Scientific Testimony against the Pain Capable Unborn Child Protection Act

My name is Matthew Facciani and I am a PhD candidate in cognitive neuroscience. I oppose bill H3114 because its legislative intent rests upon a psychologically flawed interpretation of scientific data. 

I am testifying in my capacity as a neuroscientist, psychology instructor, and science educator. Recognizing good science from bad science is part of my job and I hope to explain the flawed scientific reasoning behind this bill. The main support for this bill stems from research that fetuses can react to stimuli at around 20 weeks of development. However, the scientific consensus is that such reactions to stimuli are reflexive, not a response to pain.

In other words, just because fetuses react with reflexes we associate with pain does not mean they feel pain. As Dr. Anand noted in his report in support of a similar bill, the International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience..." The current scientific evidence supports the conclusion that fetuses can have unpleasant sensory experiences. It does not, however, support the psychological claim that these experiences are emotional. In other words, fetuses do not feel pain.

Dr. Mark Rosen, pain researcher and anesthesiologist, concludes that such reactions are analogous to the reflex from a leg when tapped by a doctor’s rubber mallet. Also, any release of stress hormones during a reflex would not necessarily indicate the experience of pain, since elevations of stress hormones also occur in the bodies of brain-dead patients during organ harvesting. These findings do not reflect feeling pain; they only reflect a sufficiently intact nervous system.

Dr. Rosen also states how the pain signal must be able to travel from receptors located all over the body, to the spinal cord, up through the brain’s thalamus and finally into the cerebral cortex to be felt. He then notes how fetuses do not have nerve fibers which extend from the thalamus and have penetrated the cortex until the third trimester which is supported in a 2010 review paper of fetal development. 

An extensive review paper on fetal pain was published in the Journal of the American Medical Association by Dr. Lee and colleagues in 2005. It remains the best available systematic multidisciplinary review on the subject of fetal pain. These researchers concluded that "Evidence regarding the capacity for fetal pain is limited but indicates that fetal perception of pain is unlikely before the third trimester." They also note how pain is an emotional and psychological experience which requires conscious recognition of a noxious stimulus. So it is highly unlikely any pain can be felt by a fetus 24 weeks or earlier in pregnancy.

Furthermore, a study by Dr. Fabrizi and colleagues in 2011 revealed that the necessary neural circuits to differentiate pain from sensation are not developed in infants until 35 weeks of age. The younger infant's neural signal indicated general tactile sensation, while the older infant's neural signal indicated actual processing of pain from the sensation.

Even if fetuses could feel pain before 24 weeks, the placenta produces biochemicals which have a sedating and even an anesthetizing effect on the fetus according to a study by Dr. Mellor and colleagues in 2005. Thus, claims of fetuses feeling pain at or before 20 weeks represent the views of a minority of researchers with no psychological scientific training, and do not have widespread acceptance in the scientific community.

Finally, a 2013 study published in the Perspectives on Sexual and Reproductive Health journal found that around one percent of abortions occur at 20 weeks or later. According to this same study, the women who had these rare abortions often had difficulty finding a provider and raising funds for the procedure and travel costs, were young and seeking work, or were dealing with an abusive partner. Thus, by banning abortions at 20 weeks, South Carolina would be harming some of its most vulnerable citizens.

In conclusion, bill H3114 is not defended by research widely supported by the scientific community as there is not substantial evidence that fetuses feel pain. The Fabrizi study provides evidence that sensation does not equal pain and the vast majority of the scientific community agrees that if a fetus could ever feel pain, it would only be possible at 24 weeks at the absolute earliest. Furthermore, the bill is foundationally flawed: It rests on the opinions of researchers who do not understand the psychological distinctions necessary to adequately address this topic. 

Thank you very much.

*This testimony was read by Matthew Facciani during the South Carolina House General Laws Subcommittee meeting on Thursday, January 22, 2015. 

 

Scientific testimony against South Carolina House Bill 4223

My name is Matthew Facciani and I am a PhD candidate in experimental psychology with a focus on cognitive neuroscience. I oppose bill H4223 for two reasons. The first of which is moral: I think that women are more than capable to make decisions regarding their body without the state's interference. However, I oppose this bill primarily because its legislative intent rests upon a psychologically flawed interpretation of scientific data. 

