JAMA Editor Defends Publishing Fetal Pain Review Despite Criticism for Not Disclosing Authors' Abortion-Related Work

Main Category: Abortion
Article Date: 29 Aug 2005 - 23:00 PDT

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Journal of the American Medical Association Editor-in-Chief Catherine DeAngelis on Thursday defended her decision to publish in Wednesday's issue a... review of existing medical evidence on fetal pain despite receiving criticism for not disclosing the abortion-related work of two of the authors, the AP/Long Island Newsday reports (Tanner, AP/Long Island Newsday, 8/25). Researchers from the University of California-San Francisco examined existing medical evidence on topics including fetal pain, the use of anesthesia and facial expressions of fetuses in reaction to a stimulus. The review found that a fetus's neurological pathways in its brain that allow for the "conscious perception of pain" do not function until after 28 weeks' gestation. The researchers concluded that women seeking abortions before the third trimester of pregnancy should not be subjected to the risks of administering anesthesia to the fetus -- which could cause bleeding, breathing problems and other complications, including death -- for the woman. However, the article does not mention that study co-author Eleanor Drey, a UCSF OB/GYN, is the medical director of the abortion clinic at San Francisco General Hospital (Kaiser Daily Reproductive Health Report, 8/24). The review also does not mention that study lead author Susan Lee -- a medical student and a lawyer -- worked in the legal department of NARAL Pro-Choice America for eight months in 1999 and 2000 (Grady, New York Times, 8/26).

DeAngelis' Comments
DeAngelis -- a Roman Catholic who opposes abortion -- said she has received dozens of "horrible, vindictive" e-mails condemning her for publishing the review. She said she will publish properly submitted comments on the review in an upcoming JAMA issue but added that there is "nothing wrong" with the review. DeAngelis said the review was based on data from dozens of medical articles by other researchers, adding, "If there weren't four other authors and this wasn't a peer-reviewed journal, I'd worry ... but I don't" (AP/Long Island Newsday, 8/25). DeAngelis also said Drey did not have to reveal her scope of practice as an OB/GYN, but added that she will find out more information about Lee's work with NARAL Pro-Choice America and give the authors "the opportunity to explain why they didn't reveal it."

Reaction
Critics of the review have said the affiliations of the authors are important when considering its results, the Chicago Tribune reports. "These are people with years of professional and ideological investment in the pro-abortion cause, not some neutral team of medical professionals," Douglas Johnson, legislative director of the National Right to Life Committee, said. Marcia Angell, a senior lecturer in social medicine at Harvard Medical School and a former editor of the New England Journal of Medicine, said, "Suppose there were an article that said that (fetuses) do feel pain and it was written by people who were involved in the right-to-life movement. Would I want to know that? I think I would" (Graham/Kotulak, Chicago Tribune, 8/26). However, Philip Darney, a UCSF OB/GYN professor and Drey's boss, said the review represents "thoughtful and thorough scholarship," adding, "No conflicts of interests were present in conducting this work and no affiliations nor clinical practice information were withheld inappropriately" (AP/Long Island Newsday, 8/26). Alan Leff, a University of Chicago pulmonologist and editor of the Proceedings of the American Thoracic Society, said, "The standard for disclosure in medical and scientific journals is not your politics," adding, "There's no obligation to tell people what your mind-set is ... as long as the data is sound and gathered objectively" (Chicago Tribune, 8/26).

"Reprinted with permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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