HC Deb 02 June 1967 vol 747 cc529-36
sir J. Hobson

I beg to move Amendment No. 5 in page 1, line 10, at the end to insert: 'a medically unacceptable'.

Mr. Deputy Speaker

I suggest that it would be convenient for the House to discuss, at the same time, Amendment No 6, in line 11, leave out 'risk to the life or of' and insert: 'a probability of death or severe permanent.' and Amendment No. 7, in line 11, after 'of', insert 'permanent'.

Sir J. Hobson

We now come to the grounds on which two doctors can form the opinion that an operation for termination is necessary. If Amendment No. 5 is accepted the earlier part of the provision will read: … that the continuance of the pregnancy would involve … a medically unacceptable risk … to the life or of injury to the physical or mental health of the pregnant woman. … I confess that the Amendment was tabled at a time when the word "well-being" was likely to remain in the Bill. I am glad to learn—and I hope that this will be the case—that the promoter and supporters of the Measure intend to delete from this important Clause the word "well-being" and this I regard as a great improvement. I hope that it will happen, and the likelihood of it happening inclines me strongly in favour of the Bill, as I had substantial doubts about it beforehand.

However, at this stage we do not know whether the word "well-being" will or will not be deleted from the Bill, and I must, therefore, proceed on the basis that we are considering a problem in which it is possible that two doctors may be considering not merely medical questions of life and health, physical and mental, but also questions of well-being with very much wider importations.

The purpose of the Amendment is merely to make it clear that the decision which two professional medical gentlemen must take is intended to be nothing other than a medical one about only the medical aspect of the problem and that we are not placing upon those in the medical profession the duty of deciding matters which lie outside the scope of their ordinary skill and training; that they are not to set themselves up, in considering the problems under the Bill, as sociologists, economists, or soothsayers; and that their individual prejudices about whether something should or should not be done are not to be exercised, but only their skill, judgment and knowledge as doctors.

3.45 p.m.

I hope that the promoters and others will recognise that this is the sole purpose of the Amendment; and will also accept that it will assist the members of the medical profession in applying the provisions of the Bill to the day-to-day duties that will fall to them. There is no doubt that doctors will have a heavy burden in considering the application of the Bill. The Bill fundamentally depends on the way in which the medical profession operates it, and the clearer we can make it to doctors what their functions are and what the scope of the question they have to consider is, the better it will be.

The Amendment has no other purpose than to lay down that doctors, when asking themselves whether they should or should not terminate a potential life involving risks to the life of another person, be it that of the woman only or of another child, must consider the problem from the point of view only of medical skill.

Under the Bill as it stands, termination can be justified upon any risk, however slight or remote, and however minimal may be the expectation of injury. In every question of risk there is always the difficult combination of the greatness of the risk and the greatness of the injury. It is that combination that the doctors will have to consider. A very minimum risk of a not very serious injury may justify an operation. A slight risk of a very serious injury, even death, might also justify an operation, but a very slight probability of a very slight injury is in a wholly different category.

We must leave a good deal to the discretion of the doctors. Whatever words we put in the Bill, the doctors will apply their own principles, experience and knowledge, and, provided that they do so in good faith, then, however unusual or illogical their decision may be, they will be in the clear under the criminal law. To that extent it is necessary to give them a fairly good indication of the basis on which they are to form their judgment.

As I say, whatever words we use, doctors are bound to have a very substantial discretion, and I am content that they should have it. We have to rely substantially on the medical profession for the administration and application of the Bill, and the way it works out will depend to a great extent on the generally accepted views and practice of the medical profession. At the moment, the Bill is quite wide open for any doctor, on any ground which he can persuade the jury is acceptable, to say that there was some risk, of a nature wholly unspecified, and thereby have a complete defence if prosecuted for performing an abortion which no other doctor would have thought justifiable on any sort of ground or condition.

I must also confess that the Amendment was prompted by the letter which was sent round on 21st April. It was signed by the promoter—the hon. Member for Roxburgh, Selkirk and Peebles (Mr. David Steel)—by the right hon. Member for Sowerby (Mr. Houghton), by the right hon. Member for Leeds, West (Mr. C. Pannell), by the noble Lord the Member for Berwick-on-Tweed (Viscount Lambton) and by my hon. Friend the Member for Plymouth, Devonport (Dame Joan Vickers). That letter, which sought hon. Members' support for the Bill, stated: The so-called 'social Clauses' have been removed from the Bill. This has been done to meet the criticism that it was wrong to separate 'social' considerations from medical and to make more clear that 'social' factors are part of the medical judgement left to the discretion of the doctors. All that my Amendment seeks to do is to see whether the promoter and supporters of the Bill really mean what they say. Clearly, in the ultimate analysis, it is the medical judgment of the doctors that has to decide the issues of life and death between a potential life and that of its mother and, possibly, the lives of other children.

Mr. Michael English (Nottingham, West)

Mr. Deputy Speaker has kindly permitted us to discuss Amendment No. 6, which is in my name, with this Amendment. There is a slight difference between Amendment No. 5 and Amendment No. 6. Amendment No. 6 would replace the word "risk" by the word "probability" and would have made another amendment which corresponds to Amendment No. 7 by adding "severe permanent" before the word "injury".

