MEDICAL TERMINATION OF PREGNANCY BILL

HL Deb 26 July 1967 vol 285 cc981-1103

4.36 p.m.

House again in Committee.

LORD SEGAL moved, in subsection (1)(a)(i), after "involve", to insert "serious". The noble Lord said: With the permission of the Committee and in order to save time, because I feel that a great many of your Lordships are anxious to get on to Amendment No. 7 at the top of page 2, I should like to be allowed to combine Amendment No. 4 with Amendment No. 6; and if the noble Baroness, Lady Wootton of Abinger, agrees it might be the will of the Committee that Amendment No. 5 should also be included.

As doubtless all your Lordships will be aware, the insertion of these two qualifying words has been the subject of long and exhaustive debates in another place, but I hope that in this instance my noble friend Lord Silkin will agree with me that these two words did find a place in both of his Abortion Bills which were passed through all the stages in this House. If this Committee does not insert the word "serious" before "risk to life", if it does not insert the word "grave"—which is merely a paraphrase of the word "serious" before "injury", what we are then sanctioning is that any doctor will be fully entitled legally to terminate a pregnancy where only a very slight risk to life may be involved and where only slight injury may be done to the physical and mental health of the pregnant woman.

I do not wish to detain the Committee very long at this stage, but among the slight risks to the life of the pregnant woman one would mention the risk of death to the mother by giving an anaesthetic during childbirth. It is a risk which is certainly present in childbirth, but, fortunately, it is very slight. But is it the will of the Committee that the possibility that the mother may need an anaesthetic during the course of labour should justify a doctor to terminate a pregnancy? There is also a risk of hæmorrhage and septicæmia following upon childbirth. As my noble friend Lady Summerskill has so often reminded your Lordships, there is a risk to the life of the pregnant woman if she has been taking a contraceptive pill during the period before her pregnancy. These are risks, fortunately very slight, but nevertheless risks of which we must be made aware.

Similarly, with the slight risk of injury. Here my noble friend Lady Wootton of Abinger desires to insert the word "prolonged" before the words "injury to the physical or mental health of the pregnant woman". An injury may be prolonged, but nevertheless it may be only a slight injury that is prolonged. Many of us, as we see by the plaster casts one or two noble Lords opposite have been wearing recently, have suffered prolonged injuries, though, fortunately—I hope I am right in saying this—slight injuries. Nevertheless, they have been able to give their full attention to the work of the House. That is one of the slight risks that may be involved; and, if I may say so, a risk of slight injury probably occurs in the majority of confinements.

There is the risk, as we all know, of perineal lacerations. There is a type of injury inflicted by the doctor known as episiotomy, when lacerations are deliberately made to facilitate the birth of the child. But noble Lords may say that although the risks to the physical and mental health may be slight, these slight risks may not affect the actual health of the pregnant woman. Here, I would venture to ask this. When we say they may not affect the health of the pregnant woman, are we referring to her existing state of health, or her subsequent state of health? Noble Lords will note that in line 16, where environment is dealt with—this is in the actual text of the Bill we are asked to pass—another place has taken great care to qualify that by saying, account may be taken of the patient's total environment actual or reasonably foreseeable". Are we then to apply the same qualification to the word "health"—the actual health, or the reasonably foreseeable health, of the mother?

What I wish to point out is this. Although all of us—I think in all quarters of the House—are anxious to see this Bill passed, I feel we have a duty, where we realise the wording of the Bill can be improved, so to improve it. And I would submit, very respectfully, to those who have given hours and hours of thought to the wording of the Bill as we have it now before us, that the insertion of these two words, "serious" and "grave"—"serious" risk to the life of the pregnant woman, and "grave" injury to the physical or mental health of the pregnant woman—do in themselves constitute an improvement in the wording of the Bill. I think it does not absolve this House to allow any other considerations to come into its way if it feels that the insertion of these qualifying words is necessary. With those few remarks, although there are a great many others one would possibly be able to make, I beg to move Amendment No. 4.

Amendment moved— Page 1, line 11, at beginning insert "serious".—(Lord Segal.)

BARONESS STOCKS

I suggest that these Amendments are unnecessary. They introduce a complication into the Bill and impose on those concerned an interpretation of words which cannot be precisely interpreted. Any risk is grave. You never know whether an injury is likely to be prolonged or not. I suggest that these Amendments be rejected.

BARONESS WOOTTON OF ABINGER

I am not very happy with the Bill as it stands at present. It says: … continuance of the pregnancy would involve risk to the life of the pregnant woman …". I suppose that, if we are going to be very literal minded, any pregnancy involves a minute risk to the life of the pregnant woman; and I think it is therefore very desirable to insert the word "serious" before "risk". On that ground I welcome the noble Lord's Amendment. What I should like to do is to effect a marriage between his Amendment and my own, so that the Bill would read: … serious risk to the life of the pregnant woman or of grave and prolonged injury to the physical or mental health …". The reason why I want to put in "prolonged", as well as "grave", is this. It is not an uncommon experience for a woman to suffer a very severe temporary depression at a certain stage in pregnancy—and it is only temporary. It would count as a serious injury to her mental health for the time being, but it might be for a matter of only a few days, and it might be disastrous if an abortion were performed in that time, since when the child is born all this will be a matter of the past and she will be delighted to have it.

4.47 p.m.

VISCOUNT DILHORNE

I should like to support the noble Lord, Lord Segal, in his proposal and the noble Baroness, Lady Wootton of Abinger. We are, after all, dealing, as my noble friend behind me has said, with an Amendment of the criminal law. I have always taken it to be the case that it really was implicit in subsection (1)(a) that the risk should be serious; that the injury would have to be grave and not trivial—and, indeed, prolonged. But if there be any likelihood of any misconception about that, I think the Bill—and this is a matter of drafting—would be improved by the inclusion of these words.

While it is perfectly true that it is impossible to give a precise definition of what is a "grave" risk, what is a "serious" risk, and what constitutes "prolonged", we are here, after all, giving guidance to the medical profession; and if we inserted these words we should be saying that, if the doctors are of the opinion that there is a grave risk of a serious and prolonged injury, they can perform the operation lawfully. I think it would improve this Bill to have those words interpolated.

I cannot think myself there will ever be a prosecution—because I do not think the evidence would be available—of a doctor on the ground that he has not formed his opinion in good faith. But I suppose it is just conceivable that you might be able to establish, if you had these words in, that he had formed the opinion that there was only a trivial risk, and, under the clause as it now stands, he thought he could lawfully perform the operation. I hope that the noble Lord, Lord Silkin, if he is not prepared to accept these Amendments now, will at least say he will give serious consideration to them between now and the Report stage, because in my belief they do no more than say expressly what I always thought was implicit in paragraph (a).

LORD AMULREE

I should like to say a word in support of what the noble Baroness, Lady Stocks, has said. I think that these Amendments are quite unnecessary and that they will do harm to the Bill. I believe words of this nature were in the Bill at one stage, and they were taken out. In matters of this sort, I feel that it is for the medical people in charge of the patient to decide. I do not really think you can make a proper definition of what is "prolonged", "grave" or "serious". I hope very much that the noble Lord, Lord Silkin, will not accept these Amendments.

BARONESS GAITSKELL

I should like to oppose this Amendment, and I want to support my noble friend Lady Stocks, and to oppose, very sadly, my noble friend Lady Wootton of Abinger. In the first place, there is the point about depression. Most women after pregnancy have a depression. It does not last a few days; it most often lasts six or seven weeks. It may not occur at all, but it is very common. Some women have very serious depressions. They become psychotic, and I myself have known of several suicides by women after a pregnancy or after they have had a child.

I should like to know one thing. No one has come forward and compared the risks, first, of pregnancy, second, of having children and, third, of having abortions. I believe that the risks of having a child are as great as the risks of having an abortion, and although I am not a doctor I certainly think that the risks of having a child are far greater than the risk of having an abortion under proper conditions, such as I believe this Bill empowers.

LORD COHEN

I have very little to say, and in fact I only want to support what the noble Baroness has said. I am induced to do so even more because in Clause 1(1)(b) the word "substantial" is put before the word "risk", which seems to me to make it all the more necessary to put in the adjective which the noble Lord, Lord Segal, desires to see inserted in subsection (1)(a).

LORD PARKER OF WADDINGTON

I should like to support this Amendment strongly, though I must declare an interest as being one of the unfortunate people who have to administer the criminal law. Unfortunately, those who have to administer the criminal law have to interpret a Statute, and they cannot look at Hansard in order to see what no doubt is the opinion of everybody in both Houses; namely, that what is intended here is a "serious" risk and not any risk, and a "real" injury and not merely a slight injury. I implore the House to vote for this Amendment so that those who administer the criminal law can direct a jury on what I am sure we are all agreed; namely, that it is not intended that it should be just any risk or a slight injury.

LORD BYERS

Before the noble and learned Lord sits down, would he, from his judicial experience, give the definition of a "serious risk", because many of us feel this is far too narrow a way to deal with an important measure of this sort. I have taken the view that it would be quite impossible to say what is a serious risk. The noble Lord, Lord Segal, has told us his interpretation of a "slight risk", but I should like to hear the noble Lord, Lord Parker of Waddington's, definition of a "serious risk".

LORD PARKER OF WADDINGTON

I quite agree that it is difficult to get a suitable form of words. Some people prefer "substantial" and others "serious". At the other end of the scale we have "more likely than not". I imagine we do not mean "any risk"; I imagine we do not mean "more likely than not", but something between the two.

LORD BYERS

May I press the noble Lord on this point? Does not what he has said mean that we are trying to legislate now for complete confusion in the law, instead of trying to clarify the issue?

BARONESS SUMMERSKILL

I hope your Lordships will reject this Amendment because I think it is most harmful. Who can define what is a "trivial injury" to a woman? Are we saying that, after this experience of childbirth, which is not only physically painful but also is a strain on the whole of her mental processes, a woman can sit back for a long time and rest? To-day, within a very short time of having a child, a woman has to do the housework, the washing, and the caring for the other children. In fact, the housewife to-day is exposed to great physical strain, whether she has had a baby or not. It is one of the most arduous tasks in the country, and we are being asked today to expect some doctor to define what will be "trivial". Doctors throughout the country will differ on this, and the only person who will suffer is the poor woman. I ask your Lordships not to confuse this Bill by introducing a word that is utterly ambiguous.

LORD CHORLEY

May I, as a lawyer, rather cross swords with what has been said by much more distinguished lawyers? It is not the doctors who will be asked to say what is "trivial"; it is a matter which will be left to the jury, and surely it is much better that the jury should judge of the doctor's honesty in the witness-box than to try to juggle with expressions such as "serious", and so on. There is a great deal in what has been said about this leading to the confusion of the jury, rather than giving them a clear guide as to how they are to decide the case. This is a matter on which, to use a schoolboy phrase, we lawyers are apt to teach our medical brethren "how to suck eggs", which I think is a great mistake.

BARONESS WOOTTON OF ABINGER

I am puzzled by what has been said by both my noble friends Lady Summerskill and Lady Gaitskell. It seemed to be the argument of Lady Gaitskell that it was far more dangerous to have a child than it was to have the pregnancy terminated, which seems to be an argument for terminating all pregnancies, because that would be the lesser risk. According to Lady Summerskill, one of the great risks of having a child is that the woman has to do the housework afterwards (which is indeed true), and that also seems to be an argument for terminating a pregnancy. I know that these are frivolous observations, but I think there is a more substantial argument behind them. That argument is this: that a door which is opened by this Bill—and let me say at once that I want that door to be open—is being gently pushed wider and wider open.

