn't matter.
| anon291 wrote:
| I don't get it. Okay, woman doesn't want to provide for fetus
| with her body, so doctor is going to 'terminate' it. If the
| termination involves pain, then I feel one must alleviate the
| fetal suffering. I'm not suggesting giving the mother
| anesthesia or any medication for the fetus's sake. I'm
| suggesting providing a painless way to end the fetus's life.
|
| Your desire for freedom shouldn't interfere with the desire
| for a fetus to not feel pain while it is being killed, since
| the latter (pain) is solely a happening of the fetal body,
| not the 'mother'.
| oblio wrote:
| Is this a real cause for concern? I don't really know how
| abortions are performed, but doesn't the fetus die quickly?
| I imagine that once it's "unplugged", depending on its age,
| it's seconds to a minute from death.
| seibelj wrote:
| prometheus76 wrote:
| You should look into the details of how abortions are
| performed and what the process entails.
| thatfrenchguy wrote:
| https://www.ucsfhealth.org/treatments/surgical-abortion-
| seco...
|
| Five seconds on Google to find the answer to your question.
|
| Embryos don't have a human brain when you use an abortion
| pills as well, and second/third-trimester abortions that
| are not "the mother's life is in danger" are incredibly
| rare, even in the United States where people are incredibly
| uneducated on the subject because of antiscientific
| religious pressure ( https://www.kff.org/womens-health-
| policy/fact-sheet/abortion... ).
| [deleted]
| epgui wrote:
| There's that, and also the fact that "pain" means something
| very different (ie.: just a nervous reflex, no more) to an
| undeveloped brain.
| Dylan16807 wrote:
| Which fetuses is that a fact for? "fetus" spans 80% of the
| development process. The nerves that transmit pain don't even
| exist for a big part of that period, let alone worrying about
| the ability to process those signals.
| qgin wrote:
| A history to keep in mind as AI progresses.
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