Friday, June 26, 2020

The unlikely story of the pro-life author of "Reconsidering Fetal Pain"

[This post is a transcription of a story I told verbally.]

Okay so I want to share this amazing story.

First the background. In the abortion debate there's controversy over the fetal pain issue. For a long time the prevailing scientific wisdom (though not a consensus) was that fetuses probably couldn't feel pain before 24 weeks, and maybe even later. And then recently—in January of this year, actually, 2020—an article came out in a well reputed journal—The Journal of Medical Ethics—called "Reconsidering Fetal Pain." And there were two things about this article that I found remarkable. The first was that it basically argued that fetuses might experience pain as early as 12 or 13 weeks (so significantly sooner than was previously thought). This possibility has major implications for the abortion debate because something like 10% of abortions happen later than 12-13 weeks, and, you know, what does it mean ethically? So that's the first major point of this article.

But the other thing about it that was interesting, and the thing that originally caught my eye, is that it was authored by two men who made a point of noting more than once during the article that they do not agree on the abortion debate. One of them is pro-life; one of them is pro-choice. And they were trying to say that their findings and conclusions regarding fetal pain should be considered apart from the politics of abortion, which should be axiomatic but unfortunately is not. Either fetuses can experience pain or they cannot, and we should explore that question regardless of the implications it has, rather than consider the implications and then only explore the question if it's safe, basically. Anyway, it seems very rare for the two sides of the abortion debate to collaborate on anything, and so it was remarkable to me to see that these two authors who apparently are quite opposed to each other on the abortion issue are with each other on the fetal pain issue.

And I guess I should say: a third important point of the article (that I didn't realize initially and learned later) is that the pro-choice author, Dr. Stuart Derbyshire, is actually the author of some of the most cited prior work on fetal pain. Specifically, he authored the 2006 British Medical Journal article "Can fetuses feel pain?" in which he argued pain experience may require both neural circuitry (which embryos and early term fetuses lack) and mindful experience (which even late term fetuses don't yet have). Stuart also co-authored the 2010 Royal College of Obstetricians and Gynaecologists' highly influential research overview "Fetal Awareness," which argues fetuses can’t feel pain until at least 24 weeks, and possibly not at all during pregnancy, because they are always in a "sleep-like" state. And then in 2020 Stuart co-authored "Reconsidering Fetal Pain," which directly contradicts some of his prior work.

So this article is remarkable both because it involves collaboration between pro-life and pro-choice researchers, and because it involves one of the researchers publishing an article that contradicts his prior work, which—even outside the abortion debate—is not very common. So I thought that was fascinating.

Oh, and a distant fourth: it was very well written. I know how difficult it is to communicate technical ideas in layman's terms that are easy for people to access and read, and it was very well written in that sense too.

So four major takeaways of this article:
  1. It argues that fetuses might feel pain as early as 12 or 13 weeks instead of 24 weeks.
  2. It was coauthored by a pro-life researcher and pro-choice researcher.
  3. The pro-choice author was contradicting his own prior work. And
  4. It was just really well written.
So it definitely caught my attention.

A month later, maybe less, I was on the Secular Pro-Life account on Twitter. And the way I use the account is I mostly just send out original content and try not to spend too much time getting into comment threads and arguments. I just don't think it's a very productive use of time, usually. And I don't usually look at other people's profiles that much either.

But every now and then if I see someone tweet something I think is particularly clever or funny, I might skim their profile and see if they have more content like that. So I was on Twitter and I saw someone make a comment on a NARAL tweet, I think, that I thought was particularly funny. So I clicked on his profile to see if he had more like that, and the pinned tweet to the top of his profile was this article—"Reconsidering Fetal Pain"—and he had pinned it because he was one of the authors! He was the pro-life author. His name is John Bockmann. And I was a little astounded. I just didn't think there'd be reason for my circle to cross with his. It never occurred to me to look for him on social media or anything.

But as soon as I saw that he was the pro-life author, I direct messaged him and basically said "I really liked your article. Great work. I would love to ask you some questions about it if you have time." And he said "Yeah, that's fine. Go ahead and email me and I'll get back to you in the next few days because I'm busy with [whatever]." And so immediately, like in that moment, I emailed him I think a dozen questions off the top of my head about how this article came to be. He indulged me over the next few days and wrote me lengthy responses. Through that back and forth I got to hear more of his story, and I have to say it was fascinating. Very inspiring. And he gave me permission to retell it here.