VISCOUNT WAVERLEY

May I say, for the guidance of the Committee, in connection with the question raised by the noble Baroness, Lady Gaitskell, about the relative risks of having a baby and having an abortion, that in fact the Registrar General's figures for 1964 show that abortions carry a four-fold risk as compared with pregnancy.

BARONESS GAITSKELL

May I ask whether those abortions were done under proper medical supervision? I know that the risks of back-street abortions are much more dangerous than having a child; but, after all, there are far fewer abortions that take place under proper medical supervision. Are those risks as great as the risks of having the child?

VISCOUNT WAVERLEY

I am sure that these figures must include backstreet abortions which, for one reason or another, have to come into hospital.

BARONESS GAITSKELL

I thank the noble Viscount.

LORD STONHAM

I think we are all agreed that the judges on the Bench have to decide whether a risk is "grave" or "serious", but the doctor has to decide long before that, and in this matter it should be the doctor who is considered before the learned judge, although the pregnant woman must always be considered first. In his speech, the noble and learned Viscount, Lord Dilhorne, said that we are giving guidance to the medical profession, and he advised my noble friend Lord Segal to press his Amendment. In giving that advice the noble and learned Viscount was rejecting the advice of the medical profession.

VISCOUNT DILHORNE

May I intervene for a moment?

LORD STONHAM

As soon as I make a statement there is an immediate movement to interrupt. But let me prove my point. The British Medical Association and the Royal College of Obstetricians and Gynæcologists have said the requirements that the risk must be "serious" and the injury to health "grave" are capable of raising considerable difficulties in practice. They may mean that terminations carried out on certain medical indications which are accepted in current medical practice would become questionable in future.

My noble friend Lord Silkin, in his Bill, and Mr. Steel, in his Bill, introduced into the Commons, both had these words in the Bill, and it was because of the strong representations of the responsible medical bodies, and because of the difficulties which they foresaw would be created, that those words were taken out in another place.

VISCOUNT DILHORNE

Does the noble Lord agree that, as the Bill now stands, if two doctors form the opinion that there is a very slight risk they will still be able to terminate the pregnancy? And, if that is so, ought not some words to be inserted to make the intent behind this a little clearer to the medical profession?

LORD STONHAM

No. If two doctors were of opinion that there was a very slight risk and they performed an abortion it would be a criminal abortion.

VISCOUNT DILHORNE

Why?

LORD STONHAM

Because they would not be acting in good faith. This Bill has to be considered as a whole, and it is when two registered medical practitioners acting in good faith are of this opinion.

5.0 p.m.

LORD PARKER OF WADDINGTON

May I ask the noble Lord a question? Does he appreciate that in most of these cases, I imagine, there will be no question at all about the good faith of the medical practitioners. The point will be, have they applied their minds to the right criterion? And I am still, I confess, thoroughly confused as to whether they are to apply their minds honestly in good faith to the question of whether there is any risk and any injury, or whether we really intend them to apply their minds to something else.

LORD STONHAM

Irrespective of whether the risks involved in abortion are greater than the risks involved in pregnancy, I would say that of course there are risks involved in pregnancy. My noble friend described them as slight risks. I would not go as far as that: I am not disputing the point. What I would ask the noble and learned Lord, the Lord Chief Justice, and the noble and learned Viscount, Lord Dilhorne, to apply their minds to is the fact that the representatives of the medical profession, whose members would have to carry out these operations, feel that it would be wrong to have these two words in the Bill; and they are going on experience. They also go so far as to say that they would make the position much narrower than it is now in Case Law under the Bourne judgment. That is the opinion of the medical profession. The noble Viscount, Lord Dilhome, said we are giving guidance to the medical profession, and I think it is only right to say what guidance they have given to us. And I hope that my noble friend Lord Segal will bear that in mind, because he is himself a member of one of those organisations.

VISCOUNT DILHORNE

May I say to the noble Lord that he ought to bear in mind that here we are drafting something which some people—of whom I am one—hope eventually to see on the Statute Book; and we are concerned about the langauge we use. The noble Lord has not answered the question I put to him. I interrupted him. He went on about bad faith and good faith. Let me put this point. Is it going to be lawful for two doctors who in good faith form the opinion that there is a slight risk to the woman to perform the operation? I would say that, reading the Bill as it now stands, the answer to that question is, Yes. I should like to know whether the Government agree. From all the debates that have taken place I should have thought it was not the intention that operations could be performed if there was any risk, however slight, in the opinion of two doctors, bona fide. That was not, I thought, the intention of this Bill; and if that is not the intention of the Bill, then words ought to be inserted to make it clear to the medical profession, and to anyone else who reads the Act of Parliament, that that is not the intention.

The noble Lord may want time to consider that point, but I would say to him, whatever may be said about the words "grave" and "serious", that if the clause is open to that interpretation, something is needed to make it clear that, for the operation to be lawful, the risk must be of a substantial character; that the opinion of the doctors must be that there is a risk of a substantial character, and that without the operation an injury of a substantial kind is likely to ensue. I hope we need not spend more time on this matter, but I think there is real substance in Lord Segal's point. I hope that the Government and the noble Lord, Lord Silkin, will say that the Bill is not intended to legalise abortions where two doctors are of opinion that there is just a minimal, slight risk, and then rely on the Act and say that the operation is lawful.

LORD SILKIN

I am perfectly willing to give further consideration to the need for inserting some such words as are contained in the three Amendments we are discussing together. At the moment I am not personally convinced that any such words are necessary, but it may be that there are other words—perhaps not so strong as those set out in the Amendments—which would give an indication that we are not discussing the very slightest hazards before any kind of operation but would give the doctors a lead that they must consider that there is, a real risk. If that satisfies my noble friends who have put down these Amendments, I am perfectly prepared to give an undertaking that this will be considered.

LORD SEGAL

I feel that we have had a very useful debate on these two Amendments, but perhaps I may be allowed to make one or two comments. The noble Lord, Lord Amulree, said it should be left for medical opinion to decide. I would mention to him that on these matters all medical opinion is not agreed, and, with all deference to the representatives of the medical profession, to which I have the honour to belong, I cannot conceive that they would deliberately try to restrict the bounds within which members of their own profession are allowed to operate. This is a matter fundamentally for this Committee itself to decide.

Other points have been touched upon. Whatever the actual figures may be which the noble Viscount, Lord Waverley, has mentioned, there is absolutely no doubt whatever that a far greater risk is involved in the traumatic process of doing an abortion than in the ordinary normal process of childbirth. Of that there can be no possible doubt whatever. The risks may be greater to inflict an abortion than to allow the pregnancy to continue.

LORD PLATT

I must interrupt and say that that is not so. It just is not a fact. It may be so with regard to illegal and septic abortions, but it is not a fact with the abortion properly procured.

LORD CITRINE

Would the noble Lord not agree that everything depends upon the period at which the operation takes place? Would he say it was a greater risk to perform the operation after two months of pregnancy than it is at childbirth?

LORD SEGAL

There is no doubt whatever that the earlier the abortion is performed the less is the risk, but the one is a traumatic interference in the normal physiological processes, however safe may be the conditions under which it is performed. I think we have to take it that any outside interference must involve, however carefully performed, some degree of greater risk than normal physiological processes. I am perfectly content to leave this matter to the will of the Committee, but let us realise that if we do not insert any qualification whatever to the words "risks to the life or injury to the physical and mental health" we are leaving the door wide open to any two partners who may be themselves professed medical abortionists to drive a coach and six through the provisions of this Bill. The noble Lord, Lord Byers, asked what is the definition of "serious". He might even have gone further and turned to the wording of the Bill as it stands and asked what is the definition of "risk". These are all matters we have to consider and, up to a certain point, we have to take for granted.

LORD BYERS

Is the noble Lord going to give a definition of "risk" and "grave"?

LORD SEGAL

I think that would be more correctly addressed to the sponsors of the Bill, not the mover of the Amendment. I am referring to the definition of the word "risk" which appears in the text of the Bill we are asked to approve. If it is the will of the Committee that, without any restriction or qualification except their own judgment, the professional medical abortionist is to be allowed to ride roughshod through the provisions of this Bill, I am quite content to accept that view. But I personally feel that, whatever the view of the representatives of the medical profession, this House ought to insert some qualification into the terms in which he is allowed to operate the provisions of this Bill. I urge that these two Amendments be inserted in the text of the Bill.

VISCOUNT DILHORNE

May I ask the noble Lord a question? I understood the noble Lord, Lord Silkin, to say that he would consider words to meet the points raised by the noble Lord, which he knows I support; and, of course, it is quite unnecessary, if you are going to deal with this question of criminal law, to seek to define "risk" in a Statute or "serious" in this particular connection. That is only misleading. But perhaps I may suggest to the noble Lord that there is advantage here in accepting the offer of the noble Lord, Lord Silkin, because one can always put down words on the next stage, in this case on the Report stage, on these points. I am with the noble Lord, and he has the support of the Lord Chief Justice and the noble and learned Lord, Lord Cohen, that there ought to be words which are descriptive of the risk and of the injury.

BARONESS STOCKS

Our attention has been called to the fact that an abortion may be a traumatic experience. That may be so. I would not know; I have never had one. But I cannot imagine any experience more traumatic than going through months of pregnancy, when one is afraid of pregnancy and what is going to happen at the end of it and what is going to happen after it. I would call your Lordships' attention to the fact that these Amendments have been discussed from the point of view of the law and from the point of view of the medical profession, but not from the point of view of the woman whose life is at stake.

LORD SEGAL

My reply to the noble Baroness is that the vast majority of ordinary, normal women would prefer to take the normal risks of childbirth rather than submit themselves to this operation.

BARONESS STOCKS

There is no reason why they should not do it, even if we pass this Bill.

LORD SEGAL

I am grateful to the noble and learned Viscount for his intervention, and if the noble Baroness, Lady Wootton of Abinger, would also accede to his suggestion, I should be glad, on the understanding mentioned by my noble friend Lord Silkin, to withdraw the Amendment at this stage.

Amendment, by leave, withdrawn.

5.13 p.m.

VISCOUNT DILHORNE moved in subsection (1)(a)(i), to leave out "or any existing children of her family". The noble and learned Viscount said: The noble Baroness, Lady Stocks, said a few moments ago that we were not paying attention to the interests of the pregnant woman. The Bill as it stands contains a provision which invites the doctors to disregard the interests of the pregnant woman and to give consideration to other factors. So I hope that I have the support of the noble Baroness in moving an Amendment which concentrates upon the condition of the pregnant woman and excludes the other factors. I move this Amendment, and I am delighted to see that, for once (I hope that it is a precedent that will be followed on numerous occasions), the most reverend Primate has added his name to this Amendment, together with my noble friend Lord Dundee. It is, I think, a most important Amendment. We had some discussion about it on Second Reading. I do not think it will be necessary in Committee for me to review all the arguments that were then advanced, but I will summarise them.

I think I have made plain where I stand on this matter. I should like to see a Bill; I think it would serve a useful purpose. I should like to see a Bill which provides for termination of pregnancy if there is a real risk to life, or a real risk of injury to the health, mental or physical, of the pregnant woman; and in considering these points the doctors concerned are, in my opinion, entitled to take into account all relevant circumstances. Indeed, Clause 1(1)(a) of this Bill, by sub-paragraph (ii), seeks to secure that. But as paragraph (a) now stands, it is not limited to that.

