The cognitive and experiential capacities of an organism are important for us in determining how they treat them. So any consideration about fetuses as moral patients needs to consider their capacities. 38-week old fetuses have a very different set of cognitive and experiential capacities compared to 24-week old fetuses, and even more so to 14-week old fetuses. Because 90% of abortions in the US occur prior to 14 weeks, and 99% before 22 weeks, the relevant questions about capacity are probably about experience in that time. At least prior to 12 weeks it seems unlikely fetuses could consciously experience pain, and unlikely they experience anything at all (EDIT: I’ve updated against this somewhat—see Callum’s comment below). As a result, and considering negative consequences for women’s autonomy in cutting abortion funding, I caution against recommendations that involve cutting any funding for abortion prior to that time.
I worry that some folks will get a little bit queasy about me launching into comparisons with animal suffering, but I think that is unavoidable, and ultimately justifiable. But when we try to determine how we should treat pigs, chickens, and shrimp, we look to their capacity to suffer, and their overall capacity to experience things. This is important because if we want to know whether it is net positive to farm animals, we need to know if farming them is net positive, i.e., if the positive experiences they have and we have as a result of farming them outweigh the suffering they experience, compared to the counterfactual of having not existed. If a particular animal doesn’t have any capacity for suffering or any kind of conscious experience, arguably they are, as an individual creature, no more a moral patient than a rock or stone. That raises the question: do fetuses have the capacity to consciously suffer or experience, and if so what sort of experience do they have?
Conscious experience is not the only consideration one would have when considering a fetus as a moral patient. There are other reasons that have been explored in more general abortion debates over the last few decades about various social factors that lead us to assign fetuses more or less personhood, which I acknowledge. But in this comment I’ll focus on the issue of conscious experience.
The conventional medical advice has been that “the cortex and intact thalamocortical tracts are necessary for pain experience”, and because these don’t develop until after 24 weeks of pregnancy, we can rule out any kind of fetal pain until that point. This is a based on a theory of human conscious pain that posits that something about the neocortex is what gives humans many or even all of our conscious experiences. Whether this is true is not clearly known but it would seem to follow from leading theories of human consciousness. The evidence that experience of pain in particular arises from the neocortex—let’s call it the “thalamo-cortical pain theory” is somewhat stronger. The neocortex contains the somatosensory cortices; it also contains the amygdala and the anterior cingulate cortex, which at least until recently have been inseparable from the conscious experience of pain in normal humans. Because those features don’t develop until some time after 24 weeks, it seems plausible fetuses don’t have conscious experience of pain until after that time.
On the other hand, there’s mounting evidence that animals without these advanced cognitive structures also have some experience of pain. I am sceptical this implies humans have experiences of conscious pain before they develop a neocortex, because those animals could have evolved other features giving them the experience of pain that humans do not have.
What’s more important is the thalamo-cortical pain theory I described in the previous paragraph is under question, specifically with respect to fetuses, raising the possibility that fetuses before 24 weeks could feel some sort of conscious pain, though it would almost certainly not reach the full expression and intensity that fully-formed humans can experience. This is based on evidence in adult human patients, including patients with disabled cortices and patients who were born insensitive to pain. On this theory of fetal pain would place development at closer to 12 weeks. This is based on the fact the “first projections from the thalamus into the cortical subplate” occur around that time. [This paragraph edited slightly to update in favor of the 12-week theory]
Overall I am somewhat convinced by the recent work that pain processing doesn’t require the neocortex, but less sure that conscious experience of pain can be had without it. However, at least in the United States, over 90% of abortions occured before 13 weeks. Less than 1% occur after 21 weeks. Prior to 13 weeks, there doesn’t seem to be a viable theory of conscious experience of fetal pain. I should acknowledge that in this context, we’re not only concerned about pain—we’re concerned about personhood more broadly. But one can infer, from the debate about pain, it seems unlikely that there are conscious experiences in general at the very least prior to 12 weeks. Consequently, any concern about the moral patienthood of fetuses at the time when most are aborted (spontaneously or otherwise) should be order of magnitude or two less than concern we might have about a fetus at that 38-week period which Peter Singer points out seems to be minimally distinguishable from an infant child.