So, according to John, he was not particularly involved in the abortion debate before. This is one of the remarkable things about this story. I work with pro-life activists all the time, and while I don't think I know everybody, I know a lot of people or at least have heard of them, and I had never heard of him before. And it turns out he was not affiliated with any pro-life groups. He doesn't really know a lot of people in the movement. He came at this, from my perspective, totally out of nowhere. He wasn't especially pro-life—maybe personally pro-life, but hadn't given it a lot of thought—and a couple things happened that made him change his mind and get more involved.

First, he had children. He got to witness his wife's pregnancies and the love he felt for his children even before they were born, and that moved him. He felt more passionate and personal about this issue.

Second—and I think this is really important—he saw David Daleiden's videos about Planned Parenthood's late-term abortions and selling of fetal body parts. John was just thunderstruck. Horrified. And he really wanted to do something, to be involved somehow. It moved him to want to try to effect some kind of change.

At the time he was in his program to become a military physician assistant, and he had to do a master's thesis. He was originally going to focus his thesis on obesity. But when the CMP videos came out, John decided he would like to change his project to fetal pain. His thought process was that if we can't stop late-term abortion from happening, we at least have a responsibility to understand what it means, what it does, and to handle it as humanely as possible. So he started looking into fetal pain.

So that's the first part of the story: he was moved by his own experiences of fatherhood and his own feelings of love for his preborn children, which I find is an extremely common reason for people to convert to being pro-life. And then also David Daleiden's videos inspired John. I think this is very important because there's no way to know how many effects those videos had. I don't think that they had the effects that Daleiden was hoping for. Planned Parenthood has not disappeared, and if anything they have gone after him very aggressively. I can't imagine how difficult that must be for him, both financially and in terms of the stress of fighting with them. And also the frustration of not seeing them taken down at least a few notches, much less entirely. That's frustrating, but there's no way to know who else has been influenced and in what ways, and I imagine that there are countless little interactions that have helped people move more towards our view on things. And you never know which of those interactions, which at the time may seem small, can lead to bigger changes, such as this story—where John was so moved by those videos that he decided to change his thesis and it resulted in a major journal article.

So John Bockmann decided to study fetal pain for his physician assistant program. And in the course of studying that, he read a lot of articles about fetal pain, including ones by Stuart basically saying that fetuses can't feel pain until about 24 weeks. So John was really involved in that research and very familiar with it when he happened to read a New York Times article in which Stuart seemed to contradict his prior research. I don't think most people would notice such a contradiction unless they happened to be following his work pretty closely.

And this brings us to the second part of the story that I find moving: I think there are a lot of pro-life people who would view Stuart and authors like him as "the enemy." I mean he was one of the lead voices basically saying we shouldn't worry about fetal pain. And if he was wrong, and if it's true that fetuses feel pain, do you know how many thousands of late-term abortions we perform every year without regard to the suffering that happens before death? It's of grave moral importance, in my opinion, and I can see how a pro-life person would view Stuart with anger.

But John read Stuart's work and, instead of lashing out, he did what I would think of as sort of the Josh Brahm approach to the abortion debate: he reached out to Stuart. He emailed and essentially said (I'm paraphrasing), "I’ve been following your work and I noticed you said this in your interview and it seemed to contradict this aspect of your paper, and I was wondering how you reconcile that? What changed?" And so in May 2016 they started chatting over email. They got to know each other and became friends, which is hugely important. People change their minds through friendship as much as or more than through logic and debate. And in the course of them becoming friends and discussing the fetal pain issue, Stuart changed his mind, or at least thought there might be significant factors that he should address. In February 2018, Stuart was asked to write an article on the current state of fetal pain scholarship, and he reached out to John for input. After much debate and collaboration, they wrote and rewrote their ideas into the article "Reconsidering Fetal Pain." And as of today, their paper is the 5th most downloaded paper for the Journal of Medical Ethics of all time and in the top 5% of 15M+ research articles scored by Altmetric.

In other words, John Bockmann, who was not particularly involved in the pro-life movement, was moved by fatherhood and the CMP videos to get involved, and when he did get involved he approached the opposition with respect in a spirit of friendship. He didn't change Stuart's mind entirely—Stuart is still pro-choice—but he changed Stuart's mind on fetal pain, and who knows who's reading that article now? And who knows how it influences their work? Who knows what influence it could have in the long term on the abortion debate? I think John did more than most people ever do, and he did it all because he was curious, respectful, and open. And I just thought it was a wonderful story.

Post script: I asked John to review this blog post for accuracy, and he added this note:
We can find important common ground with our ideological opposites, whether or not any minds change. This ability has huge implications for happiness and meaning, especially with how polarized our world is becoming. We must engage with curiosity, respect, and passion. I want everyone to know this!
John Bockmann

1 comment:

A Duck said...

This is an attempt at a comment.