This paragraph provides that, although in the opinion of two doctors there is no risk of injury to the health of the pregnant woman or to her life—although they are satisfied of that—none the less they can terminate the pregnancy if they are of opinion that its continuance would involve a risk of injury to the physical or mental health of … any existing children of her family". So that provision is seeking to introduce as a justification for abortion a criterion wholly unrelated to the condition of the pregnant woman. I find it difficult to visualise how the birth of a child to a woman can affect the physical or mental health of any existing child. But I suppose it might be that little Willie would get so upset at the prospect of another brother or sister that it might affect his health, mentally or physically. But even if it did, is that any ground for terminating a potential human life? I should have thought not.

During our Second Reading debate the noble Viscount, Lord Barrington, went through all the variations of Amendments that had been tabled to the various Bills on this subject, each of them seeking to introduce sociological considerations. I think that some of those who support the Bill in its present form think that this particular provision will include sociological considerations—and, indeed, may intend it to do so. If I may follow the example of the Government and point out that it does not achieve its purpose—if that is the purpose—I should like to do so.

The noble Lord, Lord Stonham, would, I am sure, support me here in saying that if you must have consideration for the children of the existing family, that does not mean that you can take in sociological considerations. Be that as it may, surely it is wrong to consider termination of pregnancy as being justified on that ground contained in this Bill. I do not want to say any more than this: let the test which the doctors can apply be a test of health in its widest sense; but let it be the test of health of the pregnant woman, and not the test of health of any of the children of her existing family.

Amendment moved— Page 1, line 13, leave out ("or any existing children of her family".)—(Viscount Dilhorne.)

5.19 p.m.

THE LORD ARCHBISHOP OF CANTERBURY

I put down my name in support of this Amendment, and I hope that the Committee will accept it. In a case where pregnancy constitutes a risk to the health of the mother, the mother's anxiety about her care of the other children in the family may, we know, be a real factor in the question of her health. This is a part of the mother's environment of which a doctor will take note when he forms a judgment about the mother's health in connection with a plea for an abortion. But the words now in the Bill introduce quite another principle.

The doctor is asked to form a judgment about the health of existing children. What will he do in discharging this duty which the law would give to him? Will he take all the children in the family, one by one, make a kind of diagnosis and say, "Assessing the health of this child, I believe that the birth of another child in this family will have such-and-such an effect upon the health of the child"? It would seem quite impossible for the doctor to do that. In fact, the doctor will not really be called upon to make a medical diagnosis so much as a medical judgment about the state and prospects of the family: if another child is added to the family, and is added to the burden of the mother in caring for the family, what effect, in general, will this have on the prospects of the family? Those considerations will be partly economic, partly social, and the bearing upon the health of the children will be an indirect one. I believe that this introduces a very unsound principle into the Bill, a principle which is thoroughly wrong, and I hope that the Amendment to delete the words will be accepted by the Committee.

LORD SOPER

I find it disagreeable—

LORD SOMERS

I should like to say—

LORD BROCK

My objection to the phrase, "or any existing children of her family", is simply that it departs from the medical considerations of abortion in so far as they affect the physical or mental health of the pregnant woman. Where the family background or circumstances are such as to prejudice the physical or mental health of the pregnant woman, the natural compassion of the doctor fostered by his medical experience will be sufficient to influence him to pay attention to these matters, and indeed to all matters, in advising abortion. But this phrase definitely introduces the problem of social reasons for abortion. It is the natural and worthy fear of many surgeons that they will then be called upon to perform abortions for reasons not connected with the health of the pregnant woman herself. The words as they stand do not even define the existing children of her family. They might well include five or ten step-children, and the husband might well say to her, "We have enough children. You had better get rid of the one you are carrying." It might be the woman's first child, and she might be eager to have it. I cannot imagine that the destruction of the fœtus is the right answer to such a state of affairs, though in some cases it may be because of the effect on the mother's health which is covered by the clause as a whole.

In the debate in your Lordships' House on Second Reading, I emphasised that many surgeons would be totally opposed to performing an abortion for non-medical reasons. Some might be willing to do so, but most would not. The fact that the surgeon has the technical skill and can call upon the organisation necessary to procure an abortion does not mean that he should inevitably be expected to do so. I beg your Lordships to remember that this operation has to be done by someone—in fact by a team. It cannot be right to expect a surgeon and his team to do something against their will and conviction. The retention of this phrase introduces the possibility, even the probability, that he would be asked or expected to do so.

In the recent debate on the Second Reading of the Bill it was suggested that I might say something of the mortality associated with therapeutic abortion. This seems to me to be the correct place to do this, as the figures relate to the grounds for the reluctance of surgeons to become involved in operations which have no medical basis or justification. The interest of the House in the recent discussion encourages me to give this information. The information which I now put forward is contained in the report of the Council of the Royal College of Obstetricians and Gynæcologists, and was published in the British Medical Journal on April 2, 1966. The first figure which it is important to note is that the maternal mortality for Britain is approximately 0.19 per thousand births. In Scandinavia the mortality from legalised abortion initially varied from 0.9 to 3.5 per thousand cases. The more recent figures put the mortality for Denmark at 0.7 per thousand, which is nearly three times as high as the present maternal mortality rate, including abortions, for England and Wales. I would remind the Committee that the maternal mortality rate for Britain is 0.19 per thousand, and the present mortality rate for Denmark is 0.7 per thousand. The very low mortality figures of 0.03 to 0.06 per thousand reported from countries in Eastern Europe cannot be reconciled with experiences in Northern Europe and in Britain. The figures of two deaths per 100,000 abortions which was mentioned recently in your Lordships' House would never be accepted by any practical surgeon, because every surgeon knows that you cannot do 100,000 operations with a mortality as low as that. The anæsthetic risk alone is greater.

In addition to mortality, we must consider morbidity, which can be very important after abortion. Again, I quote the observations of the Council of the Royal College of Obstetricians and Gynæcologists.

Non-fatal serious complications occur in not less than 3 per cent. of legalised abortions induced by experts under modern conditions, and morbidity rates as high as 15 per cent. are reported. These complications include hæmorrhage, rupture of the uterus, various forms of serious infection, renal failure, thrombosis and embolism. Many late complication can occur, but I would only mention sterility, which can be a personal tragedy to a young woman who wants children later. Later pregnancies after an induced therapeutic abortion are often accompanied by grave complications, which I will not enumerate.

LORD PLATT

Before the noble Lord sits down, may I clear up one point about the very varying figures about the danger of therapeutic abortion? I think that the figures which the noble Lord, Lord Brock, is quoting include abortions induced by hysterotomy, and I think that the very low figures for Eastern Europe are those procured at a very early state of pregnancy when hysterotomy is not necessary. I think that this may perhaps account for the discrepancy.

BARONESS SUMMERSKILL

I do not think the noble Lord's comments are relevant to the Amendment which is before the Committee. The Amendment before the Committee is concerned with the effect upon the existing children. It seems a little inappropriate that this Amendment should be moved a few days after the Government have raised the family allowances for the second child from 8s. to 15s., and for the third and subsequent children from 10s. to 17s. This was done following a careful investigation, and it was discovered that there existed a degree of child poverty and associated malnutrition which shocked all those who came in contact with it. The day after the increase in family allowances was made, The Times, under the heading "Poverty and childhood", said that the increase in family allowances would lead to something like 40 per cent. of low income families still being below the poverty line as defined for supplementary benefits. I have no doubt that the fact of the tragic poverty which still remains in our child population determined the action of my right honourable friend Margaret Herbison, when she resigned. Margaret Herbison, whom I have known for many years, is a sincere, dedicated woman of the highest principles, and during the many years I have known her we have often discussed the effect of abysmal poverty on the growth of children in our industrial areas.

These children about whom we are talking to-day are not the kind of children about whom the most reverend Primate was talking, where a doctor comes in and looks at them and says, "Now should Annie or Billy have another brother or sister?" We are talking about children who, for the most part, are in the slums of our big cities living in one, two or three-room homes, places where three or four share a bed, and adolescents of both sexes sleep in the same room. Indeed, the overcrowding is such that no longer can those rules and regulations which we passed many years ago to prevent the mixing of children of the two sexes in one room be observed.

There are thousands and thousands of evil, damp habitations without bathrooms, and where one lavatory, sometimes used by many families, is all that the slum possesses, and where the mother cooks on the landing. These children roam the streets because the pressure of human beings in their homes is such that the conditions there are intolerable. The father may be a drunkard, he may be near unemployable, he may be chronically sick. The mother may be shiftless and may have reached the stage of coplete defeatism. This is the family background where it could rightly be said that an addition to an already large family would involve injury to the physical or mental health of the existing children.

In my opinion, these conditions brutalise a sensitive child, and day after day in our courts the same story is told of the appalling home conditions of some child who has committed an offence. If a large family is already on the poverty line and there is then another mouth to feed, this must mean less for the existing children. It is not surprising to learn that nutritional diseases are now found in the poorest families. It is smug hypocrisy to deplore this state of affairs and then fail to protect an already large family from the demands of yet another unwanted member by denying the mother an abortion.

VISCOUNT MASSEREENE AND FERRARD

Would not the noble Baroness agree that some of the poverty among children is because family allowances are not always spent on the children? I have always thought that the National Health Service should employ far more inspectors to see that the family allowances are, in fact, spent on the children. I know many cases where the family allowances are spent on tobacco, beer and gambling, and I have frequently mentioned this fact. I just wanted to make that point.

5.34 p.m.

LORD SOPER

I do not find it pleasurable to find myself in opposition to the most reverend Primate; all the more because, although he is not my spiritual superior at the moment, in the course of years he may well be. But I find myself in complete opposition to this Amendment, because it fundamentally breaches two of the quite basic propositions on which I have sought to give my support. I believe in the social clause: I do not fear its intrusion. I am quite satisfied that 80 per cent. of all abortion cases are to be found within the framework of marriage, and among women who have already three, four or perhaps five children.

It is because I am concerned, and I think this Bill is concerned, to extend beyond the absolute question of life and death the charity and understanding and possibilities of new life to a great many people who suffer incredibly in this situation, that I believe the social clause is imperative. Therefore, though there are risks involved, and though in certain terms of theological speculation there is the question of sanctity of life, yet, as I ventured to say last week, to compare this theological abstraction, as it very largely is, with the practical need of relieving suffering leaves me unquestionably on the side of the social clause, which I hope will not be now left out of the Bill on the insistence of the noble and learned Viscount, who wishes, in his own words, to exclude all other factors save those of the health of the woman herself.

May I therefore say a word about this exclusion of all other factors, especially in the light of subsection (1)(a)(ii), which invites us to take the patient's total environment into consideration. How can you take the total environment of a woman into consideration unless you take consideration of her family; and I believe the integrity of the family must be regarded as a unity and cannot be split up. Therefore, if the wellbeing of the mother is to be considered, then that wellbeing depends in large measure on the wellbeing of the totality of her work and of her life, and that life includes her children very much.

Furthermore—and this only adds a little to what my noble friend Baroness Summerskill has just said—if it be true that we are to take into consideration the total environment, and endeavour under those circumstances to relieve the mother of conditions which are not only unendurable but, so far as most men are concerned, incalculable, is it not obvious that to delete from this Bill reference to the conditions of other children emasculates the Bill in such a way as to render it inoperative at the precise point at which I think it is most needed?

BARONESS EMMET OF AMBERLEY

I have not spoken before, so perhaps the noble Lord, Lord Conesford, will very kindly give way. I had not intended saying anything on this Amendment, but I should like to take up the noble Baroness, Lady Summerskill, on what she said about the large family. We know that she speaks from the heart, and we all feel as she does about such families, but I think she is looking to the wrong cure. It is a social cure that a family needs, not a medical cure for the mother. When you come to look at this from a logical point of view, if you are going to try to help such a family by the mother having an abortion when she becomes pregnant, she will probably have to have one every year. When are you going to stop? That is not the way to cure the troubles of the large family. It will eventually affect the woman's health.

