§ 5.51 p.m.
§ Order of the Day read for the House to be put into Committee (on Recommitment).
§ Moved, That the House do now resolve itself into Committee.—(Lord Silkin.)
§ VISCOUNT DILHORNE
My Lords, I should like to ask the noble Lord, Lord Silkin, what his intentions are in regard to this Bill. If we go into Committee on this Bill it is perfectly apparent, from the programme of Business for next week, that there is not the slightest possibility of this Bill, even if it has passed through this House, being considered at all in another place. It is bound to drop, and I would ask the noble Lord whose Bill it is whether he would explain to us what point he thinks there would be in continuing long debates in Committee on this Bill to-night. If he wishes to, it will be open to him, as it will be to the noble Baroness, Lady Summerskill, to introduce a new Bill on the same subject early in the next Parliament. I am merely seeking to find out the noble Lord's intentions.
§ LORD SILKIN
My Lords, the noble and learned Viscount, Lord Dilhorne, has suggested to me that we might merely take the non-controversial Amendments to-day and leave the Bill in that form. I have thought about it and consulted some of my friends, but the fact is that quite a number of noble Lords have come here in the belief that we are going to discuss this Bill this afternoon and this evening. They have gone to some inconvenience, and I feel that, without 521 consulting all of those who are here for that purpose, it would be unfair if I were merely to accept the noble and learned Viscount's suggestion.
So far as I am concerned, I should welcome the opportunity of an early evening, and I quite realise that this Bill cannot become law between now and March 10. Nevertheless, I think we should be serving a useful purpose if we could get this Bill through its Third Reading in this House, and it would simplify proceedings in the next Session of Parliament, when I intend to introduce another Bill. So I hope that the noble and learned Viscount will not hold it against me if I say that I feel that we should go on this evening as far as we can.
§ VISCOUNT DILHORNE
My Lords, it may be a matter for the House to decide whether we do proceed with a Committee stage which can produce no useful result. The noble Lord, Lord Silkin, may want to get this Bill read a third time for propaganda purposes, but I cannot see that it is likely to simplify the process of legislation in the next Government. In view of the news which has been announced and which noble Lords who came here did not know was going to be announced (at least, many of them would not have known: some of the noble Lords opposite may not be like Mr. George Brown, and they may have had some information), I should have thought that to ask us to spend long hours tonight discussing a Bill which cannot get any further would not be as good a procedure as for the noble Lord to withdraw his Bill now. Whatever takes place in debates on this Bill between now and Dissolution cannot affect the ultimate position.
§ LORD AIREDALE
My Lords, nothing that the noble Lord, Lord Silkin, said induced me to believe that he wished to get a Third Reading of his Bill for propaganda purposes.
§ BARONESS SUMMERSKILL
My Lords, it seems to me to be highly discourteous to the House. Not only has by noble friend done a great amount of work throughout the week-end, trying to meet all the points raised by noble Lords, but I see that the noble Lord, Lord Molson, is sitting there with a large tome open by his side. He has obviously 522 done a great deal of work, and it seems to me curious that at this last moment, after the debate has been announced, noble Lords should now be told that the noble and learned Viscount does not wish to proceed with the Committee stage.
§ BARONESS SUMMERSKILL
My Lords, as to the Dissolution, we all knew, of course, that some announcement was going to be made.
§ LORD MOLSON
My Lords, I think a number of noble Lords have come here prepared to debate this Bill. The Committee stage is one that ought to be gone over carefully. There are many issues which could be debated with great advantage, on the various Amendments which have been put down, and I see no reason why we should not proceed with it. I had not expected my noble and learned friend Lord Dilhorne to defer so abjectly to the decree of the Prime Minister as to call off the business in this House.
§ On Question, Motion agreed to.
§ House in Committee accordingly.
§ [The LORD MERTHYR in the Chair.]
§ Clause 1:
§ Medical termination of pregnancy
§ 1. Subject to the provisions of this Act it shall be lawful for a registered medical practitioner to terminate a pregnancy:
§ Provided that two registered medical practitioners, being either the pregnant women's regular doctor and a registered medical practitioner employed in a hospital under the National Health Service or two registered medical practitioners so employed, certify in writing that in their opinion the termination of the pregnancy is necessary on the ground that—
- (a) the continuance of the pregnancy would involve serious risk to the life or grave injury to the health whether physical or mental of the pregnant woman whether before at or after the birth of the child; or
- (b) the child if born would be likely to suffer from such physical or mental abnormalities as to deprive it of any prospect of reasonable enjoyment of life; or
- (c) the pregnant woman is a defective or became pregnant when under the age of sixteen or as the result of intercourse which was an offence under section 128 of the Mental Health Act 1959 or section 97 of the Mental Health (Scotland) Act 1960 (relating to sexual intercourse with patients).
§ LORD SILKIN
A good many of these Amendments which I have put down are an improvement on the existing drafting, and in most cases (I think perhaps in all) they do not affect what was intended in the Bill. This particular Amendment is to a large extent a matter of drafting. It ties up what is proposed in the present Bill with the position as it is at the moment. It also reintroduces the concept that the practitioners have to act in good faith. That was not in the Bill as it left the Committee, but I am advised that it is essential for it to be incorporated, and I have so incorporated it. I know it was represented that it might be discourteous or offensive to the medical profession to suggest that they have to act in good faith, and I was quite happy to omit those words, but it has been represented to me that those words ought to go in as a matter of proper procedure and therefore I am quite happy to include them. I beg to move.
Page 1, line 5, leave out from (" this ") to end of line 12, and insert (" section, a person shall not be guilty of an offence or crime of abortion by reason of the termination of a pregnancy by a registered medical practitioner if the practitioner is of the opinion, formed in good faith, that the termination of the pregnancy is necessary on any one or more of the following grounds, that is to say—").—(Lord Silkin.)
§ VISCOUNT DILHORNE
I hope the noble Lord will explain why he has put in these words "formed in good faith". It is surely not enough for him to tell the Committee he has been advised that it is a good thing to do. Knowing the noble Lord, I am quite sure that he asked why it was a good thing to do, and that an explanation was given to him. Therefore I hope he will give your Lordships, and me, the explanation and the reason why he accepted the advice given to him.
I must say that I find it difficult to see that the addition of these words adds anything to this Bill. Presumably the words "formed in good faith" have been inserted to enable a prosecution to be launched should the prosecution be in a position to prove, which seems to me extremely improbable, that the opinion was not formed in good faith; that is to say, that it was not the doctor's honest opinion. And if it was not the doctor's 524 honest opinion then in truth it was not his opinion. I do not see myself that the addition of these words really adds anything to the Bill. If it is not in truth the opinion of the medical practitioners, then the procedure laid down by the Bill will not be complied with. I should be grateful if the noble Lord, even at this hour, could explain fully why it is that it is thought necessary to insert these words. Certainly we may have a further opportunity of considering this.
§ 6.2 p.m.
§ THE JOINT PARLIAMENTARY UNDER-SECRETARY OF STATE, HOME OFFICE (LORD STONHAM)
support my noble friend, Lord Silkin. The Government feel that these words are necessary and the Amendment has been drafted on the advice of Parliamentary Counsel. On the precise point put by the noble and learned Viscount, I would explain our views in this way. The present draft of the Bill makes it lawful for a pregnancy to be terminated provided that two doctors certify in writing that it is necessary on one or other of the grounds specified in the Bill. The effect of this in practice would be to make the legality of the abortion depend only on the issue of the two certificates. That is an unnecessary invitation to abuse. The Amendment now moved by my noble friend, coupled with a later Amendment, provides that a pregnancy may be terminated if two doctors are of the opinion, formed in good faith, that it is necessary on one or more of the grounds specified in the Bill and if they so certify in writing. This places the legality of the abortion on the doctors' opinion formed in good faith. The doctor may be wrong in his opinion, but so long as the opinion was honestly formed he would be protected by the Bill. In other words, in the event of a prosecution, the Crown would have to prove bad faith on the part of the doctor in forming the opinion on the certificate.
The noble and learned Viscount suggested that, without the Amendment, a prosecution could lie only if it was not the doctor's honest opinion, but that is by no means as certain as he appears to think. It seems, therefore, desirable to make the position clear, as the terms of the Amendment, in our view, make it clear; because, first, it accurately reflects the true position, that the legality of the operation depends on the opinion of the 525 doctor; secondly, it safeguards the position of the doctor who has made an honest mistake in diagnosis; and, thirdly, it follows the precedent of the existing case law in theBournecase and another case, where it was held that it was not unlawful for the doctor to carry out the abortion if the act was done in good faith to preserve the life or physical or mental health of the mother. In other words, at this point the Amendment moved by my noble friend will simply implement what is the existing case law, which is already in terms of good faith, and there is, therefore, nothing new in the concept put forward by my noble friend.
This Bill deals with a special situation. It relates to an act which, if certain conditions are not complied with, is a criminal offence, and the circumstances surrounding it are therefore different from the circumstances surrounding most of the operations doctors are called upon to perform, where there is no question of any criminal offence being involved. Her Majesty's Government regard this as an Amendment which should be commended to the Committee.
§ LORD SEGAL
I should like from the noble Lord some information on what I regard as a very important matter. If this Amendment is carried, and if Amendment No. 8 is carried, the phrase "formed in good faith" will occur twice. Would any imputation of bad faith possibly arise against the doctor if it could be proved that a very large pecuniary consideration has entered into the carrying out of the operation? And, further, if he used the expression "large pecuniary gain" what figure would be involved? It is a most important point which I believe has not entered into the consideration of this Bill. I should be glad to have his opinion on what constitutes "in good faith" where large financial gain is involved.
§ LORD STONHAM
My noble friend did not himself specify what he meant by "large financial gain". I would point out that later Amendments to be moved by my noble friend Lord Silkin will specify the place of the operation, that is the hospital or equivalent of hospital approved by the Minister of Health; and will specify the standing of the doctor who will perform the operation. I should not have thought that the pay- 526 ment of a fee to the doctor, if it was done other than in a National Health hospital, would enter into it at all. The question of good faith or bad faith would rest entirely on whether or not the doctor or doctors had observed the conditions under which the termination of pregnancy would not be an offence, and the question of whether or not a doctor received a fee would not, in my view, affect the matter of a doctor's professional honour.
§ LORD CONESFORD
I am bound to say that I support this Amendment. I, think it is certainly an improvement on the wording of the Bill. While I appreciate the point made by my noble and learned friend, I think I can also see the argument the other way, and I am certainly firmly of opinion that the words inserted in the Amendment could not reasonably be taken as insulting to the medical profession. I think that what was said in theBournecase and the way it was reported is sufficient to show that putting these words in the Statute, whether or not they are strictly necessary, cannot be injurious on the ground that they are insulting to the medical profession. On those grounds, I hope the Amendment will be accepted.
§ VISCOUNT DILHORNE
I am not by any means satisfied that these words are really necessary. The noble Lord, Lord Stonham, in beginning his reply, sought to draw a distinction between the wording of this Amendment and the Bill as it is at the present time. Under the Bill two medical practitioners have to certify in writing that their opinion is so-and-so, and here again they have to give their opinion; in both cases we are dealing with matters of opinion, and I should have thought that under the Bill as it stood there was no question of prosecution if an honest opinion was given, even if it was wrong. But while I do not think these words really add anything of importance to the Bill, if the noble Lord wants them and thinks them important, I certainly shall not resist it. I am not suggesting that their addition is insulting. I think just to say they follow theBournecase is not really enough. I should have thought they were unnecessary; but if the noble Lord wants them, I do not oppose it.
