Infants, pain and what health care professionals should want to know -- a response to Cunningham Butler

A neonatologist responds to an article by Nance Cunningham Butler, in the same issue of Bioethics, that is critical of current attitudes toward management of pain in infants. Campbell mentions briefly three matters relating to pain in newborns that he believes Butler could have emphasized more: (1) the wider phenomenon of distress in babies, of which pain is a part; (2) health personnel's failure to recognize unnecessary distress in all patients, not just infants; and (3) the fact that pain control measures vary from place to place and have changed recently. Campbell then discusses alternative viewpoints to Butler's in three areas: (a) do newborns feel pain as older patients do; (b) the technicalities of pain relief in newborns; and (c) the special problems of premature infants. He argues that the onus of proof is on advocates of drug administration to control pain in infants.