I should like to see this matter tackled socially. I should also like to see it tackled from the father's point of view. I find it very difficult to understand why in this Bill there is not a single mention of the father's responsibility; and I think that where there is a feckless father he should be dealt with, and not the mother.

LORD CONESFORD

In strongly supporting this Amendment, I hope I may be allowed to say that of course nothing that I say will question the humanity of the noble Baroness, Lady Summerskill, or of the noble Lord, Lord Soper. Indeed, I thought their speeches were most valuable in bringing to the attention of the Committee the fact that this is a social clause; that this is to permit an abortion, not on any medical grounds relevant to the mother, but on sociological grounds: that the home may be a poor one, that poverty would be increased, and arguments of that kind. I thought that the most reverend Primate put the point most fairly when he pointed out that many of these questions—the size of the family and so on—would be part of the environment and could be relevant in considering the health of the mother.

But what we are considering here is something quite different, and let me bring two facts to the attention of the Committee. The first fact is that doctors, and nobody else, are to judge this matter. The second fact that I bring to the attention of the Committee is that the first of the words which we propose to delete is the word "or". The physical or mental health of the mother need not be affected at all, nor need there be any risk to her life, for an abortion to be lawful under these words. It will be sufficient that there is a risk to the health, mental or physical, of a single child. At an earlier stage the noble Baroness, Lady Wootton of Abinger, called attention, quite rightly, to the part that might be played by psychologists. Psychologists, I think, vary in merit, but so far as I can see, a psychologist might come genuinely to the conclusion that little Tommy would be very jealous if another child were added to the family, and that this would be harmful to his mental health. If a psychologist came to that conclusion an abortion might lawfully be carried out under this clause as it will stand unless we delete these words.

I do not believe that a great many Members of this Committee, no matter what their views on abortion are in general, have any conception of the extent to which these words will extend the law unless we delete them. We still leave the judgment to the doctors, though I should have thought, that, if the decision is to be on sociological grounds, it is not only the doctors who should judge, or even doctors who would be the best judges, or that it is the best doctors who would want this task thrust upon them. But to say that we should have this change in the criminal law, to allow an abortion absolutely independently of any consideration of the mother's life and health, merely because it is thought that an additional child will on social grounds inflict some harm on the family as a whole, is to transform the very nature of this Bill.

Of course, there may be room for other reforms which have nothing to do with abortion, but if we are going to revise the criminal law and are going to revise it as a body of Members of two Houses with the Government taking no responsibility, we must, I suggest, insert some principle into the Bill. The health, physical and mental, of the mother, the danger to her life and so forth, are all medical questions, and to deal with them provides a simple principle. But to go outside them to purely social grounds, and say that doctors, of all people, should be allowed to bring about an abortion, not because the health, physical or mental, of the mother will be directly concerned, but because some child may be inconvenienced—

LORD CHORLEY

May I point out to the noble Lord that the words in the Bill are quite clear? They refer to the physical and mental health of the children. It is not on purely sociological grounds at all.

LORD CONESFORD

I am obliged to the noble Lord, but he will find that it has been admitted both by the noble Lord, Lord Soper, and by the noble Baroness, Lady Summerskill, that this is a social clause. I will willingly yield to the noble Lord in a moment—we are very old personal friends, and he knows that I will fulfil my undertaking—but this is admittedly a social clause. I agree, of course, that those words, the physical or mental health of … any existing children of her family". are in the clause.

Of course, that is in the Bill; and the example I gave concerned the mental health of a child of the family that might, in the view of a psychologist, be endangered because he was so abnormally jealous that he might have a mental breakdown if another child were added to the family. That would be within the words, but I say it would be an outrageous thing to enact here. When I say that this is a social clause, we have only to look at the history of the social clause in this House and in another place, and at the frank and honest admission of the noble Lord, Lord Soper. He says that this is a social clause, and he justifies it on that ground. I think the noble Lord who has just intervened will think that I am putting the thing fairly, but, if he wishes to intervene again, I will yield at once.

There is only one other matter to which I should draw attention. I have drawn attention to the fact that it is doctors who are going to judge, and I have drawn attention to the fact that these words are introduced by the word "or". The exclusive interest of a child will be sufficient under this clause as it stands, and doctors are to decide that. The final point that I would bring to the attention of the Committee is one which was put at an earlier stage by the noble Lord, Lord Saltoun. In such a case as was put by the noble Baroness, Lady Summerskill—the case where there are already many children living in overcrowded conditions—any additional child could be aborted under these words. It may not be one child and one abortion with which we are faced. It may be repeated abortions in that same family. I am not saying that such a case does not pose a problem. Of course it does. But are we quite sure, if we want to legislate for that, that repeated abortions are preferable to sterilisation? I am not at all sure. I support as strongly as I can the Amendment of my noble and learned friend Lord Dilhorne, supported as it has been by the most reverend Primate.

5.46 p.m.

BARONESS GAITSKELL

When I first looked at the phrase, "or any existing children of her family" I thought it was simply unnecessary to include it. In fact, when the noble and learned Viscount, Lord Dilhorne, drew my attention to it I said I agreed with him that it should be taken out of paragraph (a) of subsection (1). But when I read the Bill very carefully, the more I thought about the phrase the more good sense it made to me. We are now considering the case of a woman with a large family who is desperate not to have another child. Here perhaps I may say that the idea that noble Lords have, that a woman wants an abortion at the drop of a hat, or welcomes the idea of abortion and welcomes the idea of repeated abortions, is, I think, pure fantasy on the part of noble Lords. I think they do not know what they are talking about. It is for the women to say what they feel about abortions. The idea of 9 abortions or 19 abortions is ludicrous.

As I read this subsection—and I do not think that it is particularly well drafted—I understood that it meant taking into account not just the existing children but injury, mental or physical, to the existing children of her family. It seems to me that it takes into account the consequences to her family when there is a risk of injury to the physical or mental health of a mother in bearing another child—and there really is a risk when she is terribly against having another child. In fact, we are considering the protection of the mother in order to protect the family as a whole, which includes the existing children. I believe that the existing children often need protection when, as my noble friend Lady Summer- skill pointed out, the social conditions are so terrible—and I myself have seen these conditions in a centre for homeless people in London where in one room there was a woman with eight children. Although she had no home, and, in fact, had no husband, she had eight children and was being looked after by the council.

I am against this Amendment for several reasons. I believe that to take out these words would weaken this Bill to such an extent as to make no improvement on the present legal position with regard to abortion. I think that this is wholly undesirable, because what noble Lords do not seem to realise is that the present Bill tightens up the law in several respects: it does not make it easier for women, nor does it make abortion more permissive. The idea has been put about in the Committee here this afternoon that the flood gates will be opened if this Bill is passed. I do not for one moment believe this. This Amendment, by not allowing the physical and mental health of any existing children of the family to be taken into account, seems to me to revert to the rather punishing attitude taken by opponents of this Bill. These people say that a woman who has become pregnant and does not want her child, for any of the reasons set out in the Bill, must have it, whatever happens. I am convinced that this particular phrase extends protection to the mother and to the family. To take it out would weaken the Bill when its purpose, after all, is to improve the present position.

LORD PLATT

I am afraid that I cannot support this Amendment. I say "I am afraid" because I regret having to speak in opposite terms from those of my respected and noble friend Lord Brock. Once again I find myself wanting to repeat some of the words of Lord Soper, but without being able to command his eloquence. But perhaps I may say something from the medical point of view. May I first say to the noble Baroness, Lady Emmet of Amberley, that of course I agree with her that poverty and overcrowding are remedied by social methods and not by abortion. I also agree that the proper method of family planning is by contraception and not by abortion. Surely nobody in this House would favour abortion if there were some other way out. If the noble Baroness could tell us how the housing situation could be put right overnight, or even in a matter of months, then, of course, her words would have more weight.

I consider myself to be one of the majority of people in this country, in my own profession and, I hope in your Lordships' House, whose wish it is that this Bill, if passed into law, should, with all proper safeguards, be somewhat more permissive and not more restrictive than the present state of affairs. In my view, the words which the Amendment seeks to delete are almost the only words left in this Bill that go some way towards achieving this point. Secondly, I think that these words recognise that a doctor has a duty especially in this very difficult matter of abortion, to regard it as something which affects the whole family. I think it is always the doctor's duty to take such matters into consideration.

Thirdly, I agree that this is a medical provision and not wholly a social one, because it concerns (and I will quote the words again) the "physical or mental health of the pregnant woman or any existing children". The physical and mental health of the existing children is a matter about which the medical profession, at any rate, have an opinion. Fourthly, this provision recognises that the large family that is inadequately provided for, in money and accommodation, is surely one of the principal indications which make this Bill justifiable at all. Fifthly, to rule out these words at this stage is almost tantamount to instructing doctors not to take account of the influence of social factors on the medical state of their patients and their patients' families. To my mind, this would be a new and wholly undesirable departure from good doctoring.

LORD FERRIER

I am very much opposed to this Amendment, for the reason that I entirely support what was said, in far better words than mine, by the noble Lord, Lord Soper, and the noble Baroness, Lady Summerskill. As I said before, these words bear out the Dugald Baird experimental policy in Aberdeen; namely, accepting that this is a social clause. The problem of the other children in the family has a definite bearing on the doctor's decision as to whether an abortion should be granted. I use the phrase "doctor's decision" because of the way the noble Lord Lord Cones-ford has spoken; and in the light of what I said on Amendments Nos. 1, 2 and 3. I believe it is important to emphasise that one of the doctors concerned must be related, through the National Health Service, to some sort of social work.

That brings me to what the noble Baroness, Lady Emmet of Amberley, said in her short speech which I welcomed; because hitherto I had felt rather lonely at being the only one to talk about the father. I am glad she joined me in this respect. I agree with the noble Baroness that this question of social care has a bearing on the operation of this clause in the Bill. But she went on to say that an abortion in these circumstances might lead to an abortion every year. This is not so in Aberdeen. The Baird team go further than this. Dr. Baird is personally prepared to sterilise a mother—I think it is a reversible sterilisation—so that this does not happen every year, as the noble Baroness said that it might. I welcome what the noble Lord, Lord Platt, has said: that this is, indeed, a social problem and that it requires to be recognised in the Bill's provisions, if only to insist that there is a measure of social supervision on this point. I further believe that this clause is the crux of the Bill as it has come to us from the Commons. I shall oppose the Amendment and support the Bill as it stands.

6.0 p.m.

THE MARQUESS OF SALISBURY

I have not intervened at all in the discussions on this Bill. I did not think it was a subject with which I was very familiar, nor did I think that my views would be of the slightest importance to your Lordships. But it seems to me that the Amendment which we are discussing at the moment is so extremely important that I cannot bear to remain silent. As I listened over the last half-hour to the discussion in which so many of your Lordships have taken part, I felt that the arguments put forward by the noble Baroness, Lady Summerskill, the noble Lord, Lord Soper, the noble Lord, Lord Platt, and others would have been appropriate in a discussion on birth control or family planning. Whether one agrees with those proposals or not, what was said would have been entirely relevant to a debate on that subject. But this is something quite different. What we are doing, what we are being asked to do, is to kill a living thing, or at any rate, a thing which has in it the seeds of life. I admit that we may be justified in doing that on medical grounds. The health of the mother may be fatally injured unless the fœtus is aborted; though even then I feel that it would be a terrible decision to have to take. But if we depart from the purely medical grounds for abortion and bring in social conditions, it seems to me that we get into very deep waters indeed.

