The Pain-Capable Unborn Child
Protection Act and
the Future of Abortion Jurisprudence
By Mary Spaulding Balch, J.D.,
NRLC Director of State Legislation
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Mary
Spaulding Balch, J.D.,
NRLC Director of State Legislation |
It would be difficult to
overstate the historic importance of Nebraska’s 2010
Pain-Capable Unborn Child Protection Act, the first state law to
present the Supreme Court with the opportunity to bring its
abortion jurisprudence into the 21st century. The law is
grounded in a moral empathy that resonates with the American
people: “You don’t kill unborn children capable of feeling
pain.” Basing its conclusion on an enormous body of medical
research (literally hundreds of studies), this first-of-its-kind
law conservatively sets the demarcation at 20 weeks.
So why, after publicly hinting it
was just a matter of time, have pro-abortion organizations not
challenged the law in court? Quite probably because
pro-abortionists appreciate that when abortion’s brutal
realities overcome the gauzy generalities about “choice,” the
public opinion needle moves in the direction of life. That is
precisely what happened in the long, long debate over
partial-birth abortion. Better than most, abortion advocates
understand that you don’t need coursework in fetal anatomy to
sense that at 20 weeks babies will suffer excruciating pain as
they are being torn apart.
Furthermore they understand that
the Pain-Capable Unborn Child Protection Act could not have
passed had today’s scientific understanding about and public
awareness of the unborn child not advanced leaps and bounds from
1973 when the U.S. Supreme Court handed down its infamous Roe
v. Wade decision. Sonograms of the once nearly invisible
unborn child are now plastered on refrigerators all over the
world.
There are ironies galore, but
none more stark than this. Pro-abortionists forever tell us that
pro-lifers want to “take us back.” In fact what makes the
Pain-Capable Unborn Child Protection Act so dangerous to Roe
is that it demands precisely the opposite.
Rather than freezing our
understanding of fetal development at what was available to the
High Court 38 years ago, the law says, “Come, let’s see what we
know now that we didn’t know then.” And seeing is
believing, which is why abortion proponents are so dead-set
against the passage of laws which make it possible for
abortion-vulnerable women to see an ultrasound of their unborn
babies.
“Informed choice” is the last
thing abortion clinic personnel are looking for.
Forty years ago, the unborn child
virtually did not exist in medicine. “Fetal medicine” was an
oxymoron. Our understanding of pain was so primitive that even a
newborn undergoing surgery did so without anesthesia! They
received only a paralytic to keep them still.
The use of ultrasound was
introduced in the late 1970s. The possibility of literally
seeing the unborn child opened the eyes not only of parents but
of doctors, allowing them to diagnose problems that heretofore
were only known in newborns. The concept of the unborn child as
a patient was born. It was the beginning of a subspecialty that
we know today as fetal medicine.
With the ability to see this new
patient came in utero surgery—the ability to save
premature unborn children at earlier and earlier intervals. Once
highly experimental, fetal surgery is now a frequent occurrence
at several hospitals around the country. As recent as February
8, ABC News Tonight ran an important investigative piece
on fetal surgery which is likely soon to become standard care
for some conditions such as spina bifida.
We can see in retrospect that two
lines of investigation were intersecting. On one axis doctors
were observing that when pricked by a needle, even the most
premature babies grimaced. On the other axis, physicians saw
that unborn children could experience pain, due to the
ever-increasing use of fetal surgery. The question arose: at
what point in fetal development is the child capable of
experiencing pain?
In 2005, congressional hearings
were held on the issue of unborn children’s pain. Expert
witnesses included Dr. Jean A. Wright and Dr. K.J.S. Anand. Dr.
Wright testified that “an unborn fetus after 20 weeks of
gestation has all the prerequisite anatomy, physiology,
hormones, neurotransmitters, and electrical current to close the
loop and create the conditions needed to perceive pain.”