§ On Question, Amendment agreed to.527
§ LORD SILKIN
I beg to move this Amendment, which the noble and learned Viscount will be glad to hear has been put down to meet a point which he made. It makes quite clear that the two factors, the life of the mother and the health of the mother, are independent, and that on either ground an abortion may take place. I beg to move.
Page 1, line 14, after (" or ") insert (" of ").—(Lord Silkin.)
§ VISCOUNT DILHORNE
I think this is a desirable Amendment. If it had not been made the clause would have run:….involving serious risk to the life or grave injury to the health.…That is a heavy burden for doctors to be satisfied about, that it would involve "grave injury to the health". I am sure it was the intention of the noble Lord to provide that it would either involve serious risk to the life or serious risk of grave injury to the health. The insertion of this word "of" makes provision for that.
§ On Question, Amendment agreed to.
§ 6.11 p.m.
LORD SILKINmoved, in paragraph (b), to leave out "the child if born would be likely to" and insert:
there is a substantial risk that if the child were born it would".
§ The noble Lord said: Paragraph (b) of subsection (1) deals with the child who, if born, would be likely to suffer from physical or mental abnormalities, and so on. In the earlier stages there was some discussion as to the meaning of the words, "likely to suffer." The noble and learned Viscount took them to mean that the probabilities were that the child would suffer—that is, as he now says, that there was a greater chance than otherwise that it would suffer these abnormalities and defects. I did not myself understand the words to mean that. I understood them to mean that there would be a substantial risk of a child being born with the defects, and I understand a "substantial risk" to mean that, while the odds may not be in favour of its happening, there is a strong likelihood of its happening. It is difficult to define it more closely, because I think we all understand what "substantial risk" means. Therefore I am moving the 528 Amendment to include the words "a substantial risk" of these things happening, instead of its being "likely". In my view, it is a clarification of what I had intended by that word. I beg to move.
Page 1, line 17, leave out (" the child if born would be likely to ") and insert the said new words.—(Lord Silkin.)
§ VISCOUNT DILHORNEmoved, as an Amendment to the Amendment, to leave out "there is a substantial risk" and to insert instead "it is more probable than not". The noble and learned Viscount said: The noble Lord has put down the words that he understood were the real meaning of "likely". I am afraid that I differed from him in the interpretation of the word "likely". I did not think that something was likely to happen unless the chances were that it would happen. I think it is most important that he has raised this question. I hope that your Lordships will not accept this formula. We are seeking to alter the law and to make it clear and certain. There can be nothing more uncertain than what constitutes "a substantial risk". Who is going to interpret what is "a substantial risk"?—members of the medical profession in different parts of the country, and with no guidance at all from this Bill, and no guidance from the noble Lord. What exactly does he mean by "a substantial risk"?
§ On February 1 the right reverend Prelate the Bishop of Exeter made a powerful speech on the Bill, as it was, on paragraph (b) thinking, as did the noble Lord, Lord Silkin, that it was intended to cover the case where the odds were against a child being born who would not have any prospect of reasonable enjoyment of life. What does the noble Lord regard as "a substantial risk"—one chance in 4, one chance in 10, or in 7 or in 25? I think we ought to ask the noble Lord to say what he means by this, because if he means that there is one chance in four of a child of this character being born, that means that, if you allow termination on that ground, you will be allowing termination of pregnancy which would result, in three out of four cases, in the birth of a perfectly normal person. That is what is covered by this phrase "substantial risk". In the other cases, where you regard a one-in-seven chance as a substantial risk, it means that in fact 529 you would be destroying more potential human life which will be normal to avoid having one child born who has no prospect of a reasonable enjoyment of life.
§ Whatever else is right, I feel sure that to put in words as vague as "substantial risk" will not do; and for the purpose of discussing this matter I have put down a formula which contains what I intended the word "likely" to mean—namely, that the balance of probability was in favour of the child's being of this character, and of its being born with no prospect of reasonable enjoyment of life. But I am content to go a little further than that, if need be, so long as one gives clear guidance. I should be content if it was "as probable as not" that the child would be so born—that is to say, that it was an "even money" chance. That, I think, would be as far as one can reasonably go. But to say that there is a "substantial risk" is too vague. One could say that there is a substantial risk, I suppose, if there were one chance in 10, or one in 15, of a child being so born. But surely, one could not possibly accept the proposition that, because of that chance, one in 15, 14 pregnancies could be terminated which otherwise would produce perfectly normal, healthy children.
§ The point is a short one, but an important one. I have put down my Amendment in its present form, but I should be equally agreeable to having the words "as probable as not" instead of "more probable than not". I should be content with that, and would move it in that form, if your Lordships would permit me. But I am absolutely opposed to words which are so vague and indefinite as "a substantial risk". I beg to move.
Amendment to Amendment moved—
Leave out ("there is a substantial risk") and insert ("it is more probable than not").—(Viscount Dilhorne.)
THE LORD BISHOP OF LEICESTER
I think this is a difficult question upon which to come to an opinion. Even if the words "substantial risk" were accepted, and it was taken, as I had imagined, to mean perhaps, three out of ten, or something like that, the fact that we all form our own opinions shows the danger of these words. But I have felt that in the case, for instance, of an ordinary married couple, where there is perhaps German 530 measles, or something like that, in the early stages of pregnancy, there might be a termination of the pregnancy, in the hope that there would be other, more happy pregnancies in the future. In that way I should wish to support the noble Lord, Lord Silkin. But we are embarking here, as the noble and learned Viscount has suggested, on a very drastic change in the law. We are entering a realm which is comparatively uncharted. I think that at this moment we might be very wise to follow the Amendment to the Amendment and say that we will embark on this only if, according to our present knowledge, the chance of a child being born with these abnormalities was greater rather than less.
§ LORD CONESFORD
I agree that this is an extremely difficult matter, but I am not at all happy about the Amendment to the Amendment moved by my noble and learned friend. There are few subjects in philosophy more difficult than the question of probability. I find it very difficult to attach any meaning to the words, "it is more probable than not". What I think they mean is simply, "it is probable". Had the Amendment to the Amendment been moved in that form, we should have the simple question whether we preferred the words, "there is a substantial risk" or "it is probable". I think that is an arguable and a difficult matter.
I have no medical qualifications, and I do not know how far doctors who practise in this sphere can, so to speak, state the odds numerically; but it would not astonish me to hear that in many cases it was quite impossible to do so. Therefore it seems to me that the words "substantial risk", which is the sort of thing that people have to consider in many aspects of life—and one which has to be considered from time to time by the courts—are probably about as good as we could get. I feel very strongly that what we have to choose between is the words of Lord Silkin's Amendment "there is a substantial risk", and the alternative "it is probable".
THE DEPUTY CHAIRMAN OF COMMITTEES
The noble Viscount, Lord Dilhorne, has intimated to me that he would like to move Amendment No. 4 in a slightly different form. With the permission of the Committee, I will read out the new form and, if the Committee agrees, 531 that will be the wording before your Lordships. The new form of the Amendment is to leave out the words "there is a substantial risk", and to insert the words "it is as probable as not".
§ LORD CONESFORD
I should like to say that what I have just said applies equally to the alternative wording.
§ 6.23 p.m.
§ LORD BRAIN
I hope that the noble and learned Viscount will forgive me if I say that I must oppose his Amendment to the Amendment because it is quite unrealistic from the medical point of view. I should like to give your Lordships some examples of this. To take German measles to start with, when German measles occurs during the first few weeks of pregnancy the likelihood of the child's being born deformed is considerably more than 50 per cent., but as time goes on the likelihood grows less. It would be quite impracticable for any doctor to say at any particular point, "We have passed that point at which it is as likely as not, and therefore the pregnancy ought not to be terminated".
One not uncommon mode of inheritance is such that the chances of a child being abnormal are exactly 50 per cent. I have no doubt it was that fact which the noble and learned Viscount had in mind when he made this slight alteration in his Amendment. But there are other forms of inheritance where the risk is less but quite definitely calculable. There are circumstances in which two parents, both apparently healthy, have a child who is born abnormal and who is known to suffer from a condition the risks of inheritance of which are exactly 25 per cent. Let me give your Lordships an example that came to my own notice.
Two healthy parents had a child who was abnormal and who died paralysed at the age of about a year. The risks of this condition being inherited were exactly 25 per cent. They consulted the doctor about what they should do about having another child. They were told, "The odds are 3 to 1 that your next child will be healthy". Unfortunately, the second child was exactly the same as the first; it also died paralysed at the age of one year. What advice should one give to those parents? Can one reassure them? Can one succeed in 532 relieving them of their anxieties? Do you say, "If you have another child the odds are still 3 to 1 it will be normal"? Or should one, if one accepts the principle of terminating a pregnancy on grounds of foetal risk, say that this is a case where the risk is substantial and therefore they should be allowed to have the pregnancy terminated?
It is problems of this kind with which doctors have to deal. I would say that in every-day practice doctors are quite accustomed to dealing with substantial risks, to saying, "There is a substantial risk that the effect of this operation would be so-and-so". But rarely are they in a position to say that this risk is more or less than 50 per cent. So if we accept the principle of termination of pregnancy on the ground of risk to the child, one had to take into account factors other than those which can be calculated numerically. Very often one cannot calculate them numerically.
There is another factor which is involved. The question is not merely "What is the risk?", but, "Risk of what?". A comparatively slight risk of a very serious disorder has quite different implications from a risk which is much more severe but of a much less severe disorder. I feel that on practical grounds, from a medical point of view, we should accept the principle of a substantial risk, and I propose to vote against the Amendment to the Amendment if it comes to a vote.
§ LORD SEGAL
I should like to rise to say one or two words in support of the arguments put forward by the noble Lord, Lord Brain. The noble and learned Viscount, Lord Dilhorne, said that there is some doubt as to the interpretation by the doctor of the term "substantial risk". But surely in the Amendment to the Amendment he himself has proposed, is it not a case of confusion worse confounded? Supposing there is a risk, as Lord Brain has suggested, of 25 per cent., or 33 per cent. If the Amendment to the Amendment of the noble Viscount were carried, it would have to be a risk of 51 per cent. before termination of pregnancy could be legalised. He has altered it to a slight extent by making it now 50 per cent. instead of 51 per cent. But if the risk were 49 per cent., the judgment would go against the doctor because 533 through 1 or 2 per cent. he may have put himself on the wrong side of the law. Surely we cannot judge individual cases, where a mother, for example, may already have given birth to one or two or three deformed children, on the basis of the law of averages or probability. Every doctor has to judge the individual case with which he himself is faced.
In principle one must speak against this Amendment. I am totally against this House trying to give advice to a doctor on the way in which he should exercise his particular judgment when he is faced with what is a purely medical problem. When are you going to judge the statistics as accurate? Medical science constantly advances. In the case of a woman who has already had German measles the risk may be 25 per cent. this year, but perhaps in two or three years the risk may be reduced to 15 or 10 per cent. Let us get right away from judging cases of individual difficulty on the law of averages. We have already accepted from Lord Silkin that a doctor must be judged as carrying out this operation in good faith. In my judgment, it is best for the Committee to leave it at that.
§ 6.30 p.m.