What, for instance, is the position of a doctor who is asked to perform an operation for abortion for such reasons as that? It seems to me his position would be quite impossible. He would be told that the mother had already five or six children and asked, ought she to have another? And who is he to decide to destroy life for that particular reason? The noble Lord, Lord Platt, seemed to think that he would find no difficulty in it, and I admire very much the self-confidence he shows on this subject; but I am certain there are many thousands of medical practitioners in this country who would feel that they had been put into a completely impossible position if the Bill were passed through your Lordships' House in its present form. I have spoken only for a moment or two, but I hope that your Lordships will feel that what I have said is worth while. I feel it so strongly that I thought I ought to express it in this Committee.

LORD CHORLEY

I agree very much with the noble Marquess, Lord Salisbury in regarding this as the most important part of the Bill. I agree with what the noble Lord, Lord Ferrier, and the noble Lord, Lord Platt, have said, that this, alas!, will bring very great depression to hundreds of thousands of people in this country, because it means that they will have to continue getting a back-street illegal abortion. The whole object, or the main object, of the Bill is to get rid of back-street illegal abortions. I think it clear from the statistics given to us that a very large number of the illegal abortions are asked for by married women who find that the struggle to bring up a large family is not only wearing them down but making it impossible for them to bring up a really fine family, which is the ambition of all good parents.

I think it significant that even in my lifetime, and certainly over the last century, there has been a swing towards what one might call quality in the family. The old law was very properly concerned mainly with the preservation of life. In primitive times life was very cheap, and I think the great service that the Church and the religious bodies have done is to emphasise the importance of life. But life is more than just a quantitative thing; it is quality as well, and in my lifetime the swing has been intensely towards better families; more beautiful children; better educated children; healthier children. That is what is called the social part of this question, because these things are all intimately connected with each other. The physical and mental health of the children in a family, and bringing up a good family, depend enormously (as I think was brought out extremely well in the Peckham Experiment and the book which was written about it by the fine man who ran the experiment) on the social surroundings in which that great achievement has to be carried through.

What the noble and learned Viscount is asking your Lordships to do by accepting this Amendment is to deprive people, who have been hanging on to everything which has been going on in the other place while this Bill was going through, of their last hope. The most reverend Primate is one of the most sympathetic and compassionate people it has ever been my good fortune to meet and listen to; but I wonder whether he realises that what he is asking your Lordships to do is to drive these unfortunate people back to the back-street abortionist, because that would be the inevitable result if you accept this Amendment.

The noble Lord, Lord Conesford, with whom I have crossed swords, said it is for the doctors to decide. Of course that is not so. It is the woman's task, and not only the woman, but the father as well. He comes into these cases, because it is a family decision. Very often the father sees the back-street abortionist and fixes up the operation. It is a family decision, even if the father is not mentioned in the Bill, and that is the first and most important step. The doctors come in only at the second stage.

In this Bill, if it is passed in its present form, the duty of the doctor will be to form an estimate of the effect of more births in the family on the physical and mental state of the existing children. The doctor would know the family and would be very well placed to give an estimate about it. That is why this is called the social clause, because the social element obviously comes into it; but, basically, it is a medical problem affecting the mental and physical condition of the children. That is why I reminded my noble friend that that is what the law will say if the Bill becomes law. Any doctor who tried to decide the thing on purely social grounds, without considering its effect on the mental and physical life of the children, would be going against the law and would be liable to be brought up before a court of law. In my view, these considerations make it absolutely essential that your Lordships should reject this Amendment.

LORD PARKER OF WADDINGTON

I hesitate to intervene in this debate, but after listening to it I am wondering whether we are all applying our minds to the same problem. May I illustrate it in this way? A woman comes to her doctor and says that she wants her pregnancy terminated. She says, "Look, I have got nine children. We are living in these appalling conditions in this one room. I simply cannot face it." We all agree that if the doctor is then satisfied that the birth of another child is going to have an effect on the woman's mental or physical health, an abortion would be justified. That is on the consideration of the children, the one room, the difficulty of feeding them, nutrition and everything else. It is all taken care of because the doctor has to consider the mother's total environment.

That has nothing whatever to do with the words we are considering. The case we are considering is where a mother goes to her doctor and says, "I want an abortion. Look at those children in that room. It does not affect me mentally or physically; I can cope with the situation. I can go out to work and feed them and do the best I can for them, It will not hurt me at all. But I am asking you to say, as a social question, that it is wrong for them to be living under those conditions which will be made worse if I have this child." That is the problem to which we are addressing our minds.

BARONESS WOOTTON OF ABINGER

I had intended to reserve what I wanted to say on the social clause until the next Amendment, which stands in my name and which goes a little further than the present one, but it appears that the main debate is now taking place on the words about the existing children. If this is the social clause, it has appeared before us in the various Bills we have had in a good many forms, some more objectionable and some less. I am not sure that this is the least objectionable of them.

I feel strongly that we must respect the opinion of the medical profession on medical questions, and I think that is what this Bill is designed to do. I do not think that the opinion of the medical profession on purely social considerations is necessarily more authoritative than the opinion of other persons. It is true that doctors will look at patients in their total environment, but they will use as their standard of reference the effect upon the health, whether physical or mental, of their patients.

LORD STONHAM

My noble friend said that doctors must look at the total environment of the patient, but the next Amendment in the noble Baroness's name would remove that provision. Is it her intention not to move that Amendment?

BARONESS WOOTTON OF ABINGER

That is not my intention, and I will make my reasons clear in due course. I have not overlooked the next Amendment phrased in those terms in my own name. What I am afraid of—and I speak here from what I have heard in discussions with doctors and with social workers—is that this Bill is being changed from a Bill designed to provide for the termination of pregnancy, where pregnancy it is medically inappropriate and inadvisable, to a Bill into which there sneaks a certain amount of pseudo-eugenics.

I know cases in which, understandably, doctors and social workers who have had much contact with the more distressing social areas of our community have formed strong opinions as to who ought to have children and who ought not to have them. Those opinions are not, in the strict sense, medical opinions. They are an expression of dislike of people who may live rather disorderly, and even idle, lives and who do not come up to the standards of behaviour and morality which these medical practitioners approve. There is a real risk that, if we allow a social clause, we shall be allowing the medical profession to make judgments on considerations which are not medical but social and on which they are not better qualified than other people. In short, I am anxious that we should be absolutely clear of pseudo-eugenics and regard this Bill entirely from the point of view of the pregnant woman, her welfare and the welfare of the child she may be about to bear.

LORD SOPER

May I ask my noble friend whether she finds it easy to separate a medical decision from a moral decision, especially as there is no specific definition of the amount of risk involved? It is not a question of absolute risk—you cannot be rather dead; you are just dead. But you can be rather ill—and as soon as there is a comparative judgment to make, is not the medical profession involved inevitably in making a moral judgment on medical grounds rather than a medical judgment in itself?

BARONESS WOOTTON OF ABINGER

I should be very much alarmed if the medical profession were put in a position in which they had an authority on moral questions similar to that which they have on medical questions, and I should be surprised if anyone who wears the cloth of my noble friend Lord Soper would be prepared to agree to any such idea.

6.15 p.m.

LORD MOLSON

We have had a full discussion on this matter, and I rise to indicate that the supporters of this Bill do not feel that they can accept this Amendment. It has been made perfectly plain from the beginning by my noble friend Lord Silkin, and by many of his supporters, that they are not satisfied that this Bill should be merely a restatement of the doctrine in the Bourne case. It is intended to be a measure of social reform and to go further than the existing law. It is intended that it should be more permissive than the existing law.

The Bill raises the question of social considerations and the conscience of the doctor. The noble Lord, Lord Brock, spoke for a large section of the profession when he talked of being influenced purely by medical considerations. The noble Lord, Lord Platt, also spoke for a large section of the medical profession when he expressed a contrary view. I do not believe it is possible to speak about a medical conscience, or a religious conscience, or a social conscience. I think that every man's conscience is built up of many different considerations applying to different aspects of human life; but they are all governed by what he, in his soul, believes to be right.

I believe that Clause 4—the conscience clause—as redrafted, and as it will be moved by my noble friend Lord Silkin, will cover all the proper cases of conscience, whether religious, medical or social, or combined; and if it can be shown that it does not do so, then I am sure that Amendments will be made to it. It has been argued that such cases as have been put by the noble Baronesses, Lady Summerskill and Lady Gaitskell, and other speakers, of large families living in bad conditions to whom the addition of one more child will result in increased misery and deprivation, can be covered under the words dealing with the health of the mother. Indeed, my noble and learned friend Lord Dilhorne says that it is covered.

I think that there are some doctors (possibly the noble Lord, Lord Brock, would be among them) who would find it a little difficult in their consciences to cover these social cases by reference to the health of the mother. There might be a very irresponsible mother, who did not care about the child and was not prepared to make any great additional sacrifices, whose bearing of another child would bring a deterioration for the other children, certainly in their happiness, and likely enough in their health also.

It has been argued that these matters of large families should be dealt with by the social services, and especially by family allowances. Certainly let that be done. But it cannot be done in this Bill, and it is no answer to say that some time in the future other measures can and will be taken which will reduce these problems. No social service will actually abolish the case of the large family with the feckless mother living in bad conditions—though the number of such cases may be greatly reduced. I am sure that the time will never come when there will not be a case of a mother who finds herself pregnant and who sincerely believes—and it is the opinion of those best qualified to judge—that the addition of one more child to her family will be greatly to the disadvantage of all the existing members of that family.

Therefore, on this matter, which has, been so clearly put by the noble and learned Lord the Lord Chief Justice (I do not know which way he is going to vote, but he has put the issue with his usual clarity and precision) we who support the Bill cannot possibly accept the Amendment.

VISCOUNT DILHORNE

I have the feeling that the Committee would like to proceed to a decision upon this matter fairly soon, and that is why I venture to rise to my feet at this moment. As I moved the Amendment, I should like to say a few words in reply to some of the observations which have been made. They have rather astonished me. We have had a wide-ranging debate, but, if I may say so with the greatest respect to another lawyer, the noble Lord, Lord Chorley, I thought the greatest extent of exaggeration and inaccuracy was reached by him in the course of his speech.

It may be that the main object of this Bill is to stop back-street abortions. I hope that this will be a consequence, but I do not think it will be achieved solely by this Bill. The object of the Bill is, as it says, to amend and clarify the law. I would support a Bill which amends and clarifies the law if the amendments are sound. But when the noble Lord, Lord Chorley, goes on to say that those who support this Amendment are depriving people of their last hope, and that driving people back to back-street abortions will be the inevitable result, while he may have misled himself I hope that he will not have misled your Lordships.

The noble Baroness, Lady Summerskill, has made, not for the first time, a very moving speech about the social conditions and poverty of some large families; and she was supported in that by the noble Lord, Lord Soper. If I thought for one moment that this Amendment would prevent an abortion taking place where the health of the pregnant mother would be affected by those conditions, then I should not have moved it. What will be the position? Let us take a particular case. A woman finds herself pregnant after having three, four or five children, to take the example given by the noble Lord, Lord Soper, and it will be her decision to consult her doctor to see whether the pregnancy should be terminated; and she will want it terminated. If the conditions are anything like the noble Baroness described, or those envisaged by the noble Lord, Lord Soper, I should have thought that the vast majority of doctors would be able to form the perfectly honest opinion that she should not add to her burdens in the future by having an additional child without a risk, and a serious risk, of injury to her mental and physical health.