Finally—I can’t help but spell out some of my own motivation for this comment. Although it is very clear that it advocates only for voluntary abortion reduction, the original post does recommend defunding of abortion services for which funding may have previously been provided. I have less of a unique contribution to make in this area, than in the neuroscience, so I won’t say too much about it. But it does seem to me that even defunding services could have tangible negative consequences for pregnant women’s autonomy and control over their pregnancy. That probably motivates my caution against such a recommendation, and it needs to be considered alongside the discussion about fetal personhood, and within that discussion, fetal consciousness, which is the primary topic of this post.
Hi Ben! Thanks for a well-researched and balanced description of the competing theories of fetal pain development.
I don’t have much to add on fetal pain (since you covered it so thoroughly!), but I am curious about your opinion on person-affecting versus non-person-affecting views in population ethics. It seems that your moral opinion on abortion stems from a belief that a person must already be conscious/able to suffer in order to be a moral patient—i.e. a person-affecting view. In that regard, you posit that the time at which a fetus’s capacity to experience pain begins is a critical juncture. However, many EAs hold relatively non-person-affecting views, which often compels them to act in the interests of people who will live in the far future, and have no hope of experiencing pain right now. Those EAs would be less likely to consider the point at which a fetus begins to experience pain to be a critical juncture.
I do take a non-person-affecting view, but with a sort of deontological barrier around doing things that could cause substantial harm to a large number of currently-existing people, particularly in areas I regard as “human rights”. This is not the only area I’d endorse this sort of deontological barrier. I also endorse one against committing dishonesty or fraud in the name of things that might harm the long term future, and recent events have strengthened my view on that.
There are a couple of justifications for this. First, we should have a certain amount of epistemic humility, where at some point it’s just really hard to understand what effects of current acts on the long term future will be, and we better be really sure if we cause present harm for the sake of far-future good. I have a certain amount of loss aversion when it comes to working out what sort of acts I should do. Second, we might want certain values to be sustained into the long term future, like honesty and respect for human rights, because sustaining those values will be good for future society. That might be a reason that doing things in the name of honesty or human rights that might, on the balance, have negative direct effects for the long-term future, could actually end up having long-term positive effects.
On this particular issue, I’m at least moderately pro-natalist. I think the vast majority of possible good we can do in the present to improve the long term future is just to avoid existential risk, so I don’t hugely emphasize pro-natalism. One reason is it’s not clear whether a larger population now will lead to a large population in 200 years, since future generations might compensate for higher fertility now with less fertility in their time, as long as there are resource constraints given current technologies. But on balance I do support pro-natalism, not just because of the long term future, but also because more present people enjoying the present is good. Having said that, I think the restriction on womens’ autonomy is a high cost to pay, and we might be able to get equivalent boosts in fertility through other policies, like letting children vote, providing much more financial support for parents at low incomes, and more favorable tax treatment for parents at all income levels, by, for instance, allowing not just spouses to file jointly but allowing parents to also file jointly with their children.
I worry I wasn’t actually fair enough to the “12 week fetal pain” theory—the more I think about the paper I read yesterday, the more I actually prefer it, all things considered, to its alternative, and I’ll update my post on that basis.
Thank you for a very thoughtful comment. I did just want to add that there are some who do place the possibility of fetal pain earlier—namely, if the cortex is not in fact necessary for conscious experience or pain (https://journals.sagepub.com/doi/full/10.1177/00243639211059245). I realise this is a minority view, but I do think it has some things to commend it (e.g. experiences of pain in those with anencephaly/hydranencephaly).
It’s probably worth noting as well that the sheer number of abortions makes even small percentages significant—if only 10% of abortions take place after 12 weeks, that is still 5-7 million or so a year, so plausibly still worth addressing from an EA perspective.