 

I am testifying in my capacity as a psychologist and neuroscientist. The goal of psychology is to explicitly isolate psychological states. Isolating underlying psychological states allows us to distinguish between what happens to an individual, and how the individual feels about it. It is important to see how a psychological scientist's training differs from training undergone by medical doctors. Medical training can enable a doctor to identify sources of suffering whereas scientific training can enable a psychologist to identify the psychological states of the person suffering. This also means that psychologists fundamentally distinguish a psychological state from its biological markers. In other words, we do not equate what we measure with how we measure it.

 

This is why I oppose this bill. Just because fetuses react with reflexes we associate with pain does not mean they feel pain. As Dr. Anand noted in his report in support of a similar bill, the International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience..." The current scientific evidence supports the conclusion that fetuses can have unpleasant sensory experiences. It does not, however, support the psychological claim that these experiences are emotional. In other words, fetuses do not feel pain.

 

Support for this bill stems from a minority of researchers which suggest that fetuses can feel pain at or even before 20 weeks. They support this position by noting that some fetuses around 20 weeks react to stimuli which can lead to a release of stress hormones. 

 

However, the majority of scientists agree that such reactions to stimuli are reflexive, not a response to pain. Dr. Mark Rosen, pain researcher and anesthesiologist, concludes that such reactions are analogous to the reflex from a leg when tapped by a doctor’s rubber mallet. Furthermore, the release of stress hormones does not necessarily indicate the experience of pain, since elevations of stress hormones also occur in the bodies of brain-dead patients during organ harvesting. These findings do not reflect feeling pain; they only reflect a sufficiently intact nervous system.

 

Dr. Rosen also states how the pain signal must be able to travel from receptors located all over the body, to the spinal cord, up through the brain’s thalamus and finally into the cerebral cortex to be felt. He then notes how fetuses do not have nerve fibers which extend from the thalamus and have penetrated the cortex until the third trimester which is supported in a 2010 review paper of fetal development. 

 

An extensive review paper on fetal pain was published in the Journal of the American Medical Association by Dr. Lee and colleagues in 2005. It remains the best available systematic multidisciplinary review on the subject of fetal pain. These researchers concluded that "Evidence regarding the capacity for fetal pain is limited but indicates that fetal perception of pain is unlikely before the third trimester." They also note how pain is an emotional and psychological experience which requires conscious recognition of a noxious stimulus. So it is highly unlikely any pain can be felt by a fetus 24 weeks or earlier in pregnancy. Furthermore, a study by Dr. Fabrizi and colleagues in 2011 revealed that the necessary neural circuits to differentiate pain from sensation are not developed in infants until 35 weeks of age. The younger infant's neural signal indicated general tactile sensation, while the older infant's neural signal indicated actual processing of pain from the sensation.

 

 

Even if fetuses could feel pain before 24 weeks, the placenta produces biochemicals which have a sedating and even an anesthetizing effect on the fetus according to a study by Dr. Mellor and colleagues in 2005. Thus, claims of fetuses feeling pain at or before 20 weeks represent the views of a minority of researchers with no psychological scientific training, and do not have widespread acceptance in the scientific community.

 

In conclusion, bill H4223 is not defended by research widely supported by the scientific community as there is not substantial evidence that fetuses feel pain. The Fabrizi study provides evidence that sensation does not equal pain and the vast majority of the scientific community agrees that even if a fetus can feel pain, it would only be possible at 24 weeks at the absolute earliest. Furthermore, the bill is foundationally flawed: It rests on the opinions of researchers who do not understand the psychological distinctions necessary to adequately address this topic. 

 

Thank you very much.

Pseudoscience and Psychopathy

I wrote a guest post for the Skeptical Raptor blog about my thoughts on neuroscientist James Fallon's psychopathy story. Here is an excerpt:

"My intention is not to claim that Dr. Fallon is lying and purposefully simplifying science to make a profit. I would need much more evidence for that. However, I am arguing that the news articles covering his story do not provide enough details to support his claims. I find it rather troubling that no one is even addressing this so I wanted to blog about it. It is also troubling that Dr. Fallon has not been more explicit about the limitations of his findings as he should surely be aware of them as an accomplished neuroscientist. America often ranks pretty poorly in scientific literacy and this is an example of the result. People should at least have a working understanding of the scientific methodand not blindly believe an authority figure with an interesting story."

