Political science

Local researchers under fire for study on fetal pain

By Tali Woodward

In yet another sign that it takes about three seconds for anything relating to abortion to become the subject of rancorous political debate, local researchers who recently reviewed the scientific evidence on when a fetus develops the capacity to feel pain are being slammed by the country's anti-abortion lobby – for alleged conflicts of interest.

At issue is an article in the most recent issue of the Journal of the American Medical Association by five researchers associated with the University of California at San Francisco. The researchers reviewed more than 2,000 scientific papers dealing with brain development in utero and other pertinent issues. They concluded that fetuses probably can't feel pain until the 29th week of a pregnancy because the wiring between two key parts of the brain is underdeveloped until that point. The paper notes that data on this issue is limited, and it urges that more research be conducted.

Why does the pro-life lobby care so much about the article? Well, the first and most obvious reason is that the article challenges the idea of fetuses as full-fledged people. But more specifically, the study raises questions about several pieces of legislation. The Unborn Child Pain Awareness Act, pending in Congress, would to require clinicians to tell women who are seeking an abortion after the 20th week of pregnancy that the fetus will feel pain. They would also be required to offer to anesthetize the fetus during the procedure. Similar bills have been considered in other states, including California, and have passed in Georgia and Arkansas.

The JAMA article drew notice when it was published Aug. 25, but it got increased attention when the National Right to Life Committee, an anti-abortion group, somehow figured out that lead writer Susan Lee once worked as a lawyer for the National Abortion Rights Action League. It also noticed that co-author and obstetrician-gynecologist Dr. Eleanor Drey is the director of the abortion clinic at San Francisco General Hospital.

The NRLC said that Lee and Drey are therefore "pro-abortion activists" and that the JAMA article should be discounted.

JAMA editor Catherine DeAngelis soon received dozens of angry – and in some cases, hate-filled – e-mails. She publicly defended the scientific value of the article but said she wished she had known about Lee's NARAL background, which she likely would have disclosed at the end of the article.

JAMA's author guidelines, however, are clear: Financial links within the past five years are to be disclosed. And Lee, who is now a medical student at UCSF, worked at NARAL for eight months ending in mid-2000.

"Are they saying that for controversial issues, the standard should be different?" Drey asked when the Bay Guardian spoke to her.

"It is not routine for scholars to disclose the nature of their clinical practice as a potential conflict of interest. For example, the presence of a cardiovascular surgeon as an author of an article about whether a certain cardiac surgical technique was safe would not represent a conflict of interest," UCSF chief of obstetrics and gynecology Philip Darney said in a statement.

Lee told us she never expected her past affiliation with NARAL to become an issue: "If they're doubting the objectivity, I'd encourage them to go look at the sources. There are no secrets in this."

Almost every newspaper that ran a story about the study followed up with one about the researchers' ties. Some, like the Philadelphia Inquirer, didn't cover the study at all until the pro-life groups began blasting it. (The Inquirer story is approvingly posted on the NRLC Web site.)

The last JAMA scuffle of this sort involved the 1999 firing of Dr. George Lundberg from the journal. After 17 years of employment, Lundberg published results of a survey of college students on whether they believed oral sex qualified as "sex." The article coincided with President Bill Clinton's impeachment trial, and in case it's not obvious, most of the college kids thought oral sex wasn't quite sex. Lundberg was ousted for using the journal to make a political point.

Pro-lifers are, of course, accusing JAMA of the same thing today. But mainly they are making it clear that anything related to abortion will be drawn into the always fractious debate over the medical procedure.

"The reason you do research is to answer questions you think are clinically important," Drey said. "Do they want people to feel they can't examine abortion? Someone has to look at this."

E-mail Tali Woodward at tali@sfbg.com.