(DOI: I don’t take a view of moral status that relies on conscious experiences so would be opposed to abortion even before that)
The cognitive and experiential capacities of an organism are important for us in determining how they treat them. So any consideration about fetuses as moral patients needs to consider their capacities. 38-week old fetuses have a very different set of cognitive and experiential capacities compared to 24-week old fetuses, and even more so to 14-week old fetuses. Because 90% of abortions in the US occur prior to 14 weeks, and 99% before 22 weeks, the relevant questions about capacity are probably about experience in that time. At least prior to 12 weeks it seems unlikely fetuses could consciously experience pain, and unlikely they experience anything at all (EDIT: I’ve updated against this somewhat—see Callum’s comment below). As a result, and considering negative consequences for women’s autonomy in cutting abortion funding, I caution against recommendations that involve cutting any funding for abortion prior to that time.
I worry that some folks will get a little bit queasy about me launching into comparisons with animal suffering, but I think that is unavoidable, and ultimately justifiable. But when we try to determine how we should treat pigs, chickens, and shrimp, we look to their capacity to suffer, and their overall capacity to experience things. This is important because if we want to know whether it is net positive to farm animals, we need to know if farming them is net positive, i.e., if the positive experiences they have and we have as a result of farming them outweigh the suffering they experience, compared to the counterfactual of having not existed. If a particular animal doesn’t have any capacity for suffering or any kind of conscious experience, arguably they are, as an individual creature, no more a moral patient than a rock or stone. That raises the question: do fetuses have the capacity to consciously suffer or experience, and if so what sort of experience do they have?
Conscious experience is not the only consideration one would have when considering a fetus as a moral patient. There are other reasons that have been explored in more general abortion debates over the last few decades about various social factors that lead us to assign fetuses more or less personhood, which I acknowledge. But in this comment I’ll focus on the issue of conscious experience.
The conventional medical advice has been that “the cortex and intact thalamocortical tracts are necessary for pain experience”, and because these don’t develop until after 24 weeks of pregnancy, we can rule out any kind of fetal pain until that point. This is a based on a theory of human conscious pain that posits that something about the neocortex is what gives humans many or even all of our conscious experiences. Whether this is true is not clearly known but it would seem to follow from leading theories of human consciousness. The evidence that experience of pain in particular arises from the neocortex—let’s call it the “thalamo-cortical pain theory” is somewhat stronger. The neocortex contains the somatosensory cortices; it also contains the amygdala and the anterior cingulate cortex, which at least until recently have been inseparable from the conscious experience of pain in normal humans. Because those features don’t develop until some time after 24 weeks, it seems plausible fetuses don’t have conscious experience of pain until after that time.
On the other hand, there’s mounting evidence that animals without these advanced cognitive structures also have some experience of pain. I am sceptical this implies humans have experiences of conscious pain before they develop a neocortex, because those animals could have evolved other features giving them the experience of pain that humans do not have.
What’s more important is the thalamo-cortical pain theory I described in the previous paragraph is under question, specifically with respect to fetuses, raising the possibility that fetuses before 24 weeks could feel some sort of conscious pain, though it would almost certainly not reach the full expression and intensity that fully-formed humans can experience. This is based on evidence in adult human patients, including patients with disabled cortices and patients who were born insensitive to pain. On this theory of fetal pain would place development at closer to 12 weeks. This is based on the fact the “first projections from the thalamus into the cortical subplate” occur around that time. [This paragraph edited slightly to update in favor of the 12-week theory]
Overall I am somewhat convinced by the recent work that pain processing doesn’t require the neocortex
, but less sure thatconscious experience of paincan be had without it. However, at least in the United States, over 90% of abortions occured before 13 weeks. Less than 1% occur after 21 weeks. Prior to 13 weeks, there doesn’t seem to be a viable theory of conscious experience of fetal pain. I should acknowledge that in this context, we’re not only concerned about pain—we’re concerned about personhood more broadly. But one can infer, from the debate about pain, it seems unlikely that there are conscious experiences in general at the very least prior to 12 weeks. Consequently, any concern about the moral patienthood of fetuses at the time when most are aborted (spontaneously or otherwise) should be order of magnitude or two less than concern we might have about a fetus at that 38-week period which Peter Singer points out seems to be minimally distinguishable from an infant child.Finally—I can’t help but spell out some of my own motivation for this comment. Although it is very clear that it advocates only for voluntary abortion reduction, the original post does recommend defunding of abortion services for which funding may have previously been provided. I have less of a unique contribution to make in this area, than in the neuroscience, so I won’t say too much about it. But it does seem to me that even defunding services could have tangible negative consequences for pregnant women’s autonomy and control over their pregnancy. That probably motivates my caution against such a recommendation, and it needs to be considered alongside the discussion about fetal personhood, and within that discussion, fetal consciousness, which is the primary topic of this post.