Gender should never discourage dreams: Why there are not more women in science

As a child, I was told I could be anything I wanted to be when I grew up. I never felt like I was held back from pursuing any career that I wanted during my youth. The people who told me I could follow any dream I had neglected to mention that this was due to my privilege of being both white and male. Sadly, even in 2015, women and people of color do not always have the freedom of feeling like they can grow up to be anything. It is much more subtle now though as legally women can pursue many of the same careers as men. However, residual overt sexism of years ago still rears its ugly head in our current society in more covert ways. Even today, women are still largely underrepresented in the sciences. This is particularly concerning in the in physical sciences, math, and engineering. The statistics are alarming with women scientists often making at least 10% less than men, 75% of computer and mathematical occupations done by men, and only 3% of full professors in all sciences and engineering fields in the United States are women of color to name a few. Personal anecdotes can be even more harrowing and provide personal insight of why this under representation may occur.

A very drastic example of how women are not persuaded to go into the sciences was seen with the national story of Kiera Wilmot. Kiera was a 16 year old African American high school student who was expelled, arrested, and faced two felony charges for conducting a science experiment without teacher supervision before school one day. She combined aluminum foil and toilet bowl cleaner in a water bottle which created a puff of smoke when the top popped off. Yes, this could have been dangerous if the top of the bottle hit someone in the eye, but is arresting a young girl with a curious mind really the best way to handle it? Detention or a brief suspension would have been much more appropriate instead of a hasty arrest with felony charges. This is just one case, but reflects the undercurrent of how our society is so quick to judge minorities. African Americans students are already disciplined at much higher rates than whites with black females being most disproportionally suspended. The case of Kiera Wilmot provides a clear example of how society views women and especially women of color to not be associated with science. I can speak as being a young white boy who had his fair share of mischief during high school. I was reprimanded and given detention plenty of times for committing thoughtless antics. However, I do believe that if I engaged in such behavior as a black female instead of a white male I would have had an arrest record and be nowhere near science instead of doing neuroscience for my career.

I interviewed a few of my friends to find stories of women in science that may not have generated national news like the case of Kiera Wilmot, but are still incredibly informative of our culture. I would like to start with the story from a young woman by the name of Ania Bula from Ottawa, Ontario. Ania was passionate about going to medical school since 9th grade and took a heavy load of science courses during high school. Boys her age also took the same courses, but yet only Ania was encouraged to drop some of her courses from her guidance counselors because they might be too hard. When she expressed interest in becoming a doctor to her family and friends, Ania was told to go into nursing instead. A quote from my interview with her speaks volumes of the underlying sexism still rampant in our society.

Everyone seemed to think that the idea of a woman becoming a surgeon was ridiculous. I had one person tell me that only ugly women who never plan to get married go into surgery. I had many people tell me that if I became a doctor that my future husband would have to be a doctor as well because no man would accept a mate who was better employed than he was, or made more money, or more successful, etc.”

            When young women are exposed to such harmful “advice” while considering careers, it is easy to understand why there are not more women in the sciences. Also, stereotype threat emerges with the endorsement of these harmful falsehoods that women are not smart enough for science. Stereotype threat occurs when a group performs worse on a certain task simply because that social group is told they will not do well. Many studies have shown that making one’s race or gender more salient before a test can reduce performance. However, this effect can be reduced when participants are told that gender or race has no effect on performance. So even if young women are brave enough to take science courses like Ania was, they might actually do worse than men because of stereotype threat and not because they are not as smart as men. Fortunately, Ania took these classes anyway and did not buy into these harmful and incorrect stereotypes that were thrown at her. Sadly, other young women may internalize these harmful falsehoods.