As the Bill stands, it is my belief that the cases to which the noble Baroness so movingly referred, and the cases quoted by the noble Lord, Lord Soper, are indeed covered by this Bill, because it is the woman who will go on the ground that she is desperate. And if she is desperate, is not her health likely to be affected? Is there not a real risk of her health being affected? But that is not the whole case. As my noble and learned friend the Lord Chief Justice has said, these words are deliberately intended to go wider. I am not going to argue as to whether they really achieve the result of introducing purely social considerations unconnected with health. Obviously, they are interpreted by some in that way. But clearly what they do, as the Bill now stands, is to say that when a woman goes to the doctor and says to him: "I do not want another child because I have three already" (or it may be four or five); "I do not mind about having one; it is not going to affect me or worry me; it will not affect my health or my mind" and the doctor is satisfied of this, the doctor will then be entitled, unless these words are removed, to destroy a potential human life. I think that is wrong. I think that such a case may well be an overwhelming case for the improvement of our social services, but not a case for the destruction of a fœtus.

I have made my remarks as shortly as I can. I should like to express my thanks to those who have supported me in the course of this debate. I have spoken again at this length only because it seems to me that the arguments—and it may be my fault—in favour of the Amendment have not been clearly or sufficiently appreciated by any of those who spoke so eloquently against it. There was a time when the noble Baroness, Lady Gaitskell, was in support of this Amendment. Something, I fear, has diverted her from her proper course, and I hope that, in the event, she will find it in the right Division Lobby with me.

LORD BROCK

I should like to make a brief comment on the question of the confusion that seems to have arisen in regard to the place of the doctor in this matter. The impression has been given that the doctor is quite incapable of forming

an opinion based on the obvious conditions of hardship in the family which the woman suffers. As doctors, they are worldly wise and compassionate, and they are fully capable, of taking these things into account when making their decision; and they do so. I was shocked by the comment that a doctor's duty, if this Bill is passed, is to form an honest opinion based on the circumstances of the family, and that if he does not he is liable to prosectuion. He already does this, because it is what he should do. He is quite capable of doing it, and will continue to do so.

6.27 p.m.

On Question, Whether the said Amendment (No. 7) shall be agreed to?

Their Lordships divided:—Contents, 87; Not-Contents, 86.

CONTENTS
Aberdare, L.	Dilhorne, V. [Teller.]	Lytton, E.
Albemarle, E.	Dundee, E.	Mancroft, L.
Audley, Bs.	Durham, L. Bp.	Massereene and Ferrard, V.
Barnby, L.	Emmet of Amberley, Bs.	Merrivale, L.
Barrington, V.	Exeter, L. Bp.	Mills, V.
Berkeley, Bs.	Ferrers, E.	Monckton of Brenchley, V.
Beswick, L.	Fortescue, E.	Mowbray and Stourton, L.
Blackford, L.	Furness, V.	Nugent of Guildford, L.
Boston, L.	Grantchester, L.	Oakshott, L.
Boyd of Merton, V.	Grenfell, L.	Parker of Waddington, L.
Brock, L.	Gridley, L.	Perth, E.
Brooke of Cumnor, L.	Grimston of Westbury, L.	Rockley, L.
Brooke of Ystradfellte, Bs.	Hankey, L.	St. Helens, L.
Buckton, L.	Hodson, L.	St. Oswald, L.
Canterbury, L. Abp.	Horsbrugh, Bs.	Salisbury, M.
Carnock, L.	Howard of Glossop, L.	Sandford, L.
Carrick, E.	Hylton-Foster, Bs.	Sandys, L.
Carrington, L.	Iddesleigh, E.	Sempill, Ly.
Carron, L.	Inchyra, L.	Stamp, L.
Chichester, L. Bp.	Inglewood, L.	Strang, L.
Clifford of Chudleigh, L.	Jellicoe, E.	Strange, L.
Conesford, L. [Teller.]	Kennet, L.	Strange of Knokin, Bs.
Cork and Orrery, E.	Kilmany, L.	Vaux of Harrowden, L.
Craigavon, V.	Kilmarnock, L.	Vivian, L.
Craigmyle, L.	Lilford, L.	Waverley, V.
Cullen of Ashbourne, L.	London, L. Bp.	Wedgwood, L.
Daventry, V.	Longford, E. (Lord Privy Seal.)	Wells-Pestell, L.
Denham, L.	Lothian, M.	Wolverton, L.
Derwent, L.	Lucas of Chilworth, L.	Wootton of Abinger, Bs.
NOT-CONTENTS
Addison, V.	Chorley, L.	Florey, L.
Ailwyn, L.	Cohen, L.	Gaitskell, Bs.
Amulree, L.	Collison, L.	Gardiner, L. (L. Chancellor.)
Archibald, L.	Cooper of Stockton Heath, L.	Gladwyn, L.
Asquith of Yarnbury, Bs.	Cranbrook, E.	Greenway, L.
Balerno, L.	Darwen, L.	Hacking, L.
Birdwood, L.	Dinevor, L.	Hawke, L.
Blyton, L.	Elliot of Harwood, Bs.	Hayter, L.
Bowles, L.	Falkland, V.	Henley, L.
Buckinghamshire, E.	Faringdon, L.	Hertford, M.
Byers, L.	Ferrier, L.	Hilton of Upton, L.
Caccia, L.	Fleck, L.	Hughes, L.
Hurcomb, L.	Morrison, L.	Shackleton, L.
Kahn, L.	Moyle, L.	Sherfield, L.
Killearn, L.	Moyne, L.	Silkin, L.
Kirkwood, L.	Moynihan, L.	Snow, L.
Lambert, V.	Noel-Buxton, L.	Soper, L.
Latham, L.	Norwich, V.	Sorensen, L.
Leatherland, L.	Pargiter, L.	Stocks, Bs.
Lindgren, L.	Platt, L.	Stonham, L.
Llewelyn-Davies, L.	Plummer, Bs.	Stow Hill, L.
Lloyd of Hampstead, L.	Ponsonby of Shulbrede, L.	Summerskill, Bs. [Teller.]
MacAndrew, L.	Raglan, L.	Swanborough, Bs.
McCorquodale of Newton, L.	Rea, L.	Terrington, L.
Maelor, L.	Rowley, L.	Teynham, L.
Mar, E.	Royle, L.	Vernon, L.
Mitchison, L.	St. Davids, V.	Wade, L.
Molson, L. [Teller.]	St. Just, L.	Winterbottom, L.
Monson, L.	Segal, L.

On Question, Motion agreed to.

Resolved in the affirmative, and Amendment agreed to accordingly.

6.38 p.m.

BARONESS WOOTTON OF ABINGER

had given Notice of her intention to move, in subsection (1), to leave out from "health of the pregnant woman" in paragraph (a)(i) to the end of subparagraph (ii). The noble Baroness said: In view of the decision which the Committee has just taken, it would not be proper for me to move my Amendment in its present form. The question of whether the provision regarding existing children is to be in the Bill or not has now been decided. I shall, therefore, with the consent of the Committee, move my Amendment in this form: Page 1, line 13, leave out from ("family") to the second ("or") in line 16. May I say, quite shortly, to make this perfectly clear, that what that means is that this is an Amendment to omit subsection (a)(ii); that is to say, the paragraph which reads: in determining whether or not there is such risk of injury to health account may be taken of the patient's total environment actual or reasonably foreseeable". I am moving to omit that paragraph.

My noble friend Lord Stonham asked me just now whether I intended to move this Amendment, in view of the fact that I said just now that any doctor takes into account the total situation and environment of his patient. I do intend to move this Amendment, for this reason. While a doctor always does this, I do not understand why it has been spelled out in this Bill that, in this particular instance, he has to take account of the total environment actual or foreseeable. This is normal medical practice. A little earlier we were accused of teaching doctors to "suck eggs", and it appears to me that if this clause remains in the Bill we are really emphasising an elementary point. Therefore I ask myself why the clause is in the Bill. Either it means what it says, in which case it is totally unnecessary, or it means more than it says, in which case it is yet again an attempt to widen the social provisions of the Bill as distinct from the strictly medical. It is true that the words indicate that account is to be taken of the environment only in determining whether or not there is a risk to health, but it is quite obvious that any doctor would do that. However, the criterion which he uses is the criterion of health and not of the nature of the environment as such, or the desirability of adding to the family in the social environment, as distinct from the effects upon health.

Therefore what I want to ask the noble Lord, Lord Stonham, and the sponsors of the Bill, and in particular my noble friend Lord Silkin, is this: does this clause mean exactly what it says and no more? If so, why is it in the Bill? If it means more than it says, what is the "more" that it means? I beg to move.

Amendment moved— Page 1, line 14, leave out from ("family") to the second ("or") in line 16.—(Baroness Wootton of Abinger.)

VISCOUNT DILHORNE

I have listened with the greatest interest to the noble Baroness, and I do not propose to attempt to answer the very pertinent questions which she has asked, except to say that I have put down an Amendment to alter these words which is of a drafting character. The noble Baroness asks what these words mean. I think that the drafting is defective, because it talks of account being taken of the "patient's" total environment. All the other references have been to "pregnant woman" so that is wrong. Then what is the difference between an "environment" and a "total environment"? I hope the noble Lord, Lord Silkin, will explain that. Words in a Statute of a criminal character are extremely important.

As your Lordships will see in Amendment No. 9, which it might be to the convenience of the Committee to mention now, I have sought to insert in the place of the words "patient's total environment actual or reasonably foreseeable" the words "pregnant woman's environment both at the time when the child would be born and thereafter so far as foreseeable". I think that is purely drafting. It is intended to be so, and I hope the noble Lord will accept it.

While saying that, I rather share the view of the noble Baroness Lady Wootton of Abinger that it is unnecessary to have anything of this sort in the Bill, but if there is any doubt about it I would rather have words in the Bill to show that the medical profession, in making up their minds, are fully entitled (as I think they always are) to have regard to all the relevant circumstances. That is really all one is saying by the use of the word "environment"; but not only circumstances which are likely to exist at the time of the birth but "so far as foreseeable thereafter". I doubt very much whether it is necessary to put this provision into the Bill, but if any such provision is to be in the Bill I hope the noble Lord, Lord Silkin, will accept the drafting proposals that I have made.

LORD SILKIN

May I say to my noble friend Baroness Wootton of Abinger that these words mean no more than appears on the surface. There is no hidden or underlying meaning and it is intended that the two doctors who are considering whether or not they approve of an abortion should take these factors into account. I was not quite sure what the noble and learned Viscount intended by his Amendment. If it is really a drafting Amendment and nothing else—and I was not sure whether that was in fact the case—

VISCOUNT DILHORNE

May I assure the noble Lord that it is entirely drafting.

LORD SILKIN

I take the word of the noble and learned Viscount for it; and if that is so may I, without prejudice, accept it because it does look better—subject to further consideration, if necessary, at the next stage. If it will speed matters now I am quite prepared to accept it.

BARONESS WOOTTON OF ABINGER

I am extremely glad to have my noble friend's assurance that this clause does not mean more than it says. I am still rather puzzled why it appears in the Bill at all. I have never known a doctor who considered his patient in a complete vacuum without considering his or her social circumstances and who regarded health as being divorced from environment. So it seems that these words are totally unnecessary. But in view of my noble friend's assurance I beg leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

VISCOUNT DILHORNE

I beg to move.

Amendment moved— Page 1, line 15, leave out from "the" to "or" in line 16 and insert "pregnant woman's environment both at the time when the child would be born and thereafter so far as foreseeable".—(Viscount Dilhorne.)

LORD PLATT

May I ask the noble and learned Viscount a question about his drafting Amendment, as I, in my ignorance as a non-lawyer, read it? Does this exclude consideration of the pregnant woman's condition now—that is, at the early stage of the pregnancy? The Amendment refers to "at the time when the child would be born and thereafter".