§ VISCOUNT WAVERLEY
I, too, should like to support the Amendment of the noble Lord, Lord Silkin, as supported by my noble friend Lord Brain and the noble Lord, Lord Segal. The fact is that a fifty-fifty situation would be so restrictive as to be, for practical purposes, inoperative. A fifty-fifty genetic risk is extremely high and for practical purposes does not occur. On the question of recessive genes, the maximum risk known at the moment is usually one in four, or 25 per cent., but it might be a good deal lower. Of course, it is likely that in the not very distant future, with analyses of the amniotic fluid, the fluid in which the foœtus is surrounded, it might be possible when there are these recessive genes problems to say that it is absolutely 100 per cent. certain that a child is going to be all right, or, alternatively, that it is 100 per cent. certain that a child is going to be affected. In any case, I should have thought that this would be a substantial risk, and I should have thought, also, that if it were 100 per cent. certain it would come under the category of Clause 1(a).
§ LORD MOLSON
Three eminent medical Members of your Lordships' House have all spoken against the Amendment to the Amendment. There is one further point that I should like to add. My noble and learned friend spoke as though it were essential for your Lordships' House to lay down exactly what the criteria are to be. But that, of course, is not the way in which this Bill is framed. It is the intention of this Bill that a judgment shall be formed by the two medical practitioners concerned. Therefore it is perfectly reasonable, and I think necessary, that legislation should be sufficiently widely drafted to enable that judgment to be properly exercised. To argue that there would be three pregnancies terminated unnecessarily for every one which prevented an undesirable birth—if it were believed by the medical profession that the statistics were three to one—is, of course, entirely a misunderstanding of the machinery of this Bill. All that the noble Lord's Amendment is intended to do is to widen the discretion and to enable the medical practitioners to form a judgment, without being arbitrarily restricted to some numerical proportion which we are told by the medical profession is without any reality at all. Therefore, for that practical drafting reason, I hope that your Lordships will reject the Amendment to the Amendment, as well as for the reasons which have been advanced by the three eminent doctors who have addressed us.
§ VISCOUNT DILHORNE
The wording of my Amendment was, in fact, taken from a suggestion made by the noble and learned Lord, Lord Parker of Waddington, as the noble Lord, Lord Cones-ford, will probably remember, when we were discussing this provision at an earlier stage. I think he used both expressions: "more probable than not", which I think is now fairly frequently used in the courts, though I do not seek to defend it, and also "as probable as not". I must say that I think the expression "substantial risk" is extremely indefinite in this particular context. I will not remind your Lordships of the speech made by the right reverend Prelate the Bishop of Exeter, who went very thoroughly in that speech 535 into what I understand the medical profession can say as to the prospects or chances.
I agree that in this Bill one has to entrust a wide measure of discretion to the medical profession. One must rely upon them and put faith in them, and I certainly do. But, at the same time, one must see that this Bill does not become a vehicle for abuse of what many of your Lordships would wish to see; and the noble Lord, Lord Silkin, in moving his Amendment certainly gave no indication of what interpretation he thought ought rightly to be placed upon the words "substantial risk".
The noble Lord, Lord Brain, has pointed out the difficulties about my Amendment, but none of those who have spoken has given me the slightest indication of where he thinks the borderline would come between what is a substantial risk and what is not a substantial risk. Therefore, we are left, if we accept the Amendment of the noble Lord, Lord Silkin, with a use of words with no guidance as to their interpretation, and which may be widely differently interpreted in different parts of the country.
I am sure the noble Lord, Lord Brain, will agree that, if those words are in, two members of the medical profession in one part of the country may think that one case involves no substantial risk, whereas two medical practioners in another part of the country may regard an exactly similar case as involving a substantial risk. I myself do not think that it is a very happy result if, as a result of this legislation, one can get a wide disparity of treatment. Of course, you cannot eliminate the possibility of doctors taking different views on examination. But I am postulating here two cases which are indistinguishable, and it seems to me that if you just say "substantial risk" and nothing more you are leaving it in such a way that it will not be very satisfactory, because of the widely differing interpretations that can be placed upon those words in different parts of the country.
§ LORD BRAIN
This is a matter of medical judgment and, inevitably, as the noble and learned Viscount has just said, doctors must be free to exercise their judgment. This was also true under the interpretation of the implications of the 536 Bournecase. No doubt judgments differ. This is inevitable. But the main point is that these are risks which cannot be mathematically calculated.
§ LORD SILKIN
The noble and learned Viscount is not getting over his difficulty by the words which he is proposing to use. If he says "as probable as not" there may be different opinions on the same set of facts by different doctors. You will never get complete agreement as to what are the odds on an operation. Moreover, this is not a betting transaction, and I do not think you can really lay odds that it is more probable than not, or that it is as probable as not. You must give the doctor discretion in a particular case, having regard to all the facts, to decide whether or not he is prepared to recommend an abortion. After all, there must first of all be the application of the mother. Do not let us forget that every time.
§ LORD SILKIN
It is the mother who makes the application. It is then for two doctors to decide whether her application comes within the framework of the Bill, and they have to form a judgment, as the noble Lord, Lord Brain, and other noble Lords have said, as to what is a substantial risk. I think it is a proper onus to put upon them, because it is something that doctors have to do every day of the week. They are constantly deciding what is a proper risk to take. Therefore I hope that noble Lords will accept the Amendment.
§ VISCOUNT DILHORNE
I had given way to the noble Lord, Lord Brain. I had not quite concluded what I was saying, but I did not like to interrupt the noble Lord, Lord Silkin, in his further observations upon this clause. It is quite true that there may always be an honest difference of opinion between members of the medical profession; but we are not here dealing quite with that field. We are seeking to give guidance to the medical profession, and whether you are giving sufficient guidance by using such words as "substantial risk" I rather beg leave to doubt. I hope that the noble Lord, when he comes to produce his next Bill, will give further thought to this, because I think there is a case for trying 537 to give some further guidance as to what exactly is intended here. If no further guidance is given, then many people may think that this particular provision is going far too wide.
The noble Lord will remember that I supported this particular provision at an earlier stage when it was being much criticised, and I support a provision of this kind now for this reason. I think that the German measles cases can ordinarily be dealt with underBourne'scase—I quoted some cases where they had been—and could, therefore, be dealt with under paragraph (a). But this particular provision is here only for the case where the condition of the child is not likely to cause a serious risk to the health of the mother before, at or after birth—and that I think will be a very exceptional case: it will not often arise. I shall not press my Amendment now, but I hope that the noble Lord will give some further thought to this because I think that, if he does not, he may find that a number of their Lordships and others will think that this is opening too wide a door, and a wider door than is intended.
§ Amendment to Amendment, by leave, withdrawn.
§ On Question, Amendment agreed to.
§ 6.41 p.m.
§ VISCOUNT DILHORNEmoved to leave out paragraph (c). The noble and learned Viscount said: This is an Amendment which I think is of some importance and which I hope will not be misunderstood. At an earlier stage the noble Baroness, Lady Summerskill, made a powerful speech in respect of young women who became pregnant when they were under 16. I think we all of us agree that it really can be a tragedy, and usually is, when that occurs. It is always a mother unmarried at the time of pregnancy, although, of course, in a great many of these cases the confinement, if it were allowed to take place, would take place many months after the mother's sixteenth birthday. So I start from this position: that we are not here concerned with the tragic character of the pregnancy of someone under 16. That is not the question. We can all agree upon the fact that it is a very sad thing to happen.
§ LORD SILKIN
I do not want to interrupt the noble and learned Viscount unduly, but could we not discuss Amend- 538 ments Nos. 5, 6 and 7 together?—because the real issue is only this question of the mother being under 16. On the face of it we are discussing merely No. 5 but if the noble and learned Viscount will agree that we can talk about Nos. 5, 6 and 7 together, I am quite happy that he should continue.
§ VISCOUNT DILHORNE
I am in the hands of the Committee. I am afraid I had put down my Order Paper, and I thought I was speaking on Amendment No. 7. It is my mistake. But certainly that is all I should wish to discuss upon this, and we can take Amendments Nos. 5, 6 and 7 together. I was saying that, so far as this is concerned, there is nothing between any of us, I think, in that it is terribly sad when someone under 16 becomes pregnant. But the issue here is whether such a young woman should be given a particular right to have her pregnancy terminated on the ground of her age.
The way I ask the Committee to look at it is from the point of view of the interests of no one else except the girl. When we were in Committee last time I quoted a letter I had received from an eminent gynecologist who had had something to say on this question. I will quote again, if I may, from his letter:As to the girl under 16—and I see many in my practice—nothing in my experience would justify a legalised, dangerous surgical assault on her on grounds of age alone. I do not believe it would serve her better than sympathetic and understanding obstetric care, and the provision of adoption for her child. Certainly there is to-day little social stigma left to burden her.I mentioned last time some information I had been given—I cannot say whether it is right or wrong—about the dangers of this operation, and the risks involved. I will not remind your Lordships of what I said then.
If we do not have this particular provision in this Bill, what will the position be? The person under 16 who is pregnant will go to her medical practitioners, and the issue will be whether or not she comes within paragraph (a). There is no question of excluding her from that. It will then be for the medical practitioners to say whether or not they think in the interests of her health—and they will be weighing it up—that this particular pregnancy should be terminated. I should like to see it left in that way, 539 because I can see that if by this Bill you appear to give a girl, just because she is under 16, a right to such a termination, you will be putting some medical practitioners in an extremely difficult position. She will say, "Here is this Bill. I am under 16. Here is my birth certificate. That is a ground for terminating the pregnancy." Whatever we put in this Bill, the doctor will have to consider the interests of her health, and whether it is really in the interests of her health that she should run the risk of this dangerous operation, or whether it is not really better for her, having regard to her age, to have the baby without an operation and to have it adopted.
I do not profess to judge on that, but I do feel that it is undesirable to give this special right to persons under sixteen, not depending on their health at all but depending simply upon their age. I think it would be better if such cases were dealt with—and they are dealt with now, I understand—under the decision in theBournecase, which would be covered, and indeed is expanded, by paragraph (a). I move this Amendment for those reasons, and I hope it will not be represented that I am in the least degree unsympathetic to those who, at this age, find themselves pregnant.
Page 1, line 20, leave out paragraph (c).—(Viscount Dilhorne.)
THE LORD BISHOP OF LEICESTER
I feel I have to say two things about this Amendment, and I am afraid they seem rather contradictory the one to the other. I feel I ought in honesty to say, first of all, that I know that the most reverend Primate the Archbishop of Canterbury and many other Bishops strongly support this particular Amendment, but I have thought a lot about this and the opinion that I have formed, I hope in good faith, is that I cannot support this particular Amendment. But I feel I must briefly explain the reasons which have led me to that opinion.
In a country like our own we have in many matters postponed the age of responsibility to far beyond the age of puberty, and this, I think, imposes a duty on society to deal very sympathetically with these cases when they arise. I cannot think that in all cases there would literally be a grave risk to the 540 health of the young pregnant mother, but what I do think is that there would be a very grave risk of a serious interruption of her education and normal development to maturity. Whether we have an abortion or whether we have an adoption, there will probably be in both cases some traumatic experience, but, for myself, I feel that the shorter of two processes is more likely to be beneficial than, or at any rate not so harmful as, the longer. So, with a great deal of regret on this particular point—and I think this is the only one in the list of Amendments to which this applies—I feel I have to differ from the noble and learned Viscount.
§ 6.50 p.m.
§ BARONESS SUMMERSKILL
I should like to welcome the speech which we have just heard. On other occasions I have been highly critical of some of the right reverend Prelates, but on this occasion I am delighted to have heard the speech to which the Committee has just listened. We have already debated this question, and, as the noble Viscount quite rightly said, I have already made a contribution, which I am reluctant to repeat. But this is such an important Amendment that I think we must give some time to debating it.
