Conscientious Objection (Medical Activities) Bill

The Conscientious Objection (Medical Activities) Bill was debated in the House of Lords on [HL] Friday 26th January 2018. With  strong support from  the MEA here we present Lord Altons speech.

 My Lords, I congratulate my noble friend Lady O’Loan on bringing this timely Bill to your Lordships’ House and on her eloquent and persuasive introductory remarks.My unremunerated interests linked to various charities which work on these issues are declared in the register. I served as a member of the All-Party Parliamentary Pro-Life Group’s inquiry into freedom of conscience in abortion provision, which has been referred to during the course of this debate. The inquiry was admirably chaired by the Member of Parliament for Congleton, Fiona Bruce.On Wednesday this week, I met Mary Doogan, one of the two midwives referred to by my noble friend and by the noble and learned Lord and others. The call of the midwife is an incredibly high calling. It is a call to bring new life into the world. To tell such women that they must facilitate the taking of the lives of babies in the womb or lose their jobs is not the hallmark of a liberal or tolerant society.In the 18th century, the renowned German philosopher, Immanuel Kant, understood conscience as,“an internal court in man”.It is a core premise that conscience acts as an external constraint on human b_ehaviour. Whether it is inspired by religious or secular belief is largely irrelevant.Conscience is not founded on whim or personal preference; rather, it provides meaningful conviction that allows people to structure their own ethical identity and exercise their judgment. It was in accordance with Kant’s dictum that the framers of the 1948 Universal Declaration of Human Rights, written as the world emerged from the horrors of the Second World War, understood conscience. Conscience features prominently in the document, with the very first article recognising that:“All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience”.Both the Universal Declaration of Human Rights and the European Convention on Human Rights explicitly guarantee the right to freedom of conscience for all, and it has been recognised in every major human rights treaty since then. It was also recognised in another place and here during the debates in 1967 that formed the Abortion Act.It was David Steel, now the noble Lord, Lord Steel, who told the House of Commons:“The Bill imposes no obligation on anyone to participate in an operation”,and that:“The Clause also gives nurses and hospital employees a clear right to opt out”.—[Official Report, Commons, 13/7/67; col. 1318.]The case of Mary Doogan shows how that assurance, which was given in sincerity and in the genuine belief that it would be implemented, has at the very least been diluted and watered down.While conscientious objection was specifically enshrined in Section 4 of the Act, in practice the report that we undertook over the last two years found that medical professionals are far too dependent on the individual attitudes and discretion of their personal line managers or colleagues.During the inquiry, evidence from the British Medical Association confirmed that some doctors had complained of being harassed and discriminated against specifically because of their conscientious objection to abortion. The inquiry also heard evidence on how career progression opportunities—a point that the noble Lord, Lord McColl of Dulwich, with so much experience in this field, made during his speech earlier today—particularly in the field of obstetrics and gynaecology, had been limited for those wanting to exercise their conscience.I was particularly struck by a piece of evidence from one of the country’s leading paediatricians, Professor John Wyatt. He told us:“Over the last century there have been many startling and egregious cases in which the core moral commitments of medicine have been corrupted and violated because of state coercion exercised on physicians”.The vast majority of evidence that we received accorded with what Professor Wyatt said to us and recognised the importance of conscience as a key part of what it means to live as a free and fulfilled individual in a diverse and democratic society.My noble friend Lord Rowe-Beddoe referred to Dr Mary Neal, a senior lecturer in law at the University of Strathclyde. I met her earlier this week too. In her written evidence, she said:“We should not expect someone who believes abortion to be seriously morally wrong to be willing to participate in it in any capacity, and conscience provisions should be drafted and interpreted so as to protect health care practitioners against any such expectations”.At its core, the Bill is about the minority’s right to dissent from mainstream opinion and to resist compelled action. It prevents the abuse of a dominant position and is deeply concerned with the right of individual liberty.Most of the arguments against the Bill that have been advanced during today’s debate simply do not stand up to scrutiny.The Abortion Act already limits the scope of conscientious objection. If it were working in such a pernicious way as some have described in preventing people from participating in abortions, it really would not enable one abortion to take place every three minutes in this country, 20 every hour—that is, over 8 million since the passage of the legislation. So I do not believe that argument stacks up.However, the state has a duty to safeguard the conscience of individual professionals, as well as providing an effective healthcare service. The denial of conscience is an attribute, indeed the hallmark, of an illiberal society because it is an act of coercion.A doctor, nurse or midwife is not a functionary or an automaton; as the father of a young doctor, I am acutely conscious of the high calling of a healer.Two and a half thousand years ago Hippocrates, the father of medicine, enunciated a revolutionary devotion to the preservation of human life. Here I agree with the noble Baroness, Lady Richardson: we are not compelled to go to heroic lengths to keep someone alive who would otherwise die. That is not at the core of palliative medicine, and her heartbreaking story is an example of bad medical practice. However, nor should we tell doctors that they have to give lethal injections to take life.My noble friend’s Bill is consistent with the tradition of Hippocrates, who said, in a fundamental move away from more primitive medical traditions, that there would be prohibitions o_nAbortion and euthanasia. He refused to accommodate those who believed that “care” and “kill” could be used as synonyms. Nor does my noble friend, and that is why I hope her Bill will receive a Second Reading in your Lordships’ House today.               Fourteen speeches were made in favour of the Bill and ten were opposed. It was given a Second Reading and will now proceed to Committee of the    whole House.  For the full debate and Lady O’Loan’s introductory speech go to:   

David Alton(Lord Alton of Liverpool)

Professor the Lord Alton of Liverpool,
Independent Crossbench Member of the House of Lords.