Hi Ben! Thanks for a well-researched and balanced description of the competing theories of fetal pain development.
I don’t have much to add on fetal pain (since you covered it so thoroughly!), but I am curious about your opinion on person-affecting versus non-person-affecting views in population ethics. It seems that your moral opinion on abortion stems from a belief that a person must already be conscious/able to suffer in order to be a moral patient—i.e. a person-affecting view. In that regard, you posit that the time at which a fetus’s capacity to experience pain begins is a critical juncture. However, many EAs hold relatively non-person-affecting views, which often compels them to act in the interests of people who will live in the far future, and have no hope of experiencing pain right now. Those EAs would be less likely to consider the point at which a fetus begins to experience pain to be a critical juncture.
I do take a non-person-affecting view, but with a sort of deontological barrier around doing things that could cause substantial harm to a large number of currently-existing people, particularly in areas I regard as “human rights”. This is not the only area I’d endorse this sort of deontological barrier. I also endorse one against committing dishonesty or fraud in the name of things that might harm the long term future, and recent events have strengthened my view on that.
There are a couple of justifications for this. First, we should have a certain amount of epistemic humility, where at some point it’s just really hard to understand what effects of current acts on the long term future will be, and we better be really sure if we cause present harm for the sake of far-future good. I have a certain amount of loss aversion when it comes to working out what sort of acts I should do. Second, we might want certain values to be sustained into the long term future, like honesty and respect for human rights, because sustaining those values will be good for future society. That might be a reason that doing things in the name of honesty or human rights that might, on the balance, have negative direct effects for the long-term future, could actually end up having long-term positive effects.
On this particular issue, I’m at least moderately pro-natalist. I think the vast majority of possible good we can do in the present to improve the long term future is just to avoid existential risk, so I don’t hugely emphasize pro-natalism. One reason is it’s not clear whether a larger population now will lead to a large population in 200 years, since future generations might compensate for higher fertility now with less fertility in their time, as long as there are resource constraints given current technologies. But on balance I do support pro-natalism, not just because of the long term future, but also because more present people enjoying the present is good. Having said that, I think the restriction on womens’ autonomy is a high cost to pay, and we might be able to get equivalent boosts in fertility through other policies, like letting children vote, providing much more financial support for parents at low incomes, and more favorable tax treatment for parents at all income levels, by, for instance, allowing not just spouses to file jointly but allowing parents to also file jointly with their children.
I worry I wasn’t actually fair enough to the “12 week fetal pain” theory—the more I think about the paper I read yesterday, the more I actually prefer it, all things considered, to its alternative, and I’ll update my post on that basis.
Thanks for your thorough and clear writeup!
Thank you for a very thoughtful comment. I did just want to add that there are some who do place the possibility of fetal pain earlier—namely, if the cortex is not in fact necessary for conscious experience or pain (https://journals.sagepub.com/doi/full/10.1177/00243639211059245). I realise this is a minority view, but I do think it has some things to commend it (e.g. experiences of pain in those with anencephaly/hydranencephaly).
It’s probably worth noting as well that the sheer number of abortions makes even small percentages significant—if only 10% of abortions take place after 12 weeks, that is still 5-7 million or so a year, so plausibly still worth addressing from an EA perspective.
(DOI: I don’t take a view of moral status that relies on conscious experiences so would be opposed to abortion even before that)
Thank you! That’s a reasonably significant update for me.