I would remind the Committee that we are now discussing the plight of girls of under 16—and next year girls of that age will still be schoolgirls because, as I have said before, we are raising the school-leaving age to 16. If we were debating this next year we should be saying: Should we give a schoolgirl the right of abortion? There is no compulsion here; no girl is compelled to have an abortion. Should we give the under-16 (and some girls are now having babies at 13), the 13, 14 or 15-year-old girl, the right to abortion? I should like to remind your Lordships of Alec Bourne who risked his whole professional career when he aborted a girl of 14. One cannot say that when that happened the country was condemnatory; on the contrary they admired the courage of that man who was prepared to risk the whole of his career, rather than see a little girl of 14 made a mother—the mother of an unwanted child—many years before her time.
I feel that this Amendment is punitive; for unless the girl's life is in danger she 541 is condemned to carry the burden of an illegitimate child all her life. I cannot agree with the noble and learned Viscount when he says that there is no stigma. We know that many of these young mothers are hiding themselves in London and the big centres of population. Why do they do that if there is no stigma? Why not remain, say, in Ireland? I say this because we have had to send a special officer from the G.L.C. to Ireland, in order to arrange the adoption of some children, born here, of Irish girls. If there is no stigma, why do they hide in London? If there is no stigma, why does a landlady refuse to accept a girl with a fatherless baby in her arms? It is nonsense for the noble and learned Viscount to say that there is no stigma. The stigma is as great now as it was in the last century, and in the century before that.
The right reverend Prelate mentioned school. I have said that this Amendment is punitive. Let us see how it affects the girl of 13, 14 or 15 who is to have her baby next year, when it will be compulsory for her to stay at school until she is 16. Will she be denied further education? What is to happen to the baby? I am not being frivolous when I ask, what is the girl to do with the baby? Is she to push it to school, and perhaps try to get it into a nursery in the neighbourhood, as perhaps her mother, and other working mothers, do with their babies? And has this little girl to make all these arrangements for herself and for her child? We must he realistic and think in terms of the child, born in poverty-stricken circumstances, who has this baby and is compelled, while herself still a child, to make all the arrangements for it.
The noble and learned Viscount said that he had consulted a gynecologist. He read out a letter from a gynecologist. Gynaecologists are concerned only with the mechanics of obstetrics. No doubt the gynecologist is right in saying that the pelvis of the average girl of 14 or 15 to-day will permit a normal confinement. The reason it will permit a normal confinement is that she has been adequately fed, and there is very little rickets in the country. Rickets is a nutritional disease. In the old days it was very serious, and a rickety mother often had difficulty at confinement. The noble and learned Viscount was told by the gynæcologist, 542 who is there to assess all these possibilities, what are the chances of a girl surviving the confinement. He knows the chances are quite high.
But are we here only to discuss the anatomy of the girl of 13, 14 or 15 and the details of her delivery? What of the immaturity of the girl's mind? The right reverend Prelate has already mentioned that she is not granted by the State any of the privileges which are given to her older sisters; and that she will not even be able to vote until she is 21. We are here discussing motherhood. Are we treating this child as an animal bearing its puppies or are we concerning ourselves, as we should, with her psyche and her ultimate welfare? Are we going to say, as the noble and learned, Viscount had just said "Let her have a baby; let it be adopted." I could scarcely believe that I heard that phrase from the noble and learned Viscount.
§ VISCOUNT DILHORNE
The noble Lady has attributed to me personally a quotation that I read, to the effect that there was to-day little social stigma. I do not mind the noble Lady attributing to me views which I had not personally expressed; but I ought to make it clear that I was quoting from a letter.
§ BARONESS SUMMERSKILL
The noble and learned Viscount and I have considerable experience in both Houses. Neither I nor he would quote a letter in support of a case if we did not believe what the letter said. We have been told, in the letter by the gynecologist and by others, that the thing to do is to let the child of 13, 14 or 15 produce a baby and then get rid of it as quickly as possible. Only a man could say that—only someone who has never been pregnant. The maternal instinct, the desire for procreation, in a woman is so great that to tell her that all she has to do is to produce a child and then to give it away is really the acme of cynicism.
I ask the Committee's forgiveness for becoming a little impassioned on this question. This argument we have heard to-day would be paralleled by asserting that every youth of 14 or 15 who is capable of sexual intercourse is fit to assume parenthood—that he is fit for 543 parenthood, with all its attendant responsibilities: to find a home at 15; to earn sufficient money to ensure his and his child's present and future wellbeing. Would the noble and learned Viscount like to see his child, a boy of 15, saddled with a baby which he had to find a job to keep, and so be denied his education? Yet this is the treatment to be meted out to the girl. She is expected to carry this burden: to find a home; to keep the child.
I ask noble Lords to envisage the picture. When the noble and learned Viscount was speaking, I felt that he could be thinking only of a girl from a poor home, a girl accustomed to hardship. That is why he argued that she is used to a tough life, she is used to poverty, she is used to hardship and she will manage to weather this. I would ask the noble and learned Viscount whether, if a 15-year-old girl in an expensive boarding school were to be impregnated by some lout hanging about the school, he would be equally happy about the situation. I know exactly what would happen to her. She would be whisked away to a discreet nursing home where the pregnancy would be terminated. But the friends of some of the less well-off girls, these 14 and 15-year-olds of whom we are speaking, may be equally solicitous and would busy themselves with finding a back-street abortionist for her. Last week, after being passed by a free vote in this House, the original paragraph (c) was deleted. Last week's vote was manipulated. Never before, in the whole of my Parliamentary career, have I seen a vote manipulated as was the vote last week, after the paragraph had been deleted by a free vote, with a majority of 25. By accepting this Amendment to-night we should ensure that the evil we have sought to eliminate—the back-street abortion—was still with us.
§ 7.1 p.m.
§ BARONESS GAITSKELL
I wish to support my noble friend's Amendment No. 6, and to speak against the Amendment to the Amendment of the noble and learned Viscount, Lord Dilhorne. However physically mature a girl of sixteen is, I do not believe that it is desirable that she should become a mother unless she wants to. The Amendment to the Amendment further weakens the Bill, 544 which is a very small advance towards liberalising our attitude to abortion. In fact, it would put on the Statute Book only what is current medical practice to-day.
I have not spoken in this debate so far, because I should have liked to see a very different Bill passed in your Lordships' House. I strongly hold the view that the decision as to whether a woman should or should not have a child is not only the woman's right, but her birthright. The noble and learned Viscount has said that such a Bill would not have a chance of being passed in this House. That may be so, but it does not reflect any particular credit on this House. The reasons are purely biological. If the sex ratio of men and women in your Lordships' House were reversed, I believe that such a Bill would stand a very good chance. I am a fairly mild feminist. I should not wish to die on a battlefield for equal pay. But I hold the view on the use of all contraceptive methods, including abortion, in the early months, when it is necessary, and if done under proper medical conditions, that it is the woman's right to decide. Of course, I do not speak of those whose religion precludes them from all this.
The noble and learned Viscount has enlarged on the risks of abortion generally. But the right of decision for a woman also includes the right to take the risk, if she so wishes. After all, one may consider that a pregnant woman risks the life of an unborn child when she goes for a ride in a car these days. Listening carefully to all the arguments about the sanctity of human life, I still found them a little hollow. Quite apart from the fact that we are often so profligate about sending men to be killed in a war, I do not believe that society gives its blessing either to the unmarried mother or the illegitimate child. They are still the outcasts of our society and all we do to help the mother is to try to take the child away from her. So, as this Bill does not go really very far to humanise and civilise the law on abortion, and whilst I think that it will not do very much to stop back-street abortions, I am against any Amendment which will further weaken the Bill and I do not support the Amendment to the Amendment.
§ THE EARL OF IDDESLEIGH
I hope that I may be useful to the noble and learned Viscount, Lord Dilhorne, if I tell the Committee of a solution which has not yet been mentioned, and which is by no means uncommon in the country village. In these communities, if a girl has an illegitimate baby, especially if she is very young, it is customary for the grandmother of the child to take the child and tell the village that it is her own youngest child. The village is not in the least deceived, but being right and sensible people, the villagers accept the convention and the mother of the child helps her mother to bring up her child, which she calls her little brother or sister. I have known this happen in a highly educated family, whose daughter became pregnant while at boarding school. I do not think that that solution is practised as much as it should be, but it is the humane and good solution in all these cases.
On this question, I wonder whether we could have some survey of psychological opinion. I am informed by authorities I trust that many psychologists consider that the termination of pregnancy in such a girl will have a bad psychological effect. The school girl who gets into trouble is frequently a girl who suffers from personality defects. She is the unsuccessful girl, who has never made much success of her schooldays. She is now going to produce something. It is held by some that the final discouragement of the termination of her pregnancy—saying to her that this is one more failure on her part—might have a discouraging and had effect on her psychological future. I do not know whether psychological opinion is much represented in this House, but I hope that before the Bill is re-introduced there will be an opportunity to find out what psychologists say of the effect of termination upon such a girl.
§ 7.9 p.m.
§ LORD CONESFORD
I do not wish to intervene on the main question here, but I think that the noble Baroness, Lady Summerskill, made some comments which should not go without any reply. She said, about an Amendment proposed by the noble Baroness, Lady Wootton of Abinger, and argued at great length in this House and decided by a Division in a very full House, that the issue was manipulated. That is an accusation against this House. Had it been made in 546 another place, it would have been wildly out of order, but I do not think that even in this House it should pass without protest.
I have on occasions supported the noble Lady. I respect her deeply. I know with what sincerity she speaks. But I would suggest to her that she should do what all of us have to try to do—that is, credit with humanity and sincerity those who take views different from those we take ourselves. I am one who opposed the inadequate mother clause, both on the Committee stage and on the Report stage. I thought that there were overwhelming reasons against it, which I endeavoured to put to the Committee and to the House. But there were a number of noble Lords who voted one way on the Committee stage and another way on the Report stage. One perfectly honest reason may have been that they were actually convinced by the reasons advanced by the noble Baroness, Lady Wootton of Abinger. This House is not manipulated if it listens to the noble Baroness, Lady Wootton of Abinger. Many of us believe that she is one of the people supremely worth listening to.
§ BARONESS SUMMERSKILL
When the noble Lord says that I could not possibly say it in another place, he knows as well as I do that such a thing could not have happened in another place.
§ LORD CONESFORD
Indeed it could. I had some twenty years in the other place, but I do not know whether that was as long or longer than the period when the noble Baroness was there. But I assure her that it could happen. It is not at all unknown there for something decided in Committee to be reversed on Report.
§ 7.12 p.m.
Not for the first time I feel in some difficulty here, because I do not want to be more out of order than the noble Baroness has been accused of being; but I comfort myself with something that the Leader of the House once said: that it is almost impossible to get out of order in this House. As there have been some very general issues raised in this debate, I would put myself in your Lordships' hands and ask whether I might make some comment on those issues, which I think are important, 547 because the whole point of debating this Bill at the moment is, I think, to shed what light we can on it, even if we say things now which could possibly be better said on Third Reading, if only because it gives an opportunity of their being, knocked down.
What I want to say is that, without being a doctor or a lawyer, I would support this Amendment of the noble and learned Viscount, Lord Dilhorne, on this ground. It seems to me that doctors in ordinary cases are expected to judge only on questions of health. They may judge right or wrong; but we all put our lives in their hands, and, so far as I am concerned, I do not think I can praise too highly those whom I have known.