VISCOUNT DILHORNE

This definition does not exclude any such consideration but merely makes it perfectly clear that the environment at the time of the birth of the child and in the future can be included in the consideration. It does not mean that one has to look only at that. One looks at the health of the pregnant woman at the time when she is examined.

LORD PLATT

I thank the noble Lord.

6.48 p.m.

THE LORD BISHOP OF DURHAM moved, in subsection (1), to leave out "(b) that there is" and insert "of". The right reverend Prelate said: I think it might be appropriate if the discussion were to range over Amendments 11 and 12 as well, if the noble Baroness, Lady Emmet of Amberley, and your Lordships agree.

BARONESS EMMET OF AMBERLEY

I shall be quite willing.

THE LORD BISHOP OF DURHAM

The intention of this Amendment, No. 10, is to ensure that these cases of handicapped children should be explicitly considered in the Bill but—and I think it is a big "but" after our earlier discussion—in the context of the mother; someone who is there and present before the doctor and on whom he can, we hope, reliably base his diagnosis. I need not spell out again, I think, the reasons of compassion and sensitivity which moved me, and I am sure others, to press for some explicit provision in the Bill in the case of the child who, if born, will be very seriously handicapped. The same motives of sensitivity and compassion apply here as in the earlier case we have considered.

The unamended clause in the Bill as it stands would, admittedly, make provision for these cases, but it would leave the mother entirely out of consideration. It would isolate the fœtus and then base the decision to abort, not on any diagnosis whatever but on a statistical probability: as I said in the Second Reading debate, a probability that might be one in two, would be more likely one in four, and might perhaps be one in eight. This seems to me to be incoherent reasoning, to decide to do something to a mother on the basis of an argument carried out on the fœtus in isolation. It seems to me first of all to be incoherent and muddled reasoning; it then seems to be a violation of medical practice to do something on the basis not of diagnosis but of statistical probability and, against all that, to show scant respect for what is far more likely than not in the fœtus, a human life. It might be said that this Amendment is unnecessary. Here we have echoes of what has been said in the last quarter of an hour or so—at least it might have been said once—because "total environment" covers all we need. But in fact the word "total" has now gone, and we have only "environment". So I should have thought that there was more of a case than ever for spelling out what we mean by "environment" at any point where it might be misleading or unnecessarily restrictive.

I divide my argument into four points to show why I think, even though "environment" is still in, this Amendment is needed in order to care for the case of the deformed and defective child, but not in isolation. First, it is always possible to take "environment" in an impersonal sense, as we speak of environmental factors, say, in sociology. There is always a risk that "environment" will not be given a wide interpretation, and now that "total" has been taken out that risk is more than ever likely. If it is given such an interpretation, there is always the risk that it may be thought to be no more than a disingenuous quibble and bring the law into even further disrepute.

The Amendment I am proposing would point out explicitly a recognised and important interpretation. It would indicate beyond all doubt that the case of the deformed and defective child is one that ought to be considered in the context of the mother. My suggestion is to spell it out expressly so that the man's conscience will legitimately see that consideration can properly be given to it—and I do not think that in this I am teaching anyone to suck eggs, even less omelettes. I think it is just spelling out what otherwise might not be very clear. If there is any doubt whatever, I agree with the noble Viscount, Lord Dilhorne, that we should spell it out beyond misunderstanding. That is my first point.

My second point is this. The case of this handicapped child is a very exceptional one in relation to the environment, because it is the one factor in that environment which the abortion would remove. It deserves a very special place because of its very special nature in the environment. Thirdly, in cases where this factor is at all relevant it is likely to be an important, if not the determining, factor, and therefore I think justifiably highlighted.

Fourthly, by setting this case of the handicapped child in the context of the mother, as this Amendment suggests, not leaving out of consideration the handicapped child at all but bringing it in where, in my view, it ought to be, it seems to me that we avoid difficulties that might otherwise occur over words like "substantial" and "serious" in the original Bill. We are already having a semantic half-holiday, as it were, in terms of "risk" and everything else.

We can "go to town" even more when we get to the next clause about the words "substantial" and "serious". We can be here all night and most of to-morrow; there is no limit. I think if we put the case of the handicapped child in the context of the mother, a good deal of that semantic steam can be evaporated here and now, because what will be done if the Amendment is agreed to is that the case will be judged in relation to the mother. We shall ask the question: Has this possible handicap such a degree of risk about it, or is the handicap such that the mother will be seriously and substantially affected? These words are slanted on to the mother herself, and are then in a much better state for being answered intelligently. We are asking: Is this mother, if she fulfils the normal duty of bringing the handicapped child to birth, going to be adversely affected in her life and health, and seriously and substantially? I do not say that the words are clear in their meaning. If they were they would be more or less useless. But they are tagged in their meaning to a reliable situation, and a more reasonable decision can then ensue.

These are my reasons for moving this Amendment, which I hope does all that anyone of sensitivity and compassion would wish to see done for the handicapped child, and yet does it in a way which is not incoherent, which is medically reliable and, I hope, on principle, sound. I beg to move.

Amendment moved— Page 1, line 17, leave out ("(b) that there is") and insert ("of").—(The Bishop of Durham.)

LORD BROCK

I support this Amendment because, as the right reverend Prelate has so eloquently shown, it moves the possible risk of the child being born abnormal back to the effect on the mother's physical or mental health, and away from this difficult and argumenta- tive problem that a fœtus should be deliberately destroyed because of an undefined but perhaps small risk that it might be born deformed. The approach in this new wording is quite different, and is in conformity with the general principle acceptable to many of judging the problem against the ill effects on the pregnant woman.

THE EARL OF DUNDEE

I am very grateful to the right reverend Prelate for the suggestion that my Amendment, No. 11, might be discussed at the same time as his, and also the Amendment of my noble and learned friend Lord Dilhorne, No. 12. I shall state the case for my Amendment very shortly, because to me the case seems to be a very simple one. I am not going to reinforce it with any figures, although I should be very glad indeed if any of your Lordships who know more about medical history than I know gave any figures showing the proportion between pre-natal expectation of possible deformity and actual resulting deformity as revealed by the event of birth. If the proportion is, as I think it very often is, a fairly low one, it is certainly no reflection on doctors, because doctors asked to give an opinion of this kind are expected to measure their advice against normality. If you ask a doctor whether your wife, who is pregnant, is in danger of her life, and he thinks there is only a 10 per cent. danger, of course he is bound to say great danger, because 10 per cent. is very great compared with the normal danger of pregnancy. Similarly, if you ask whether there is a grave risk to the life of your child if you take him into a tropical country, if there is only a 5 or 10 per cent. risk he would have to say there is a grave risk, because that is a great proportion compared with the normal risk of moving from one area to another.

If we find that of pre-natal expected deformities only a small proportion are actually born deformed, maybe one in five, your Lordships will naturally ask: is it right, is it good, that we should destroy five lives of which only one would be deformed and four normal? I would say that it is wrong to destroy two lives in order to prevent the risk of one being abnormal. That is my first reason for moving this Amendment, and I hope it is one with which your Lordships will agree.

My other reason your Lordships may not agree with so readily, but for myself I should think it wrong to destroy an unborn life even if you were certain that it was going to be deformed. Again, I have very little personal experience or direct knowledge of the care of deformed children. Many of your Lordships have far greater experience than I have, and I hope that any of your Lordships who can do so will give any examples that may be relevant. But there are certainly many thousands of cases of deformed children, very seriously deformed, sometimes without legs, who are trained and taught to move in the most marvellous way, and to enjoy life with the greatest zest and do exceedingly useful work, far more useful work than some normal people do.

Whatever we may happen to believe or not believe about the origin of life, at least we can be certain that we did not make ourselves. If we are going to deny life to an unborn child because we think it may not be able to do the same kind of work as we do, or to take the same amount of exercise as we do, or to enjoy exactly the same kind of pleasures as we enjoy, then surely we are acting like proud man in Measure for Measure: Drest in a little brief authority, Most ignorant of what he's most assured, His glassy essence, like an angry ape, Plays such fantastic tricks before high heaven As make the angels weep.

BARONESS GAITSKELL

May I put the women's point of view in regard to the noble Earl's speech? We can use statistics, and perhaps a man would say that, "There is a 10 per cent. chance that the child may be deformed or mentally handicapped. Well, I will have it. I shall not let my wife have an abortion". But I think if you apply that same percentage to the woman you might find a quite different answer. The thought for any woman of having a mentally or physically handicapped child is absolutely appalling. No man will ever understand it. This does not mean that when two people have a mentally or physically handicapped child they do not love it. Of course they do.

THE EARL OF DUNDEE

May I interrupt the noble Baroness? Surely, if the effect on the mother is so appalling, then she would in any case be able to have her pregnancy terminated under the first clause.

BARONESS GAITSKELL

One does not know the effect on the mother totally before she has the child. Perhaps the noble Earl has not been round a home or hospital for mentally or physically handicapped children, as several years ago I and my late husband used to do. I could hardly bear to go into the wards where I saw these physically handicapped children. I could hardly bear their misery, and I simply do not understand noble Lords who talk about the happy lives of these children. I do not know how they know about these things. I do not know how they can venture to say that these extremely mentally handicapped children and physically handicapped children have a chance of happiness in this life.

THE EARL OF DUNDEE

Perhaps the noble Baroness a year ago on television might have seen some striking examples of their activities.

7.4 p.m.

VISCOUNT DILHORNE

Before we get into more argument about the activities of these poor handicapped children, may I say how glad I shall be to discuss the Amendment in my name at the same time as that of the right reverend Prelate? He has moved his Amendment in a charming, ecclesiastical fashion; but of course his object, if one discloses it, is precisely the same as the object of my noble friend. As the Bill now stands, under paragraph (b) you look at the question whether there is a substantial risk of the child being seriously handicapped. You look only at the interests and the case of the child. It comes under paragraph (a) if there is any question of that risk affecting the mother's health. What the right reverend Prelate is seeking to achieve by his Amendment is really to take out paragraph (b) as a separate issue and make it one of the matters taken into account in relation to the mother's health.

There is absolutely no need for that, and the only reason that the right reverend Prelate is doing it is really to seek to get rid in that way of paragraph (b) in its present form. I support his objective, but not his method. In my view, it is without those words absolutely clear that if there is a question of a woman's health being affected by the prospect of having a seriously handicapped child, that is a factor that the doctors can take into account under paragraph (a), and it is not right to regard that possibility as environment. That is a misuse of the words. And if the right reverend Prelate thinks that the adjective "total" is of such importance before the word "environment", I hope that when he comes to reply he will explain to me what is the difference between "total environment" and "environment". "Environment" really means surroundings. We are not talking about the surroundings of the woman here; we are talking about the risk that the child she has will be seriously handicapped, and if that is likely to affect her health then, under paragraph (a), that is a matter that the doctors can take into account, and rightly.

Therefore, in my view, the Amendment is wholly unnecessary. I agree that it is a matter that should be taken into account. I am against its being specially spelt out in the way that the right reverend Prelate suggests, because I think it is not right to put all that weight particularly on one factor which has got to be taken into account. But the real reason the right reverend Prelate is putting it in that way, as I am sure he will say quite frankly, is to get rid of the consideration of the question of the unborn child by itself, because, as the Bill now stands, you can, under paragraph (a), look at the health of the mother, and paragraph (b), as the Bill now stands, applies only when you can say, "It would not affect the health of the mother, physical or mental; there would be no risk of injury to her to have this child". But you are saying, "Despite that, there must be power legally to take and destroy the life of this prospective child".

