The elderly gynecologist earned the sobriquet Mahatman-great soul-for his saintly ways with patients and people. In recent weeks he found that the infants delivered in the hospital he worked for had all the vital signs but lacked a certain brain-wave pattern that supposedly indicate presence of the divine spark or the human soul in the body. To remedy such a lack, the gynecologist commits suicide in hope that shreds and tatters of his soul could be channeled for reentry to the soulless bodies. So ends John Brunner's The Vitanuls, a cautionary sci-fi uptake on overpopulation.
That was a reassertion of Plato's belief that the human soul doesn't enter the body until birth. On the other hand, Pythagoreans assert that the human soul was created at the time of conception, a notion echoed in the Hippocratic Oath- and Hippocrates viewed abortion not as destruction of tissue but as an act of homicide.
"I would say that about 90 percent of fetuses are personality. They exhibit different behavior in utero. And about 10 percent are patients," pointed up Dr. Asim Kurjak who serves as professor in the University of Zagreb's obstetrics and gynecology department. His work has encompassed fetal biometry, intrauterine growth retardation, placentography, prenatal diagnosis of congenital anomalies, fetal biopsy and surgical techniques, fetal monitoring, ovarian and fallopian-tube imaging, (power) doppler ultrasound, and 3-D sonography, among other topics in obstetrics and gynecology.
Personality is neither a medical nor a scientific matter. It is philosophical. But thanks to modern technology, arguments can be put to rest.
"The fetus is an individual virtually from conception," maintained Kurjak. At the earliest stage of development-fertilized egg undergoes cell division, leaves the ovary on a journey with the possibility to become a human being-preimplantation diagnosis can be done. That gives the fetus or embryo the status of a patient, he pointed out.
Even so Kurjak also noted that the concept of fetus as a patient stems from development of techniques in fetal diagnosis and management that aim to optimize fetal outcome: "Embryos are, by definition, previable and are therefore patients only as a result of the pregnant woman's autonomy."
While early human development can be visualized virtually-through 3-D and 4-D sonography-from conception, Kurjak admits that still won't settle controversies "regarding the beginning of human life and the status of embryo and fetus. After 20 years of hard work and reading everything available, despite tremendous scientific advances, when and how human life begins has still not been conclusively established."
Until the 14th day after fertilization, all that happens is simply preparation of the protective and nutritional systems of the developing zygote. Monozygotic twins speak against the beginning of human life at the time of conception. And, "lack of the coexistence of the embryo with its mother until implantation and the product of fertilization may be a tumor or a hydatidiform mole or cholorioephitelioma," he explained.
As the fetus settles in its mother's womb, there is active flow of maternal blood through the wall of the placenta, bringing nutrition and oxygen to support the baby's growth. Scientific measurements can start at this stage of fetal development.
By eight weeks, the first cerebral circulation will start. In nine, brain perfusion is richly vascularized; 10 weeks of gestation and the morphology and entire circulatory system become visible. Week 11: an almost precise vascular anatomy is evident.
"And we have complex fetal movements at 12 weeks. You see flexion and extension of the baby at 13 weeks-there's movement of the fist and fingers and other physiological activities," he said.
With 3-D and 4-D sonography, a lot of data can be gleaned and foster bonding between mother-to-be and fetus-even father-to-be might not contain himself he'd likely kiss the screen of the maternal abdomen, Kurjak said.
"I think that modern scientific methods are proving what religion used to teach us 2,000 years ago. And more than ever, religious beliefs do meet scientific results. The fetus is an individual from conception," he reiterated.
While medicine embraces a global sphere of practice, prevailing laws are often parochial in scope-laws will differ in implementing rules and regulations within national boundaries.
"Life starts at the time of conception," he said. "However, the problem is when are we going to protect it? What are the scientific reasons of the beginning of human life which we should give to our law colleagues to produce legal protection of the fetus?"
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