But in this case they are also being asked to make a decision on a question of law, and if it is not out of order, or wasting your Lordships' time, I would ask whether anyone noticed a letter which appeared in theBritish Medical Journalrecently, giving the view of a large number of gynecologists who were circulated in the Birmingham area. It appeared on February 5. They were asked by the gynaecologist who wrote the letter whether they approved of the general principles of this Bill; if they thought it would help or hinder in the task of clarifying the law. Your Lordships, if you wish, can of course read the letter for yourselves, but the last but one paragraph of the letter said:It seems doubtful whether most British gynecologists would alter their present practice however the laws relating to abortion were to he liberalised, and they would wish to retain the right to be personally responsible for the final decision.The cases for and against the Bill were set out in that letter, and gynaecologists were asked to give a decision under four heads: whether they were in agreement with the memorandum which was against altering the law, and would have their names used; whether they were in agreement with it, but preferred their names not to be used; whether they were in agreement with it with modifications; or whether they were not in agreement. The answers given in that letter were discouraging to me as to the clarification effected by this Bill, because 3 said that they would like the law to be altered, 548 10 said that they preferred it to remain substantially the same, and 55 said that they did not want it altered and thought it was best as it is. That is not offered as evidence, of course; but I think the letter is worth looking at, if only because, although the noble Lady said they were concerned only with obstetrics, they are the people who, on this subject, want to know what the law is. With respect, I should have thought that the view of lawyers on the point of clarifying the law was worth listening to.
It is difficult in a debate like this, when we have ranged at tremendous lengths over this difficult subject, to cut down anything one has to say. I would only say—and I would not say this if I did not rely on the noble Baroness's maternal instinct; because I think she has a great kindness towards immature and undeveloped people—that it seems to me that a crucial point is raised here which has not been discussed enough. It is that we are not concerned only with the mother. The question is: are we also concerned with another living human being? The general view of many people is that to regard a foetus as a living person with any rights is so absurd that it is not worth discussing. If I were to say that I always understood that the Anglican teaching was that "children and the fruit of the womb are a gift that comes from God", I should be thought to be highly superstitious. If I said that they are something that we do not well understand, and cannot produce ourselves artificially, I think I should be on safer ground. We do not understand our children. We do not understand, if one is killed, how to replace it. If it is said that no scientist has ever suggested that a fœtus is a human being from the word "Go"—and I use the phrase "the word Go" deliberately to mean a word of command from something (whether you call it God or Nature may not matter, any more than whether the noble Lady, who does not believe in the soul, does believe in the psyche) but from the word "Go" something happens which causes the thing to live—then I should like to read to your Lordships three short extracts from a talk that was originally delivered by a scientist who is a lecturer in anatomy at Cambridge. It was delivered to the Newman Society, and was 549 published afterwards in theMonthfor January, 1964. The seven lines I wish to read are these:Of course, if we study the development of the embryo with modern techniques of microscopy, we know that it can properly be called 'human' right from the time of conception …. The fertilised human ovum contains all the genetic instructions, the principle or organisation, of 'form' in the Aristotelian sense, that will result in its developing precisely into Tom and not Harry."—that is to say, the individual and not merely one of human species.The genetic endowment, conferring individuality on the developing organism, survives, in experimental animals, even the transfer of the embryo from the natural mother into the body of a foster mother.A technique for that is being done. That is not put up as a suggestion of Papal infallibility; it is not presented as a Papal Bull; but what is sauce for the bull is sauce for the bulldozer, and there is a certain tendency to bulldoze your Lordships into assuming that we are not concerned at all with a third party.
The noble and learned Viscount, Lord Dilhorne, 'has frequently brought' out that this is an extremely serious thing to do—to take a potential life of a potential human being. I do not entirely understand the word" potential". But I feel that some alternative view ought to be given. If an embryo from the word "Go" is not a human being with rights, I should be very interested to know what it is. We have had a view from the noble Lord, Lord Soper. I read it very carefully and I cannot at present say that I have found it very helpful—perhaps because I found it difficult to follow.
The noble Baroness Lady Summer-skill gave a concise answer. She put it in the form of a counter-question. She said: How can you compare a fœtus to an adult educated person? That is the question which I think ought to be answered. I can only answer it in this way. I should compare them in the same way as I compare myself to the noble Baroness. On the face of it, there are a good many differences of opinion; and even when we go into the same Lobby it is often with a different point of view. Certainly we appear to have one thing in common; I believe that we are the only two Members of your Lordships' House who are capable of being shocked by an Anglican Bishop; but as we are shocked in different directions, by dif- 550 ferent Bishops, that in itself is not a sign of resemblance.
On any ground of utility—I was going to say" beautility"—in this comparison I should be left with very much the short end of the stethoscope, or whatever instrument doctors use for these purposes. But the one thing we really have in common is that, so far as I know, we were both begotten by a man on a woman and successfully avoided (in one case deservedly) being aborted. That is something we have in common with each other, and with the rest of your Lordships, but not with an amoeba or a tumour, or an inflamed appendix or an Avocado pear, or any of the other things which the noble Baroness, in full lyrical flight, is so brilliant at bringing out, if I may say so a little unfairly, to discredit the fœtus; because the fœtus is already handicapped, and I am speaking as one who is probably nearer to a fœtus than any of your Lordships, in that I am probably less developed. It is handicapped by its name.
I mean that quite seriously, because often when we think in terms of words I believe that we are apt to be confused. I should like to give one illustration of that. There is a verse in the Psalms:Thy word has been a light unto my feet and a lantern to my ways.We may think that is nonsense, or sense; but nobody can say that it is undignified or that if one quotes it one is trying to be funny. If I slightly altered one word and said:Thy word has been a lantern unto my fœtusI should be accused of making a very bad joke in very bad taste; because the word "fœtus" is comic; because it is a scientific word. If one thinks what these two words mean, why should it be comic to suggest that there is Divine guidance for the whole of a human being in an undeveloped state, and not to suggest there should be guidance for a part of it on which it progresses here and there? I think that is a subject for thought which is worth going into.
My feeling is that, as the whole purpose of this debate is to throw light on these things, I will not detain your Lordships any longer because it would take much too long to go into them further. But Light is not only a word 551 which is used in the Bible for Life; it also symbolises consciousness; and that is a kind of light which, as the noble Baroness knows, when consciousness has been" knocked out", can be restored. Light in the sense of Life is a thing that cannot.Put out the light, and then put out the light:If I quench thee, thou flaming minister"—and I think it is not necessary to remind your Lordships that Othello in Shakespeare's play was not talking to any member of the Venetian Cabinet, but to a candle by the light of which he was proposing to extinguish a life, as he thought on excellent grounds, though he discovered afterwards that the evidence was not good enough.If I quench thee, thou flaming minister,I can again thy former light restore,Should I repent me: but once put out thy light,Thou cunning'st pattern of excelling nature "—
§ LORD STONHAM
May I interrupt the noble Viscount for one moment? Is he aware that we are discussing the somewhat narrow point of whether paragraph (c) should be deleted from the Bill?
I fully realise that, and I apologise to your Lordships for being carried away by the eloquence of the noble Baroness, Lady Summerskill, on these points. The point of the quotation is that that sort of light-life cannot be put back again.I know not where is that Promethean heat That can that light relume.My Lords, until we know that, we ought to go very carefully indeed.
§ LORD RAGLAN
I have only one small point in support of the noble Lord, Lord Silkin. A young girl under 16 is supposed to be protected by law, and yet we say that she has no right to a remedy if she conceives. I see no point in having one law which is meant to protect, and another law which ignores the damage if that protection fails.
§ 7.23 p.m.
§ LORD STONHAM
I do not wish to express any opinions at all on the matter 552 before the Committee, but in view of some of the things that have been said I think we should get back to a few facts. One is that nothing in my noble friend's Amendment would compel any child to have an abortion. I think it is necessary to say that, in view of the suggestion made by the noble Earl, Lord Iddesleigh, that it might have a bad psychological effect on a child if a pregnancy was terminated, and that she might think that this was just one more failure. No responsible doctor would wish to terminate a pregnancy if the girl did not want it. Another fact is that we are considering children under 16.
§ THE EARL OF IDDESLEIGH
We are considering, after all, a poor little girl who has got herself into a scrape, and who can be made to do what her elders tell her. I do not think the question of the girl's consent is really very significant. We have to act in her interests and consider what the psychological effect would be on her, and not what she wants to do.
§ LORD STONHAM
That is how I understood the noble Earl's point. The second point I want to make, which has not been made in the debate so far, is that we are talking about children under 16 who are pregnant, and who cannot in law give consent to intercourse or marry. Therefore it is highly probable, if not certain, that they must have been the subject of an offence; otherwise they would not be pregnant. These are the children we are considering in this Amendment. As the right reverend Prelate said, it must have a major effect on the life of such a child if she is going to have a baby.
The noble and learned Viscount rightly said that an abortion is an operation. It could be a very serious operation—one would not dispute that—but I think the figure for the death rate from therapeutic abortions is about one in 1,500, whereas the death rate for all gyæecological operations is one in 300.
§ VISCOUNT DILHORNE
I asked the noble Lord on the last occasion if he could give me some figures as to the numbers who had died during this last year from operations in connection with the termination of pregnancies, in National Health Service hospitals.
§ LORD STONHAM
The number for a period of three years up to the year 1963 were five, and from that we get the average of one in 1,500 of therapeutic abortions. With regard to the termination of pregnancy, that would be for a variety of causes, and the deaths from such operations in 1961 were one in 700 as compared with one in 300 for all gynecological operations. I merely mention this lest noble Lords might think that there is a greater danger to a child in having such an operation than not having it.
One other point should be mentioned. My noble friend Baroness Summerskill assured us that in a child of 14 or 15 her pelvis was such, in these days of better feeding and better health, that she could safely bear a child. The really important thing is not whether she can safely hear a child because, as the noble and learned Viscount has pointed out, if she could not do so she would be covered by paragraph (a). The important thing is whether she, and perhaps her parents, feel that in all the circumstances of her pregnancy and its likely effects on her future life she should have her pregnancy terminated. As I told the House in Committee before, if the House wants a provision on these lines then the Government see no practical objection to it.
There is one last technical point which I might nut to my noble friend Lord Silk in. It is that the words inserted by his Amendment, if they are accented, will not appear as paragraph (c) of Clause l but as a "full-out" provision after paragraph (b). The reason is that the cases of the defective and the under-16 cannot properly appear on the same footing as paragraphs (a) and (b), which are governed by the words in Amendment 1. These are:if the practitioner is of the opinion, formed in good faith, that the termination of the pregnancy is necessary on any one or more of the following grounds,".These words imply that it is a matter of medical judgment whether one of these grounds justifies an abortion in a particular case. But in the case of the defective or the under-16 it is more appropriate that requirement should be that the practitioner should be of the opinion, formed in good faith, that the pregnant 554 Woman is a defective or became pregnant while under the age of 16.
§ 7.33 p.m.
§ LORD SILKIN
I do not think the House wants to prolong this discussion very much longer. We had a debate on this subject in Committee. On that occasion the noble and learned Viscount put down a similar Amendment but did not press it to a Division. I do not know whether he feels more strongly about it this evening than he did last time, but we went into all the pros and cons of this subject and I do not propose to do so again.
I just want to deal with one point which he made. I gather he was not unsympathetic to the girl under 16 who has conceived having an abortion. What he is objecting to is that she should have it as a matter of course, on demand, simply because she is under 16. But is that so? Even under this Bill as drafted that was not my view. My view was that she should be able to ask for it because she is under 16 but it would still be for the two doctors to decide, and if, as the noble and learned Viscount suggested, there should be grounds why it would be injurious to her health to have an abortion, and the doctors take that view, then they would have every justification for not allowing her to have an abortion. Therefore I do not feel that is in itself a reason for objecting to this provision.
