Cite for a scientist questioning whether an infant can feel pain?
Your phrase “as we understand it” is doing a lot of work in that post. It would help to clarify it.
Okay, get a drink and a snack, because this could be a long one. I want to mention a few things right off the bat.
First, I'm not endorsing any of the ideas that I'll be describing in this post. In fact, for various reasons, I think I probably disagree with the particular understanding of neonatal cognition and experiential reality that I'll be going over. I just want to make that clear to forestall the inevitable, "Are you really saying..." responses.
Second, I'm also not saying this view is the majority view. It used to be, as I understand it, considered common knowledge, but more recent research is pushing most scientists away from this view and toward the view that newborns and even fetuses almost certainly can "feel pain."
Third, to avoid jumping around to different developmental stages, for the purpose of this discussion, I'm going to situate the issue specifically with newborns. I'm doing this for two reasons. First, I think all of us can probably agree that, ethically speaking, a newborn is a full human person, with all the fundamental rights that human persons have simply by the virtue of being a human person. An exhaustive list of such rights is not necessary; I hope we can all agree that any such list would include the right not to be subjected to gratuitous discomfort. In layman's terms, you might say that a newborn has a right not to be tortured. In other words, I hope we can agree that, if a newborn can "feel pain," then it has a right not to be subjected to said pain gratuitously. Second, however, a newborn is developmentally the equivalent of a late-term fetus. So whatever we might conclude about pain in newborns would almost certainly apply to at least some fetuses, as well. This makes sense. After all, thanks to our big heads, we are born severely undeveloped compared to other mammals. As newborns, we really are just fetuses outside the womb.
Now, to the meat of it. You might notice I put "feel pain" in quotes a couple of times above. That's because you're right to notice that "as we understand it" was doing a lot of work in my previous post. Specifically, the work it was doing was setting the stage to put some definitional limits around the surprisingly vague and undefined word "feel." What does it mean to "feel" pain? To explore whether a newborn can feel pain, we must understand what it means to feel anything.
If by "feel pain," we simply mean that someone has the ability to create signals in nerves as a result of various stimuli, and to process those signals in the brain in a way that, in an adult, would be recognizable as the phenomenon of pain, then absolutely, newborns can feel pain. This is indisputable. However, when we talk about someone feeling pain, I think we are actually talking about something more than nerve signals and brain processing.
I think what we are really concerned with - and what we should be concerned with - is the
experience of pain. It's not the mechanical process of pain that infringes on our personal well-being, but the first-person experiential state of
being in pain that does. In previous discussions, I've talked about qualia, which are the discrete experiences which we all presumably have as we travel through existence and reality. Mechanically, something happens to us. Experientially, there is
something that it is like for that thing to be happening to us. So it is with pain. When something painful happens to us, there is a physical reality - an injury, perhaps, neurons firing, and so on - but there is also the innate personal experience; there is
something that it is like to be in pain. And that something is where all the marbles are. Any being that has the ability to experience that something certainly has the right to expect not to be subjected to it without damn good reason.
So, when it comes to newborns, a key question is this: do newborns have qualia? Do they experience anything at all? Or are they merely biological stimulus-response machines? For most of the 20th century, the common wisdom was the latter. It was felt that newborns simply weren't developed enough to truly experience existence as adults do, and that this ability really didn't develop until a baby was 12-18 months old. A consequence of this is that newborns were considered to not truly experience pain, and this is why, as you found in your searching, it was common for sometimes even serious surgery to be done with little to no pain management. It was thought that the potential negative side effects of too much anesthesia were not worth the risk if the painful experiences they were meant to avoid didn't really exist, anyway.
One of the primary reasons it was common wisdom that newborns didn't have a truly experiential existence is memory. Most of us don't have reliable memories from before we were about 18-24 months old, or even later. It was thought by some that these memories don't exist because they were never formed, and that implies that the experiences didn't really happen. That is to say, if we truly experienced our own existence during our first year alive, we'd likely have at least some memories, even if they were vague or difficult to understand*.
As I said, we seem to be moving away from that model toward one in which newborns do, in fact, experience qualia, and therefore, true pain. For various reasons (although none of them scientific), I think this shift is correct. But the change isn't universal. The debate over pain in newborns (and fetuses) isn't over. One side has the momentum, but it hasn't won the day, yet.
*This paragraph is the primary reason why I don't endorse this view of human neonatal existence, which we might perhaps have cause to explore in a future topic, but would be very much out of place here.
en.m.wikipedia.org
