By Alan Holdren
Rome, Italy, Dec 20, 2010 / 15:02 pm
Dr. Carlo Bellieni, a neonatal doctor in Siena, Italy, is working tirelessly to change the way the world looks at unborn children.
In more than 20 years of work and study he has developed new channels of understanding the unborn and the newborn child and new methods of giving them medical assistance.
He is an avid researcher, often collaborating with other scientists and doctors internationally to produce books, scientific papers and new studies examining pre-born and newborn babies. The Italian Neonatology Society, the European Society for Pediatric Research and the Pontifical Academy for Life count him as a member. He is a frequent contributor to the Vatican’s newspaper, L’Osservatore Romano.
His particular passion is researching the way an unborn or a newborn child feels pain and finding ways to alleviate it through pioneering medical methods and strategies that don't use pharmaceutical drugs.
There are many things that go untold about neonatal medicine from the "horrendous" to the "beautiful," the doctor told CNA in November.
His research has led him to make the "very strange" discovery that modern medicine has often created a harsh environment for the prematurely born child due to a lack of understanding and research.
In the 1990s, he found that sound levels and the strength of magnetic fields in incubators were off the charts, for example. Pain scales and pain relief measures for those premature babies needing surgeries were non-existent or inadequate, he said.
These and other examples led him to ask, "Why didn't anyone realize this before?"
According to available research, the unborn child experiences sensations of pleasure, taste, hearing and pain. In a world where these possibilities are often neglected, these studies give the fetus "a human face," said Dr. Bellieni.
At 20 weeks from conception the baby's brain is developed to the point where it begins to process painful stimuli. The fetus responds to pain by releasing the same hormones and exhibiting changed heart-rate frequencies just as adults do in the presence of pain, said Bellieni.
One study has even recorded a baby crying in the womb.
Under normal development, by the time a baby is born, he can feel not only pain but has also begun to prepare for the outside world.
When a baby is born, he is already accustomed to the voice, cadence and even the language of his mother. Her diet will have influenced his food preferences and he will recognize the sound of his mother's favorite sitcom, music and other common ambient sounds.
Bellieni described the studies that relatively recently uncovered these details as "bellissimi," using the Italian word for beautiful, because they shed light on the small world of the womb.
Babies' senses are so advanced when they are born, in fact, that a heel-prick, an injection or other medical interventions that are minor for adults are "devastating" for them, said Dr. Bellieni.
Still, few people are studying the way the unborn child and the newborn feel. According to Dr. Bellieni, the lack of investigation is the result of science treating them as second-class citizens.
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That a fetus is alive and has human DNA give the child membership in the human species "and therefore give them the right to be a human being," said the neonatologist.
He explained his case in simple terms. “There is no reasonable person who can say that 'I was never an embryo'.”
"It's clear that I was once an embryo, just as I am a human being. There was never a moment in which I was not me, but some say that certain states of the human being are worth less than others."
Knowing that the fetus is also a human being is not a question of religion, he said, but of science and biology. No university student who answered to the contrary would be passed by a professor of any creed or none at all, he said.
Bellieni blamed ideologies for stacking the deck against the unborn child.
He cited the influence of philosophers who argue that a child has neither sufficient self- awareness nor an adult's pain level up to one year old. And lacking these qualities, they say, it does not have the dignity of personhood.
"In sum," said Dr. Bellieni, "they deny that someone who does not have self-awareness can feel pain."
This philosophy extends to those with senile dementia and the mentally handicapped and is on the way to including those with serious and debilitating diseases, he said.
He warned that there is an ever-growing pool of candidates for those who don't qualify for the "right of citizenship" under these standards.
To explain, he divides human beings into type-A and type-B. Those who have self-awareness and those who are unable to fully exercise their own rights.
Trends show a continual erosion of citizenship, he warned. Being type-B means achieving statelessness, becoming a person that has lost his "citizenship."
"It's as if they came from a foreign state and were blocked at the border. Fetuses, the elderly and the mentally handicapped are blocked at the border of personhood," he said.
There is "no reason" to treat one form of human being with less dignity than another, said the doctor. In the current context, however, "barriers are being created, which means terrible discrimination between equal persons."
In medicine, this discrimination translates into official protocol against treating vulnerable fetuses or premature babies for diseases, malformations, or to help them survive because it could put their future quality of life at risk.
Such questions would never come into play for an adult with a heart attack or stroke, Bellieni noted. They also have a high risk of ending up disabled, yet "any doctor" would rush them in for treatment.
And, he explained, the treatment would be solely in the patient's interests. For the very premature baby, on the other hand, his parents' interest is taken into account and unless they explicitly plead on his behalf, "many doctors and many protocols of many hospitals avoid treating him. They leave him to die."
He called this policy "absurd," citing a fundamental discrimination between two equal human beings in such action.
Much of the problem comes down to ethics, and a lot of the literature out there promotes "the myth of autonomy," said Dr. Bellieni. This "says that you can do everything you decide, you just have to decide it and it's automatically ethical."
What is needed is an ethic of solidarity, he said, one that considers the baby another human being and utilizes current scientific research.
Doctors have seen that babies born just 22 weeks after conception have a hope of survival. In many places including parts of the U.S., however, children are still untreated if born before 25 weeks.
They must be given a chance, Bellieni said, and if the baby does not respond "one mustn't insist in an unreasonable manner."
The point is that standard protocol needs to keep up with research, he said.
He praised the recent legislation in Nebraska protecting unborn children from abortion after 20 weeks of gestation because of their ability to feel pain. This is an "optimal" piece of legislation, he said, because it takes scientific study into account.
However, many laws and protocols continue to be based on old research, he said, while "in the meantime science has moved ahead."
Advances in medicine come little by little, but they are steady. All told, there has been a "huge leap" in progress from the 1970s to today, he said. Most premature babies born under two pounds died at birth back then, while today 90 percent of them survive.
Ten years ago it was possible for babies to survive if born at 25 weeks, now studies show that it's possible, although with a low probability, that they can survive after birth at 22 weeks.
"It seems little, but it's a grand step ahead," said Bellieni.
There are many studies out there that show how science is "always an ally of reason when it says yes to life," he observed.
Advances like operating on a fetus in the womb for certain diseases and malformations so that it is given a better chance of surviving, are "not a fantasy of the future," but today's reality, he underscored.
It all comes down to the fact that when you treat someone who is sick, "è una cosa bellisima," he said. "It's a beautiful thing."