On the last occasion I put to noble Lords a frank personal question. I asked them whether, if this girl under 16 happened to be their own daughter, they would not move heaven and earth to get an abortion somehow, and I pointed out that they would not mind whether it was under paragraph (a) or any other paragraph. I cannot imagine any noble Lord, not even the noble and learned Viscount, if he has a daughter, allowing that daughter's pregnancy to go to term and her giving birth to a child if he had an opportunity of getting her an abortion. I would go further and say that if noble Lords in this House could not get it in the normal way they would use every means of getting it. I feel is is quite wrong to have two different standards: one for what we should do in our own personal lives and the other that we are going to prescribe for other people.
555 If the noble and learned Viscount is not satisfied that the two doctors could refuse an abortion because it would be injurious to her health, I am perfectly prepared to give an assurance that I will consult medical friends and others and see whether some provision of this kind might not be introduced into the new version of my Bill which I hope to introduce at the beginning of the next Parliament, and provide that, in considering this, the doctors have to take into account what would be the effect on the health or mental condition of the girl under 16. As that is the main point raised by the noble and learned Viscount, I hope that with that assurance he may be satisfied that the clause can now go through, as amended by me.
§ VISCOUNT DILHORNE
I have listened to this debate, which has covered a wide field, but I really did not think that a speech I made was capable of the gross misrepresentation which the noble Baroness, Lady Summerskill, gave to it. I am extremely sorry that she did. She introduced a new note into our debates. I hope it will not be repeated. I am also sorry that the noble Lord, Lord Silkin, has sought to raise personal questions in regard to noble Lords' families. If he really wants to know, I have two unmarried daughters, one under 16. He posed the question whether if she became pregnant I would move heaven and earth to secure an abortion for her. I would say this to him, and this is my approach to this matter: if she did become pregnant I would regard it as a tragedy, and if that tragedy occurred I should certainly want to see that she had the best possible advice and help—but that does not necessarily mean abortion.
The noble Baroness, Lady Summer-skill, speaks as if an abortion was of an absolutely trivial character. She does not have any regard to the psychological consequences to the child. She talks about deprivation and the effect on the maternal instincts if the child is adopted, but she does not talk about the psychological effect if the pregnancy is terminated. Lady Gaitskell's approach was of a very different kind, and I sympathise with, although I do not share, the point of view which she expressed. It is certainly an arguable proposition that a woman should not have a baby unless 556 she wants to. But in assessing all this we must, I think, have regard to the risks involved. What the noble Lord, Lord Stonham, said really supported what I said on the last occasion about the risks. There have been, he says, in the last five years, or three years, five deaths, with this operation perfectly properly performed. I think I am right in saying that in the last year alone there have been three, and I am not in the least shaken myself by the knowledge that when there have to be gynecological operations for health reasons the death rate is one in 300. Here we are considering cases of young people who are pregnant and saying they must have the right to run the risk of this operation involving that particular death rate.
But of course it is not only the death rate that is the consequence. The noble Baroness, Lady Summerskill, did me a great injustice when she tried to represent that I was thinking of a girl from a poor home accustomed to hardship. Then she said that with a 15-year-old schoolgirl we all know what would happen here. That is not my approach at all, and there is nothing I said which would justify that kind of observation, which I greatly resent. My approach is quite different. Here we are concerned with health, and it is a very narrow issue; because the 13-year-old, the 14-year-old and perhaps the 15-year-old would almost certainly come under paragraph (a), where the doctor is required to balance the health of the pregnant woman before, at or after pregnancy against the risks of the operation. In many of these cases of pregnancy before 16, with all the emphasis about how in many cases it will be the result of a criminal offence, the confinement will be after 16 and it will be possible to marry before confinement takes place. But here what is proposed is that this special category should be put in a special position where, on proof of age, production of birth certificate, a doctor can say, "The law says that on that you are entitled to termination"; that is what this particular provision will provide. Think what the doctor's decision is going to be if he is convinced by the noble Baroness, Lady Summerskill, and others that this operation really involves no risk to health at all.
557 I am concerned that the doctors in their discretion should give the best possible advice, and I quoted from a letter of an eminent gyæecologist. He, of course, does not rely only on his opinion. It is no use the noble Baroness taking him as if he were concerned only with obstetrics. He has reports from psychiatrists and others upon these people. What I am trying to secure is a proper balance; not that someone will come along and say, "I am under sixteen; here is my birth certificate. Please abort me"; but that the doctor, without any pressure put upon him, shall have the right, as he will have under paragraph (a), to decide and do what is in the best interest of that unfortunate girl under 16. If you leave this Bill with paragraph (a) alone, that he can do, and in many cases he may think it right to terminate; in other case he might think it right and better for the girl to have the baby, and if she cannot bring it up to have it adopted. But each case will have to be separately considered. What I think is wrong is to put a provision in this Bill which prejudices the doctor's decision in favour of termination, because if you put in this para-
§ Resolved in the negative, and Amendment to the Amendment disagreed to accordingly.
§ [The Sitting was suspended at seven minutes before eight, and resumed at a quarter before nine o'clock.]558
§ graph (c) you are, saying that, by proving her age by production of a birth certificate, that is ground for abortion, taken by itself. I think this matter is adequately covered under paragraph (a), and I shall therefore seek to secure that effect is given to that view in this Bill.
Page 1, line 25, at end insert (" or that the pregnant woman is a defective or became pregnant while under the age of sixteen ").—(Lord Silkin.)
Amendment to Amendment moved—
leave out (" or became pregnant while under the age of sixteen ").—(Viscount Dilhorne.)
§ 7.50 p.m.
§ On Question, Whether the Amendment to the Amendment (No. 7) shall be agreed to?
§ Their Lordships divided: Contents, 21; Not-Contents, 26.557
|Amulree, L.||Dilhorne, V.||Iddesleigh, E. [Teller.]|
|Atholl, D.||Falkland, V.||Newall, L.|
|Audley, Bs.||Ferrers, E.[Teller.]||Oxford, L. Bp.|
|Barrington, V.||Forster of Harraby, L.||St. Aldwyn, E.|
|Brain, L.||Furness, V.||St. Just, L.|
|Conesford, L.||Grenfell, L.||Waverley, V.|
|Craigmyle, L.||Hereford, V.||Ypres, E.|
|Champion, L.||Latham, L.||Silkin, L.|
|Colwyn, L.||Leicester, L. Bp.||Southwark, L. Bp.|
|Effingham, E.||Molson, L.||Stonham, L.|
|Gaitskell, Bs.||Morrison, L.||Strabolgi, L.|
|Gardiner, L. (L. Chancellor.)||Peddie, L.||Strange of Knokin, Bs.|
|Greenway, L.||Plummer, Bs.||Summerskill, Bs.[Teller.]|
|Henderson, L.||Raglan, L.||Wellington, D.|
|Hurcomb, L.||Segal, L.||Winterbottom, L.[Teller.]|
|Lambert, V.||Shepherd, L.|
On Question, Amendment agreed to.
§ 8.45 p.m.
LORD SILKINmoved to add to the clause:
( ) Except in a case where the practitioner is of the opinion, formed in good faith, that the termination is immediately necessary in order to save the life of the pregnant woman (and certifies his opinion in writing either before or after carrying out the treatment), the following conditions must be complied with
in connection with any treatment for the termination of a pregnancy, that is to say—
( ) In determining the matters referred to in paragraph (a) of subsection (1) of this section, a registered medical practitioner may take into account such circumstances, whether past, present or prospective, as are in his opinion relevant to his patient's physical or mental health.
§ The noble Lord said: This Amendment is designed to improve the drafting, but it is partly an Amendment of substance. I think that I can best serve the purposes of the Committee if I go through the paragraphs (a), (b), (c) and (d) very briefly and indicate where they differ from the Bill as originally drafted, or as passed in Committee on a previous occasion. Paragraph (a) is an alteration from the provision that there should be—
§ VISCOUNT DILHORNE
I do not know whether the noble Lord would forgive me for interrupting for one moment, but I think, speaking for two out of three Members on this side of the Committee, that there is no issue arising on the earlier part of this Amendment. The only issue arises as to whether Amendments to the Amendments Nos. 9 and 10 should be carried. So if it would help the noble Lord, he might save a little time on that.
§ LORD SILKIN
If that is the case, I will reserve what I have to say in the introduction to the Amendment, and move it formally.
Page 1, line 25, at end insert the said subsections.—(Lord Silkin.)
§ VISCOUNT DILHORNEmoved, as an Amendment to the Amendment, to leave out all words from the beginning down to and including "the treatment),". The noble and learned Viscount said: It might be for the convenience of the Committee at this late hour to consider together Amendments Nos. 9 and 10 to the Amendment. No. 9 is to leave out what I might call the emergency procedure provision. I myself have never felt that there was need for that, because I could not visualise circumstances in this country where it would not be possible to get the opinion of two medical practitioners of the character described in the Bill. I do not think it will have any application, but I will reserve. my position with regard to that and, if need be, move a later Amendment.
§ With regard to Amendment No. 10 to the Amendment, this is one to which the noble Baroness, Lady Wootton of Abinger, and the noble Lord, Lord Amulree, and I myself attach considerable importance. This operation is of a very different character from an operation conducted just for health reasons—
§ LORD SILKIN
The noble and learned Viscount interrupted me and said that what I had to say on the original Amendment was unnecessary. May I say to him that I am prepared to accept No. 10.
Amendment to Amendment moved—
Leave out from beginning to (" the") in line 5.—(Viscount Dilhorne.)
§ Amendment to Amendment, by leave. withdrawn.
§ Amendment to Amendment moved—
After paragraph (d) insert the following new paragraph—
( "( ) there has been before treatment an application in writing by the pregnant woman, or, if under sixteen years of age, of the pregnant girl and one of her parents or of the pregnant girl and her guardian for the termination of the pregnancy.")— (Viscount Dilhorne.)
§ On Question, Amendment to Amendment agreed to.561
LORD STRANGEmoved, as an Amendment to the Amendment, to add as a new subsection:
( ) Where a registered medical practitioner refuses to carry out treatment for the termination of a pregnancy, he shall immediately notify a female welfare officer, appointed by the local authority, of such refusal, and it shall thereupon be the duty of the welfare officer so far as practicable to secure the physical and mental health and well-being of the pregnant woman and of the child if born.
§ The noble Lord said: I would explain that, though my Amendment seems very simple, there is an implication behind it which I think is very important to this Bill; and I do not think that this part of the Bill has been touched on before. I shall try to illustrate what I mean by using the figures which have been bandied about at various times in this debate. I know that these figures cannot be accurate, because, of course, abortionists will not employ chartered accountants, and we must therefore assume what are the real facts. We must also assume that all women who require an abortion go to their general practitioners, and first ask them for an abortion before they seek out an illegal abortionist. I do not think that is true at all, but we cannot have any figures on this point and, therefore, we must assume that this is the case. We must also assume that all women go to their local general practitioner and consult him at all times. These assumptions are not quite true, but they are made in order to give an illustration.
§ The illustration I would give is this. If these assumptions were true, then at the end of the surgery queues throughout the country, on every day of the year, there would be a number of moist-palmed girls with drooping heads, and there would be a number of very worried old ladies who lived in a shoe. They would be waiting till the doctor came, and as the law stands at the moment he would be able to tell between 2,000 and 3,000 of them, "I can help you". If this Bill goes through (and it is very difficult to estimate this, because it is changing somewhat the ones who are going to get through and the ones who are not), all the women to whom it would be harmful to have a child would be given an abortion, and on these assumptive figures that would mean that to about 20,000 women the doctor could say, "I can help 562 you", while about 80,000 women would go out into the street with abortion and suicide in their minds.