It is, I think, not wholly morally acceptable, strangely enough, to people who are violently opposed to the Bill. Addressing myself to Roman Catholic hon. Members, I do not personally share their views although, of course, I respect them. I think that the hon. Member for Chelmsford (Mr. St. John-Stevas), in whose name Amendment No. 7 stands, would say that to insert the word "probability" rather than "risk" is merely to say that if a 10 per cent. risk is acceptable it means that one would abort 10 children one of whom might be deformed or whose birth might cause injury and that my proposal would replace one for nine instead of one-for-one.

Although I respect the views of such colleagues, I do not share them.

Mr. St. John-Stevas

I do not think that my Amendment does that. It says "permanent".

Mr. English

I am sorry. I was using the terminology of the mover of the Amendment to describe the hon. Member. I was suggesting that in this particular context the hon. Member might take the view, as I understood he did, that any abortion was unacceptable on moral grounds. If I am wrong I apologise to the hon. Member. I was not suggesting that that was the purport of Amendment No. 7. I am sorry if I have been misunderstood in that respect.

I think it true to say that there are many people who regard the Bill as unacceptable in principle. I was trying to say, perhaps inadequately, that this is not my view but my view is that it is too wide. The Clause we are discussing says: that the continuance of the pregnancy would involve risk to the life or of injury to the physical or mental health of the pregnant woman or the future well-being of herself and or the child or her other children; I am aware that certain portions of that are to be deleted by the supporters of the Bill. The question I ask the House to consider concerns the word "risk". A risk can be a risk of any kind. If it were a risk of destroying the prospective life of a child it seems that the risk must be substantial and must be defined.

The whole issue which exercises the minds not merely of myself but of many people in the country on this difficult matter is what sort of definition we have in mind. Many hon. Members who support the Bill say that the definition must be as wide as possible because if it is not as wide as possible many illegal abortions will go on. That is the most immoral argument I have ever heard. If hon. Members take that view, I accept that they are only the extreme supporters, and if they take it to its logical conclusion every other piece of legislation taken to ultimate conclusions would be limited.

The argument basically is that, because there are people who do not obey the law of the land, therefore the law should be altered. This is not a position which one can take up on any moral principle, whether one supports the Bill or is against it. There is no morality in such a position. There is no question or view of right or wrong.

I realise that in many respects this is a highly-charged emotional issue. I z want to try to introduce an element of rationality into it. The provision at the moment is that the pregnancy involves risk. The Clause does not define the risk. It does not specify the amount of risk. It does not say what degree of risk there should be. As I understand, there is always some risk in any pregnancy. There is always some risk of injury, for example, to the pregnant woman. There may always be some risk that an abnormal child will be born.

We are told by the geneticists that every human being on average contains within himself three lethal genes which he may pass on to his children. That does not matter. It may not matter for thousands of years until one of them meets with its pair and causes a child to be born stillborn. There is always a risk when dealing with any biological set of circumstances. The whole basis of life itself is a matter of risk.

The question at issue is: what degree of risk? I accept that the theologian would not say that this was a logical position, but in my Amendment I try to say simply that the degree of risk is that where it can be foreseen that, if the abortion does not take place, another death would result, or alternatively severe permanent injury would result. In other words, I am saying that the risk should be one of 50 per cent.

I do not see how any other position can be justified. To use the analogy of President Truman's authorising the dropping of the atomic bomb on Hiroshima, he said many years after the event that, if he had been faced with making the same decision again—it was a terrible decision for any man to have to make, whether one approves of the decision or not—on the same evidence he would have made exactly the same decision again; because, although he killed hundreds of thousands of people in Hiroshima and Nagasaki, in his view at the time he saved the lives of hundreds of thousands of Americans who would otherwise, over a long, bloody war, have had to conquer the islands of Japan. [HON. MEMBERS: Oh".] If hon. Members object to this, they must not forget that what they are arguing for is that one should destroy more children, that one should take the risk of 10 per cent. as being acceptable. I am saying that a risk of 50 per cent. is a practical and realistic risk and that such a definition should be put into the Clause.

I could not find it in my own personal conscience to say that, just because there are many illegal and back-street abortions—this is the basic argument of the proponents of the Bill—large numbers of which abortions result from our own hypocrisy as a society in refusing to teach people contraception, although we are debating this Bill, we must take the action they propose. For example, there is still a Bill, which is nowhere near being passed, to permit free advice on contraception.

Mr. Speaker

Order. The hon. Gentleman must keep to his own Amendment.

Mr. English

I accept your Ruling, Mr. Speaker.

I think that we as a society are guilty of a certain degree of hypocrisy. The point at issue is this: are the supporters of the Bill prepared, in Amendments which they are prepared to accept to the Clause, to permit a definition of the degree of risk which is acceptable? If so, does that definition mean that we shall not destroy one prospective life unless another is in danger of death or of severe permanent injury?

Amendment No. 6 differs somewhat from Amendment No. 5. One sees the point of the right hon. and learned Gentleman who has just moved that Amendment, but I do not think—

It being Four o'clock, the debate stood adjourned.

Debate to be resumed upon Monday next.