            Zoë Toth studies biomedical engineering at the University of South Carolina and was fortunate to have a social network that supported her scientific interests. However, Zoë told me a harrowing story of girl named Sam she knew in high school. One day, Zoë, Sam, and others were having a discussion on intelligence and gender. A young boy was suggesting that men were smarter than women while Zoë was arguing for equality. Sam, though quite gifted in mathematics, remained silent during the discussion until she interjected to agree with the young boy that men are indeed smarter. Sam explained that god had made men better than women and while Zoë and she were smart, they will always be inferior. Zoë ended our interview with an inspiring quote:

“Although I am not sure what I want to do for the rest of my life, science holds a part in my future. It is something that I love that helps explain the world to me. And I know it should be held near to my heart, because there are people trying to pry it away from me. Some part of me hopes that if I go far enough perhaps I will be a reason for a young Sam somewhere one day to no longer think of herself as inferior.

It is absolutely terrible that a young woman gifted academically will always think of herself inferior to men. Religion may make this explicit for some women, but our society certainly reinforces those harmful beliefs.

Xandra Best, a math and computer science major at St. Olaf College, did notice some problematic things with her scientific pursuits as well. Though Xandra had supportive math and science teachers in high school, she told me that this was not the case for some of her female math major friends as they were discouraged from pursuing math by their high school teachers. Xandra also noticed a concerning trend when she was a math tutor.  Xandra was just as qualified as male tutors, but would get less overall work, less advanced students, and less male students compared to the male tutors. She had to lower her wages to keep competitive with her male counterparts. It was through this experience that Xandra came to a disconcerting realization:

That was when I first started wondering if a math major would be less valuable to me as a woman than it would be if I were a man. How many potential employers would also believe that I was less qualified for a position because of my gender?”

This disturbing anecdote could provide some insight as to why women in the math and sciences have significantly lower incomes than their male counterparts. Regarding computer science, Xandra noted how few women are in that field which promotes stereotype threat and less people suggesting women should be computer science majors.

“The most frustrating thing about this is that all the reasons that make it difficult for a woman to major in computer science are prevalent because there are so few women in computer science.”

Anna Butterfield is currently pursuing her master’s in biology at the University of Center Florida and took many science classes throughout high school and college. Her parents were supportive of her scientific interests and she did not report much overt trouble from her male peers; especially after she would set the curve on the first test. However, Anna did notice that there tended to be a type of savior complex with some of the young men in her science courses. Men were eager to help women in the science classes, but became colder towards them when the women did well on their own.

Also, a lot of guys kind of shut me out after I performed well on tests. I imagine it may be because they thought they could help me and when they realized that I didn't need help, I was not nearly as interesting anymore.”

This savior complex is quite problematic because it penalizes women for doing well in the sciences and also rewards them for needing help.  This creates a vicious cycle which only promotes the stereotype of women not belonging in science. Luckily, despite these cases, there are still many women who have overall positive experiences in pursuing science.

Alex Cottle is a pre-medical student at The Ohio State University. She was an excellent student all through high school and took many advanced science courses as she knew she wanted to be a doctor at an early age. Alex went to a high school where many women excelled in academics and she feels this could have played a role in reducing any potential sexism.

Actually, in my grade, the top 10 students were female. So, I think that my peers grew up seeing us 10 females excelling beyond all of my other peers, and they were just accustomed to us being interested in science.”

Additionally, Alex’s community was very supportive to women in science by having a "Women in Science Day," a "Math Awareness Day," and offers scholarships for women in science. So it seems like having visible successful women in academics as well as an environment which supports women in science and academics in general can play a large role in reducing sexism and stereotype threat. There are also many other female friends of mine who are excelling in science and also had a very supportive and open environment.

There still is work to be done, but there has been great progress made in this area over the years. As a neuroscientist, I am surrounded by many brilliant scientists in my department. I also interned at a hospital doing neuropsychology evaluations on brain injury patients and my cohort there was also exclusively female. Additionally, I attended Westminster College which is the number one college for women in science. So because of my experiences of being surrounded by so many brilliant women, I find it ridiculous that women are ever thought to be less intelligent in the sciences. However, people shouldn't need to share my experiences to know sex does not play a role in scientific intelligence. This is why we need to continue making strides in making the scientific world more accepting of women despite the progress we have had. We need more men to call out sexism and foster a more open, safer, and accepting environment for young women who want to pursue science. It pains me to think of how many brilliant women who could excel in science choose a worse fit for them because of social pressures. No one should ever be discouraged from their dreams because of their gender. 