§ My small Amendment introduces another factor into the Bill. The factor is that the general practitioner would be able to tell them, "You will be put in touch with a social officer appointed by the local council, and she will try to help you." I feel that this large number of rejected women who would not come under the Bill could be helped to a great extent by another woman. They could get some sympathy and they could discuss their case. But as things are at the moment, I do not anticipate that the social worker would be able to do very much good. I think that the majority of the women would slip through her fingers and would go off to an illegal abortionist. The only time the social officer would see these unsuccessful women would be when they crawled up to her and asked her to get them a bed to die in. She would not see the majority of them again. However, this would be a step in the right direction and, what is more, it would be a foot through the door for what I think to-day must be done. I do not think the question of the women who will not be qualified under the Bill and who must seek illegal abortion should be left standing, and this foot through the door would open the way to forming one day a legal bridge.
§ The noble Baroness, Lady Summerskill, has brought off a unique political double, and her equally brilliant daughter in the other House is pushing forward a Bill which I can honestly describe as a charter for the unmarried mother. If a legal bridge could be built between the Abortion Bill and the charter for the unmarried mother, and if the adoption law could be altered somewhat, I think it would form a flarepath which a great number of these women would accept, rather than seek out the illegal abortionist. They would have something offered them, in any case. But, of course, I cannot suggest this at the moment. I think that if I suggested the idea of forming a legal bridge between two Bills which are not yet law, and of altering an existing law which has given every satisfaction the way it is, the noble and learned Lords in this House might describe my legal bridge aspons asinorum;so I will not suggest it.
§ I believe in this so much; and I have stayed especially for two or three weeks, 563 not with the idea of keeping and boring your Lordships when you all want to go home, but because I believe in this thing, and I will try to explain what could happen if this legal bridge was ever erected. First of all, the foot through the door, for which I am asking to-day, would be established; and therefore these women would be in touch with female social workers. Such a worker would talk to them and would explain to them, first, what are, I think, the real dangers of abortion. The noble and learned Viscount, Lord Dilhorne, has given us some very interesting figures about abortion in this country and the effect it had concerning one gynecological ward, but we do not really know. In this country there are no real figures to tell us how effective it is and how dangerous it is. Owing to this lack of figures I think the average woman is inclined to tell her girl friend, "Abortion is just like having a tooth out"; but I do not think that that is the case.
§ The noble Baroness, Lady Summerskill, gave us earlier (I memorised the column: it is col. 1194 of Volume 270) a description of abortion in Russia. She visited, I think I am correct in saying, an abortion centre—I do not know how many there were—and according to the figures she gave us an abortion was being performed on a woman every 30 seconds through the working day, presumably, and through the working year. I do not suppose that in the history of the world any other country has ever performed so many abortions and, presumably, kept records of them. One result of it is that the Russians have abandoned or altered their law in connection with abortion. Now the Russians are very tough people. I have read about two people who sold pies which did not have in them the proper meat ration laid down by law, and who were hanged. Therefore, I think that what the Russians have done in altering the law means that it is dangerous. One has got to get it into one's head that abortion is dangerous—that is my view. Anyway, this social worker would explain to these women that it is dangerous and that they are taking a risk. She would then explain to them this legal bridge which I have outlined and which would take them down a sort of flarepath, under the umbrella of what I call the helpful State 564 in which we live, and lead them to adoption.
§ There is another point that I should make, which I have not heard mentioned in this debate, although it may have been referred to. According to the colonial reports, 10 per cent. of the women, after they had received abortion, were very sorry they had received it. They regretted losing their babies. On these figures, it would mean 10,000 women. I think that if this were put to these women, that they could take a choice of having a baby and having it adopted, a large percentage, especially of "the old ladies who live in a shoe", or some of the tougher of the sweaty-palmed girls, would take it.
§ But, of course, there would be a small percentage of girls who were terrified of what the neighbours would say, of the shame and so on, and in their cases it would depend on whether they fell among the right type of female social officers. If she was the right type—and this is what I should do if I were she—she would say," We will get you out of this place. We will put you somewhere else. Here is a wedding ring, slip it on and give yourself your own husband". Because so great is the mental torture these women go through that it is worth anything to correct it. So far as the actual adoption is concerned, whether it is good or bad, I would remind you that the noble Baroness, Lady Wootton of Abinger, gave us a case history of which she had knowledge, with which she was concerned and which was very effective.
§ Personally I rather wish that Mr. Charles Dickens could be here, or, failing him, Mrs. Harriet Beecher Stowe or Miss Florence Montgomery or Mrs. Molesworth. They could have written on this subject a wonderful Victorian tale. They could have told how this innocent babe was cast to a brothel-cum-off-licence-abortionist; then that she or he was adopted by criminal parents and turned out to be something likeEric or Little by Littleand led these parents into the sunshine outside, reformed, with piety in their hearts, in their Sunday clothes, with prayer books, and baskets overflowing with crusts and stale fish to give to the starving poor. It would have been a wonderful story. Actually it is true—without the stale fish and the crusts of bread.565
§ There is one point which is the wasp in the raspberry jam of my idea of the bridge; and that is that once a woman sees a child, or hears it call, it releases in her a very great number of interlocked hereditary instincts which go right back through our race and into the darkness beyond. Once she has heard the cry of the child she would try to seek it, she would even give her life for the child. So it would be essential that she should not see that child, otherwise she would chase it and probably find it and she would ruin the child's life, the adoptive parents' life and hurt her own. How that could be done is difficult if it could not be done at home. It is certainly very unfair to have it done in a hospital or in a private room.
§ If my legal bridge could ever be constructed—and I think something should be done for the rejected woman—I feel it would be criticised on the ground that it was a passport to immorality. That is about what it is—a passport to immorality. But we live in an evolutionary society and evolution takes place from time to time in our history and in that of other races. In this evolutionary cycle the automatic are triggered to run down everything established and old fashioned and put nothing in its place. Of course, the laws of morality act on these automatic people like a cloak waved to a fighting bull. They are not satisfied they have the thing down, but in the end they lose their instinct to tear things down and feel rather lost, as if they were trying to play football without rules. Non-automatic people build up the old morality laws much as they were before; but sharper, tighter and clearer. That of course is the object of this exercise, because it moves us another step in the evolutionary ladder.
§ I dare say people will criticise it on religious grounds, as religion runs through this Bill. It cannot help it. I personally believe that if this bridge were ever constructed, it would be pure Christianity. I trust that the right reverend Prelate will not think I am breaking in where Anglicans fear to tread. I think I may be a fringe Christian: but I think the "Man without a shadow" taught the recognition of moral equality; he recognised not only the established, the lucky, the physically strong, the easy-to-be-good; but also the 566 rejected, the despised and the outcast—the woman taken in adultery, the dying thief, the Pagan company commander, the local whore.
§ I would give a reason why I have been so persistent in mentioning this addition to the Bill at all. About twelve years ago a doctor friend of mine told me a case history that he thought that might interest me as a writer. You will understand that I am not trying to boast of my books; they are all out-of-date and unreadable to-day. However, the story stuck in my mind. The manager of a large hotel had reports of a girl who was said to be trying to commit suicide. He was a busy man. He turned a psychiatrist loose on her and the psychiatrist put her in hospital. She got the job of mending linen, and was given thread of a suitable colour and a new packet of needles. After a day or two the sister in charge noticed that the packet of needles was empty. After a certain amount of persuasion, the girl told her she had been swallowing them. She informed the doctor, who came and counted the empty tucks in the packet and estimated how many needles she had swallowed. He operated on her and left her in cotton wool until she recovered. The psychiatrist told him that the girl was the only child of a widow, who had been carefully brought up and this was the first time she had had a job away from home. Both agreed that the girl was perfectly sane and they thought she was rather a nice girl. The doctor was able to tell the psychiatrist that she was pregnant and had tried to obtain an abortion by swallowing the needles.
§ I did not know what to think of this. It was fantastic that in the 1950s a girl should be so ignorant that she did not even know the geography of her own body. Later, being imaginative, it worked in my mind and I tried to put myself in her position. I imagined that I went to an hotel with a man, received flattery which I had never had before, went out to a pub, had a few drinks, pretending to be like the rest of them, and then when the sexual impulse was aroused was unable to resist. Then, when she found out she was pregnant and the young man or old man knew, he probably cleared out. With all that, I can sympathise and understand; but when it came to the final 567 point, I felt that no man could realise the agony in a woman's mind which would reduce her to swallowing needles one by one over a period of days. After thinking it over for a good long time, I came to the conclusion that I could understand it and, for the first time in my life, I realised what the recognition of moral equality really meant.
§ If a legal bridge can be built one day, I believe that it will be for the first time in over 2,000 years that we have ever tried to put into practice the Christian doctrine of the recognition of moral equality. I thank the noble Lord, Lord Silkin, for bringing in this Bill, which has brought forward so many interesting and instructive speeches which form a good foundation for the future, and also for allowing me to say my piece. I trust that I have not confused your Lordships with my soap-box oratory on this simple Amendment, that the rejected woman be associated with the female officer appointed by the local committee. I trust that your Lordships will remember that there must be some solution for the women who want abortion and are not included in this Bill. I beg to move.
Amendment to Amendment moved—
At end insert the said subsection.—(Lord Strange.)
§ BARONESS SUMMERSKILL
I should like to support the noble Lord's Amendment. This is a modification of the Amendment he put down on Committee stage. After our rather heated discussions on who shall and who shall not be eligible for an abortion, this may appear to be a limited Amendment which perhaps does not deserve mention in this Bill. But the noble Lord has spoken about an important category of women who desperately hoped that they would be eligible under the Bill—namely, the married woman who already has a big family living in crowded quarters and with an uncooperative husband; the healthy single girl over 16 who is faced with the difficulties of being the mother of an illegitimate child. She also may go, sincerely believing that she will be eligible. and find that she cannot be accepted; and, as the noble Lord said, she will feel rejected.
We really cannot ignore the end products of this Bill, which is what these 568 women who do not qualify will be. Many of us have said, particularly after paragraph (c) was deleted—I said this in the last debate—that these women would not be deterred but would seek a back-street abortionist. I believe there are about 2,000 legal abortions, but there are 60,000 illegal abortions. These women, finding that they cannot be aborted legally, will, as I say, go to the back-street abortionist.
My noble friend suggests that at this stage these women should be put under the wing of some woman who is sympathetic, understanding and knowledgeable, who not only can be their friend, but can direct them to that particular welfare agency where they might be aided. I think, therefore, that this is an important part of this Bill. We are providing for people who come into the field of operation of the Bill, but who cannot have their needs met. I would only ask my noble friend, as somebody who knows the world, how this welfare officer can be injected into the situation. When the woman goes to her general practitioner, and he says to her, "You do not qualify", will he then reveal the fact that she is pregnant to anybody? She may not want it to be revealed. I want to say to my noble friend that the principle here is right. I cannot at the moment think how the mechanics would work, but the principle is absolutely right, and we should provide for these women who hope that the Bill might meet their case but who find that they cannot be helped.