Subsequently Dr. Anand, currently a professor of pediatrics,
anesthesiology, and neurobiology at the University of Tennessee
Health Science Center, said in a document accepted as expert by
a federal court, “It is my opinion that the human fetus
possesses the ability to experience pain from 20 weeks of
gestation, if not earlier, and that pain perceived by a fetus is
possibly more intense than that perceived by newborns or older
children.”
Is there evidence that the
Supreme Court is aware of all this? There is clear evidence
Justice Kennedy is. Justice Kennedy has described the gruesome
nature of the most common abortion technique used in the second
trimester, dilation and evacuation or D & E, in terms that make
clear that it would be extremely painful: “[F]riction causes the
fetus to tear apart. For example, a leg might be ripped off the
fetus ... ,” he wrote in the 2007 case of Gonzales v. Carhart.
Justice Kennedy used even more graphic descriptions of D&E
abortions in his dissent in Stenberg v. Carhart, “The
fetus, in many cases, dies just as a human adult or child would:
It bleeds to death as it is torn limb from limb.”
In
Gonzales v.
Carhart, the decision upholding the federal ban on
partial-birth abortions,
Justice Kennedy also dealt with two
other issues germane to the Pain-Capable Unborn Child Protection
Act. He wrote:
“In a decision so fraught with
emotional consequence some doctors may prefer not to disclose
precise details of the means that will be used, confining
themselves to the required statement of risks the procedure
entails. ... It is, however, precisely this lack of information
concerning the way in which the fetus will be killed that is of
legitimate concern to the State. ... It is self-evident that a
mother who comes to regret her choice to abort must struggle
with grief more anguished and sorrow more profound when she
learns, only after the event, what she once did not know: that
she allowed a doctor to pierce the skull and vacuum the
fast-developing brain of her unborn child, a child assuming the
human form.”
What
Justice Kennedy for the Court stated to be true with regard to
partial-birth abortion—its impact on the mother, and the state’s
interest—may equally be applied to those abortions performed
when the unborn child is capable of experiencing, and does
experience, pain from the abortion technique.
Equally
important, Kennedy (widely understood to be the decisive fifth
vote in abortion cases) wrote in Gonzales that “it is
inappropriate for the Judicial Branch to provide an exhaustive
list of state interests implicated by abortion.”
The justices have never addressed
the issue of an unborn child’s pain. If/when they do it would be
a case of “first impression,” as lawyers put it.
Recognizing a compelling state
interest in the unborn child who is capable of experiencing pain
would not require the Court to overturn, but only to supplement,
its prior recognition of a compelling “state interest” in the
unborn child after viability. The federal Partial-Birth Abortion
Ban Act was upheld in Gonzales, although it made no
distinction based on viability. As Justice Kennedy wrote, “The
[Partial-Birth Abortion Ban] Act does apply both previability
and postviability because, by common understanding and
scientific terminology, a fetus is a living organism while
within the womb, whether or not it is viable outside the womb.”
It is critically important to
understand that the interest asserted here is not just
one in diminishing or eliminating the unborn children’s pain
during an abortion. Rather, it is that the unborn child’s
capacity to experience pain is a significant developmental
milepost, making the unborn child at that point sufficiently
akin to an infant or older child to trigger a compelling state
interest.
The stage of development at which
the unborn child is capable of experiencing pain is at least as
“clear” and arguably more “workable” in comparison with
viability. While viability is predominately an extrinsic
measurement of the capacity of medical science to sustain the
life of a premature infant, the capacity to feel pain is an
intrinsic, innate feature of the unborn child at a particular
stage of development.
While no one can definitively
predict how the majority of the Supreme Court, and in particular
Justice Kennedy, would rule on the constitutionality of the
Pain-Capable Unborn Child Protection Act, the evolving
development of the High Court’s abortion litigation, and
particularly its decision in Gonzales v. Carhart, leads
us to this conclusion. There may well be receptivity to a
well-documented effort to demonstrate the reasonableness of
recognizing the reality of fetal pain by 20 weeks
post-fertilization, and the justification for acting to minimize
it by preventing abortions not necessary to avert death or
substantial and long-lasting physical impairment of a major
bodily organ from 20 weeks on. |