Even when drugs are approved by the FDA, it may not be entirely clear how they work, just that they do. And sometimes, the FDA label describing how they work is actually wrong, as is the case with the emergency contraceptive pill Plan B.
The pill and others like it, which are to be taken as a last-ditch birth control effort after unprotected sex, deliver a one-time dose of a hormone that prevents pregnancy. Because the label suggests that the pill may prevent pregnancy by keeping a fertilized egg from implanting in the uterus, which falls under some definitions of abortion, Plan B and other emergency contraceptives have popped up in political debate, with Mitt Romney calling them “abortive pills” and other Republican politicians making similar statements. The New York Times investigated the claim on the label, however, and found that it had been placed there by the FDA despite the fact that there was no evidence that the drug did so. Citing confidentially, the FDA will not say why.
In a development that’s certain to stir passions in the abortion debate, the Royal College of Obstetricians and Gynaecologists in the UK published a report today on “fetal awareness.” The group states, citing a review of current research, that human fetuses cannot feel pain before 24 weeks.
The group’s reasoning, as described in a press release, is based on these points:
-The fetus cannot feel pain before 24 weeks because the connections in the fetal brain are not fully formed
-The fetus, while in the chemical environment of the womb, is in a state of induced sleep and is unconscious
-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 [Royal College of Obstetricians and Gynaecologists]
This is certainly not the first debate over whether a fetus can feel pain. Fetal surgeries have led doctors to ask this question, as they determined whether anesthesia was appropriate and at what stage in development. As summarized in a 2008 New York Times Magazine article, researchers have looked at fetal flinch responses, heart rate, and levels of stress hormones. But any metric has remained controversial. Take stress hormones, for example. Do you say that any fetus that can release these hormones feels pain? Or do you wait until it develops the nervous system to register those hormones? Or do you say that an undeveloped nervous system makes the fetus more susceptible to pain, since it hasn’t developed the system to suppress it?