 

*This article originally appeared in the September 2013 edition of The Feminist Observer which focused on youth issues. 

 

Pseudoscience in the Media

 My good friend Sarah showed me a clip of the celebrity physician Dr. Oz discuss a near death experience (NDE) with some 'experts' and a patient who claimed to have had one. I'll briefly summarize the clip and address some major concerns I had with it.

    Dr. Oz brings on a lady who was hit by a truck while riding 
her bike and claimed to have a near death experience. Before that, Dr. Oz talks to a grief consoler who doesn’t say anything of value in my opinion. He mentions how people often see their mother before they die, but doesn’t bring up any statistics or research studies. Then an emotional video plays about the accident the lady had and she then comes on to speak. Basically, after she was hit by the truck, she saw a light and experienced some euphoria despite how badly damaged she was. Then they have a physician who is a near death experience expert and talk to him. 

Let's disregard the clear appeal to emotion from this and just get to the facts. The NDE expert first discusses how improbable it is that people have memories despite being so injured. However, he doesn’t mention how these memories might not be from the actual event, but could be formed afterward. Dr. Oz does actually start to explain what physiologically may happen during an NDE which actually isn’t too bad. The problem is that he doesn’t go into details of an opposing side of NDE. Sam Harris does a great job explaining the other side here after a neurosurgeon claimed his NDE was ‘Proof of Heaven’. 

Basically, the brain releases a spike of the neurotransmitter DMT when it is damaged which causes some pretty trippy psychological effects. This could account for all the types of hallucinogenic effects in the brain, yet it is never mentioned here. Even if we had NO idea of why people would have these sorts of NDE’s it doesn’t prove there is consciousness outside the brain, it just suggests we still have a lot to learn about how the brain works. The NDE expert then mentions how he has studied thousands of patients and has seen similar things to the lady on the show. This again doesn’t prove in any way that there is consciousness outside the brain. The expert tries to prove how DNE’s are medically inexplicable with how blind people have visual NDE’s. I was surprised to see there actually was a journal article written by him on this subject. However, it was written in little known “Journal of Near Death Studies”and had all sorts of issues.  

During the show, they made it seem like they interviewed these blind participants who 'saw' right after their NDE right after it happened. However, in the study they searched for blind 
people who said they had a NDE. Beyond that, they only recorded data from those who "had appropriate qualifications for our study" That’s right, they only collected data from those who confirmed their hypothesis. That is why this was published in “Journal of Near Death Studies” instead of Science. 
 
This study looked for people who confirmed their hypothesis and found them. Impressive. Again, my issue is even if this study was designed better it doesn’t say anything about supernatural. The journal article even admits that some of the blind participants admitted they did not know what the researcher meant by ‘seeing.’ How can we be sure that the blind who reported seeing just described what they might think seeing could be. Perhaps these blind people had DMT in their brain and allowed to feel like they were seeing. Blind people do have dreams and a brain injury could just alter them during their NDE. Perhaps those who they picked to respond were lead to believe they had some out of body experience due to cognitive bias. The important issue here is that just because we don't understand everything about the brain; it does not mean there is not a scientific answer for it. To say because we don’t understand something and that must mean it is unexplainable is simply willful ignorance. 

The overlying problem with all this isn’t that this episode of Dr. Oz didn’t really explain NDE’s in detail. It is that pseudoscience in the media has terrible implications. People watch these doctors say things on television and believe them simply because they are authority figures. The scientific method is never mentioned. Publishing in a good scientific journal is hard! These reviewers are really tough, I know from experience. When I submit an article for publication in a high quality science journal, I wish I could just say “hey trust me because I’m getting a PhD” or “I only recorded data from those who confirmed our hypothesis” and still get published, but that’s just not how it works. The scientific method is not understood well and having it bastardized in the media doesn’t help. Americans already do not have very good science literacyand having pseudoscience only causes further problems. We need more television shows and other media which explain the actual method of science and not just the sexy results.