§ BARONESS GAITSKELL
I am absolutely against this Amendment, because I think it is a gross infringement of privacy. I think that a lot of these women who go to a medical practitioner would not want that medical practitioner to notify anybody about the fact that they want an abortion. If we are to deal with this problem, surely the best way to do it is to proceed as the Swedes do. The stigma in Sweden is less. They have kindergartens and homes for the children. The mothers go out to work. And the mothers often marry again, because there is less stigma attached Is it suggested that we simply notify the welfare officer and allow the welfare officer to have the responsibility of caring both for the mother and for the child. My goodness! welfare officers are so few. Where are we going to get them? And where are we 569 to get those who are really sympathetic to this point of view? I do not know. Personally, I think this is not the way to tackle a problem of this kind.
§ LORD SEGAL
This is one of the occasions in which I find myself in total disagreement with my noble friend Lady Gaitskell. I cannot for a moment understand why there should be any infringement of privacy if a case of a pregnant mother is referred to a female welfare officer. Surely, these welfare officers are highly trained and highly skilled. They understand the position in which the woman finds herself, and they can be absolutely trusted to retain the confidence when it is made to them. I think it is most important that a pregnant girl, when she finds that she has been rejected by her own medical practitioner, or by a consultant in a hospital, should not be driven to one of two alternatives: either to carry on the pregnancy when she feels deep down that she is no longer able to carry on with it, or going to the back street abortionist.
What is a woman in such a position to do? She will say: "My own general practitioner feels that I have not a case to stand on. In his kindness of heart he has referred me to a hospital, and there the registrar or the consultant has endorsed his view." Surely the woman left in that position will try every means possible to turn somewhere else, to another doctor, perhaps to some other hospital which will take a kinder and more humane view of her difficulty. So what is she to do? To whom is she to turn? I think the opinion of this House and the country is united, at all costs, on trying to undermine the position of the illegal abortionist. Here, I think, is a supreme instance where a pregnant girl, left in this predicament, will find a satisfactory way out.
Let us remember this. Not every general practitioner is compelled to be on the midwifery list. He can often refer one of his own patients who is pregnant to some other doctor, a general practitioner, who may be having special midwifery cases of his own, but who also receives them from other doctors. In the same way, we have to realise that once this Bill is passed it is entirely permissive. There may be a great many doctors who may refuse, on religious or 570 conscientious grounds, to carry the provisions of this Bill into effect. Imagine the predicament of a pregnant mother, in some remote country district, where she has no other doctor to turn to, and where the whole area may be under the medical care of a partnership. What is she to do? There must be some way out for her to avoid recourse to the back street abortionist.
Therefore I earnestly hope that the noble Lord, Lord Strange, will persist with this Amendment and insist on carrying it through to a Division, so that a woman in this position will still have the alternative open to her in the terms of his Amendment. It says:… it shall thereupon be the duty of the Welfare Officer …"—that is a statutory duty imposed upon her—so far as practicable to secure "—I should prefer to say "to assist in securing", because it may not be within her means actually to secure—the physical and mental health and wellbeing of the pregnant woman …That takes her back to paragraph (a) of Clause 1, so that she does not have to despair if she is turned down by her own doctor or by her nearest hospital. In the same way that certain doctors have their own midwifery list, I hope the welfare officer will have her own list of doctors willing to perform an abortion on humanitarian grounds, where there is some justification for it, so that she can refer the woman to another medical officer who is more sympathetic, who has access, perhaps, to another hospital more in line with the Aberdeen method of approach to this problem, so that she is not left in despair and driven into the mercies of the professional abortionist and there is some way out of relieving her from her own trouble and her own predicament.
§ 9.18 p.m.
THE LORD BISHOP OF LEICESTER
I shall detain your Lordships for only a few moments, but there was almost a direct challenge from the mover of this Amendment to these Benches to answer the question whether or not there would be a religious objection. Of course, the opposite is the case. I think there may be some sociological difficulties to be straightened out. I am not absolutely 571 certain whether you can impose on the medical profession this social duty without, at any rate, knowing from them whether they are willing and able to bear it. But as far as the unmarried mothers are concerned, a large number of them are already put in touch with social workers, many of them, though not all, in connection with the Church, and before these laws are enforced at all there are those who are very fully occupied in trying to secure the physical, mental and spiritual wellbeing of those who find themselves in this predicament. I am a little alarmed at some of the things which have been said in the last few moments. The idea of a welfare service existing, so to speak, to make up for the deficiencies of doctors who do not think it right to perform abortions—
§ LORD SEGAL
If the right reverend Prelate will forgive me for interrupting, I think the implication of my remarks was not in respect of the deficiencies of doctors. The corollary often would be that the woman in this predicament, instead of being left to the single opinion of her own practitioner or of one hospital, would be able to obtain confirmatory advice from other similar sources to enable her to go on with her pregnancy with a much easier mind.
THE LORD BISHOP OF LEICESTER
That is putting it in a less questionable form, but in the way I understood it I thought some doctors might resent it very much if they thought there was a social welfare service to suggest better advice than they considered it right to give.
I think these questions would have to be considered before this Bill became law, but as this is a kind of trial run I think I could bring myself to vote for this Amendment, although I should have been much happier if it had been the duty of the medical practitioner to offer this service to his patients. I think that would be safer. Also I am a little surprised that the noble Baroness, Lady Gaitskell, should praise the Swedish example. I believe Sweden is the country with the highest suicide rate, and I think we should ask ourselves whether or not they have found the answer to all the social problems yet.
§ LORD STONHAM
The noble Lord, Lord Strange, has cast his spell again, and he has apparently persuaded all my noble friends that his Amendment should be accepted. The noble Lord's evocative imagery is such that at one time I thought I heard him refer to a legal bridge made of raspberry jam with a wasp in it. That is an impossible proposition, I know, but it gives an example of the spell-binding oratory of the noble Lord. I hope he will forgive me if I just examine one or two of the propositions and, as it were, get back to what he said in the Amendment, and not some of the constructions which have been put upon it.
I would agree entirely with what I think are the intentions of the noble Lord. I would agree entirely with what my noble friend Baroness Summerskill said about the predicament of the woman, desperately hoping that she might be eligible and finding that she is not. Then, as my noble friend said, the noble Lord has at least part of the answer, and the principle of what he wants to do is absolutely right: namely, that there should be suitable succour, advice, friendship and help for a woman in these distressing circumstances who finds that she has been refused an abortion under this Bill when it becomes an Act. It does not help her to be told that she does not satisfy the rules and regulations. She is still in such a condition that, as the noble Lord said, she might be driven to swallowing needles in the hope of ending her mental and physical torment.
When we consider these matters it is not a case of deciding intentions. When we put them into the Bill, it is not good enough to have intentions; we have to say what those words would mean if they were put into a Statute I would submit that, however much there is in practice, and there is a very great deal, to be said for a doctor in appropriate cases referring to a welfare authority any woman whose request for an abortion has been refused, there is unquestionably the point, put by my noble friend Lady Gaitskell, that there must be many women in such circumstances who would not wish that to be done as a statutory responsibility, so that whether they want it or not some other person is going to be told.
The noble Lord made some calculations. I was not quite able to follow 573 them all and I did not understand their basis. But it does seem to me that throughout our discussions on this Bill there has been a lack of knowledge of what goes on in our hospitals now. In the latest year for which I have figures, 1962, it is estimated that in our hospitals the rate of admissions for abortions had reached 72,400, which is 78.1 per 10.000 women in this country aged between 15 and 44. Out of that number some 2,800 were therapeutic abortions. Of the remainder, roughly 70,000, it is anybody's guess how many were inevitable abortions occurring naturally and abortions which may have been procured. I mention these figures because this is not something new, and also because our hospitals will be able to cope.
Another figure I may mention is the figure for Finland, where the position is rather more generous than it may well be if my noble friend's Bill becomes an Act. The most recent figures of legal abortions there show a little over 6,000–75.3 per 1,000 normal deliveries; they have about one tenth of our population. So again we get an idea of what might happen in this country.
Coming back to the point of the noble Lord's Amendment, that there shall be a statutory obligation placed on a doctor, when he has refused to perform an abortion under this Bill, to refer the woman to a female welfare officer who shallso far as practicable"—I do not quite know what that means—secure the physical and mental health and well-being of the pregnant woman …it does not seem to me a statutory starter. Nor does it seem necessary or desirable to make statutory provision for this. Surely it would be better, as I believe the noble Lord wants, for the matter to be left to the discretion of the doctor to take such action as he considers desirable in the circumstances of the individual case, having regard to the wishes and the needs of the pregnant woman. But on the grounds of impracticability, I hope the noble Lord will see that his Amendment, at least as it is framed, is not acceptable either to him or to anyone else. It is not appropriate to make statutory provision in this matter. For one thing, he does not provide in his Amendment any sanction for failure to notify. In all other matters in this Bill we provide sanctions, but he does not 574 provide anything of that kind. May I ask the noble Lord this question? He referred to the doctor refusing an abortion. Would he consider it to be a refusal if a doctor said "Certainly not" when a woman came to him and demanded an abortion which was illegal under this Bill when it becomes an Act? That is what his Amendment would mean.
However much I agree that these women, all women, should be given all possible help by all the social services, and however valuable this discussion may have been because it has shown up a need, I hope the noble Lord will agree that his Amendment, at least, does not meet that need and is not acceptable.
§ 9.30 p.m.
§ LORD SILKIN
I have great sympathy with the intention of this Amendment, but I do not think it will work. First of all, I think it quite wrong to put an additional burden, a compulsory burden, on the doctor immediately to notify a female welfare officer. Already we are putting considerable burdens on the doctor. We do not say which doctor, but actually in the Amendment there are two. We are already putting sufficient burdens on them. If they carry out an abortion they have to notify it to the medical officer of health, and I think this is putting a burden on them which may act as a deterrent. I am much in favour of bringing the social worker into this field wherever appropriate, and I would not accept the view that it is an infringement of privacy, except if the unfortunate woman is compelled, willy-nilly, to be interviewed by a female welfare officer. I think she herself ought to have some discretion as to whether she wants to be interviewed by a female welfare officer, and should not have it decided for her.
If the noble Lord is prepared to accept my assurance, I should like further to consider in what way we can bring the welfare officer into the picture in appropriate cases. I do not think it is appropriate in all cases. As I have already indicated, it is my intention to introduce another measure immediately after the reassembly, when I should certainly take into consideration the views that have been expressed about the possibility of bringing the female social welfare officer into the picture in appropriate cases. If 575 the noble Lord is prepared to accept that assurance from me, I hope that perhaps he may feel willing to withdraw this Amendment.
§ LORD STRANGE
I thank the noble Lord and the noble Baroness who have spoken on this question. I am most sincere about it and would like to press the Amendment. I will tell your Lordships why. When the Bill gets to the
THE DEPUTY CHAIRMAN OF COMMITTEES
As it appears that fewer than 30 Lords have voted, in accordance with Standing Order No. 51 I declare the Question not decided and, pursuant to 576 Report stage it can be altered, and things can be put into it; but I should not like to see it leave the Bill for ever, because I think the idea is basically right. Therefore, I am pressing my Amendment.
§ 9.37 p.m.
§ On Question, Whether the said Amendment to the Amendment (No. 11) shall be agreed to?
§ Their Lordships divided:Contents,7;Not-Contents, 10.575
|Effingham, E.||Segal, L.||Summerskill, Bs. [Teller.]|
|Greenway, L.||Strange, L. [Teller.]||Ypres, E.|
|Brain, L.||Molson, L.||Stonham, L.|
|Colwyn, L.||Raglan, L.[Teller.]||Waverley, V.|
|Gaitskell, Bs.[Teller.]||Silkin, L.||Wellington, D.|
§ the Standing Order, the House will now resume.
§ House resumed accordingly.
§ House adjourned at seventeen minutes before ten o'clock.