As I understand it, that is how the Bill is drawn. I do not think I am being controversial about it. I think that is what the Bill says. I had down an Amendment to alter the language of paragraph (b) because I thought it was far too wide. It talks of a "substantial risk", and the possibility of the child being seriously handicapped. As your Lordships will see, I have put down an Amendment to narrow that, because if you are looking only at the interests of the child, which you are, under paragraph (b)—you are not looking at the health of the mother under paragraph (b)—can you possibly justify terminating that fœtus because the chances are one in three or one in four of the fœtus turning out to be an abnormal child?

I do not think you can justify that where there is no question about the health of the mother. Where it is a question of the health of the mother different considerations might apply which the doctors will assess. But under paragraph (b) you have to take the position where no question of the health of the mother arises. Then I would say, if you are looking only at the child you have no justification for destroying that fœtus because there is one chance in three that if that child is born it will be abnormal. That is why I would say that the furthest I would go, and would have been prepared to go, is to say that that might be justifiable where it was more likely than not that the infant, if born, would have no enjoyment of life. I tabled an Amendment to that effect in a spirit of compromise, that being as far as I was prepared to go.

I do not think there is really any chance of compromise now. On reflection, I do not think it is right, even then, to say, "We will destroy this child before it is born, because it would be better for the child if it never had been born; for this child has no prospect of enjoyment of life." A great many people, in this House and outside were surprised when the noble Earl, Lord Longford, in his eloquent speech on Second Reading, referred to euthanasia. They did not quite see how it related to this subject. Are not the people in favour of paragraph (b) as it now stands failing to face up to the fact that what they want is a form of euthanasia?—not in the interests of the mother, because there is no question of risk to her health. Are they not saying, "There is one chance in three of this child being born wholly abnormal—a monstrosity. It is not right to take this chance. The child might be a perfectly normal human being, but because there is one chance in three, or one chance in four, that it might not be, it must be destroyed without being born"? Are they not arguing that because they dare not come forward and say, "Wait to see when the child is born whether it is a monstrosity or normal, and if it is a monstrosity, destroy it"?

If they came before this House or the other House with that argument, I should respect their arguments more, because they would be frank and clear. But that is not what they are seeking to do by paragraph (b), as it stands. What they are seeking to do by paragraph (b) is not to see whether the child is a monstrosity, abnormal, the kind of child to which Lady Gaitskell so eloquently referred, but, if there is any substantial risk of that being the consequence, not to give that fœtus the chance of becoming a normal human being.

Therefore, if my noble friend Lord Dundee presses his Amendment to a Division, I shall certainly support him, and I hope that it will be carried. I shall not move my Amendment because his Amendment meets my objectives. On reflection, I do not think that it would be right to move my alternative wording. I hope that the right reverend Prelate will not move his Amendment, for the reasons I have given. He, too, wants to get rid of paragraph (b). Let us have a clear-cut issue and vote against the inclusion of (b) and then consider the Bill again before Report.

BARONESS WOOTTON OF ABINGER

I do not like to say it, but, if one had to choose, I think I would much prefer infanticide to the provision in the Bill as it stands at the moment—I mean decent infanticide, decently done, immediately, in the case of a monstrosity. Because we have no prospect of getting that legalised, I am very much in two minds as to what we ought to do about this particular clause. I think that on the whole the Amendment in the name of the right reverend Prelate is the one which bridges this gulf most effectively. It does not prevent us, where there is the possibility that a woman is carrying a child with a doubtful heredity, a child which may be born gravely handicapped, from taking that factor into account in deciding whether the pregnancy should or should not be terminated. But it does not involve making actuarial calculations, which the medical profession would find extremely difficult, as to the probability of this event occurring without reference to the health of the woman. Therefore, failing infanticide, if I may so put it, I feel disposed to support the Amendment moved by the right reverend Prelate.

BARONESS EMMET OF AMBERLEY

Might I join in this debate, as there have been two ladies on the other side who have spoken about this matter? My objection to paragraph (b) is that it brings an entirely new element into this Bill, which was first launched and contrived in the desire for the benefit of the mother and to improve the abortion laws. The question of the deformed child is a quite secondary and additional matter which has crept in. I have a great deal of sympathy with the Amendment of the right reverend Prelate, because obviously he has the same object in mind as the noble Earl, Lord Dundee, and myself in the Amendment which we have put forward.

Surely it would be better that this Bill should relate entirely to the point at issue; namely, the welfare of the mother and an abortion, if that is necessary, for her sake. This paragraph would have been much better dealt with, if required, by an amendment of the Infant Life Preservation Act 1922. After all, it is a quite separate issue. I feel that at present the medical profession—and they have stated so themselves—are not in a position to give a sufficiently accurate diagnosis of the fœtus at the time when it may legitimately be removed to allow us to have a clear conscience in this matter. It is terrible to think that we would sacrifice two, or three, healthy babies because we think—though we do not know—that there may be a deformed child. It puts me in mind of our general outlook in legal matters, that people are innocent until they are proved guilty. Here, apparently, five children are to be judged guilty, as it were, though they may be innocent, for the sake of one. It is almost as if you stood five people in a row and shot them because you could not make up your mind and had not sufficient evidence as to which of them was guilty. It is quite out of any sort of proportion.

Further, we are here putting far too much responsibility on the medical service. It is not fair to ask them to make these decisions when they have already said that at this stage they have not the means at their disposal. There are people who take the Christian point of view of the sanctity of life, as I do. I am not a Catholic, but I am a Christian. We know that there are humanists who take the opposite view, that a fœtus is not a human being until it becomes viable. But the medical profession has been bound, long before Christianity, by the Hippocratic Oath, and that Oath binds them to try to save life and not to take it unnecessarily. Therefore, we are putting on the medical profession an undue burden, to which they are quite right to object. I should like to see a vote on the Amendment which the noble Earl, Lord Dundee, and myself have put down. Failing that, the right reverend Prelate has the right to put his Amendment first, and I should certainly vote for it. But I hope that in this Bill we shall not mix up the health and the wellbeing of the mother with a totally isolated matter, which is confused, and I think would not bring credit on this House.

BARONESS STOCKS

I should like to oppose this Amendment, and the Amendment in the name of the noble Baroness, Lady Emmet of Amberley. Let us imagine (and one does not have to stretch one's imagination very far, because it is not a very unusual state of affairs) a woman who is perfectly healthy, who may also have several children, who is mentally sound and well balanced, and in no way psychologically disturbed. She becomes pregnant at a dangerous time, in that during her pregnancy she contracts German measles and is told that there is a chance that the child will be born blind or otherwise handicapped. It may be a 5 per cent. chance, a 30 per cent. chance or a 50 per cent. chance—I do not know: I believe that there are differing views as to the actual percentage. Looking at it from the point of view of that mother, she is not going to be psychologically disturbed, but she is going to be very unhappy if she has to go through that pregnancy in seven or eight months' time.

What can she do? Under the present law she can force a doctor to make what is perhaps a difficult decision. She can consult a psychiatrist, and she can put on an act and threaten to be mentally disturbed or suicidal if she has to go through a pregnancy under those conditions. She will doubtless get away with it, and she will have an abortion. We are living in an age of planned families and, presumably, that woman and her husband have decided how many children they intend to have. What she is doing is not sacrificing one life; she is exchanging the possibility of a good life, a normal life, for a handicapped child, because when she has recovered from her abortion she will have another pregnancy if she wants to increase her family. No fewer children are going to be born as a result.

BARONESS EMMET OF AMBERLEY

Before the noble Baroness sits down, may I put this point to her? No pregnant mother can guarantee that she will have a normal child at any time. Abnormalities occur from time to time in every family, and you cannot completely guard against these. I do not think her argument holds good at all.

BARONESS STOCKS

Of course a mother cannot guarantee that she will have a normal child. But in the circumstances I have mentioned there is a probability that she will not, and that is the probability that she takes into account.

7.22 p.m.

LORD STONHAM

I consider that this subject is perhaps the most important of the whole Bill. These Amendments which we are considering are those about which there is the deepest feeling and the deepest concern. The Amendment moved by the right reverend Prelate the Bishop of Durham has the effect that a substantial risk of abnormality in the fœtus will in itself no longer be a ground for abortion. As the right reverend Prelate said, he is putting it all with the mother.

Whatever the moral effect of the retention of the words in the Bill linked up in the manner the Amendment suggests, I agree with what I understood to be the view of the noble and learned Viscount, Lord Dilhorne, that they would have no practical effect whatsoever. So despite the eloquence of the right reverend Prelate, and his understandable desire to change these words in the Bill, I am bound to say that they would have no effect, because all that he wants to do can already be achieved by paragraph (a). Therefore, if it is your Lordships' desire not to have these words in at all, then the right reverend Prelate does nothing of practical effect. I may not have used the same words as the noble and learned Viscount, but I take comfort from the fact that I have expressed the sense of what he said.

One other thing should be made clear. The doctors could be in considerable difficulty if paragraph (b) were deleted altogether, and my information is that the British Medical Association is in favour of allowing abortion where there is a serious risk of abnormality of the fœtus; and the Royal College of Obstetricians and Gynæcologists also supports a provision on the lines of the present paragraph (b).

It seems to me that I have been more of a listener than a speaker this afternoon. I think I have heard every word that has been uttered on the last two Amendments, without any intervention at all. But it seems to me that we have been putting our own thoughts, our own feelings in this matter, and have virtually excluded at almost all times the three most important sets of people concerned—first, foremost and all the time, the pregnant woman; secondly, the child; and, thirdly, the doctor. Most doctors are not also lawyers, but in some of the legal discussions on single words which I have heard I have been appalled to think of the difficulties which they would put up for the doctor's understanding. Therefore, on these two Amendments I am going to devote all my remarks to the mother, the child and the doctor.

First of all, no-one can compel a mother to have an abortion. She decides. So many speeches have been made that one would think there was an assumption that a woman was obliged to have an abortion. It is necessary to say that. If the mother thinks she is likely to have a defective child, and she is prepared to accept all that that entails, that is the end of the matter. She should have the child. But if for whatever reason the mother recoils from the prospect, then those who would delete paragraph (b) entirely are, in effect, saying that unless the doctor thinks it will have a serious effect on her physical or mental health she must have that child. I very much doubt whether, if we ourselves had to say that to the individual woman after knowing all the circumstances, we should feel that we could say it. But that is what is collectively being said with regard to this Amendment, and I can only say that it is an awful responsibility. As I understood the noble and learned Viscount, if Amendment No. 11 to delete paragraph (b) were carried, he would not then think it necessary to move his own Amendment.

VISCOUNT DILHORNE

That is right. If the Amendment in my noble friend's name is carried, I shall certainly not seek, in this Committee stage at least, to move the Amendment standing in my name. Therefore, there is no need for the noble Lord to comment on that.

LORD STONHAM

Nevertheless (I assure the noble and learned Viscount that I am not reading a brief), I think it right to consider this subject in the round, because when I first looked at the noble and learned Viscount's Amendment I thought it was still an attempt to try to cover this point, but only in those cases where it was more likely than not that a child would be born defective. It really is not art alternative at all to the deletion of paragraph (b), because it is only in the very rarest cases that doctors could say, if they would say, that there was a 51 per cent. chance that the child would be abnormal.

VISCOUNT DILHORNE

The noble Lord will appreciate that my argument was that it was only if the doctors could say that, that the termination of the fœtus on the ground that the child would be abnormal—with the mother's health not in the least affected—could possibly be justified.

LORD STONHAM

I quite agree with the noble and learned Viscount. I am not disputing this. I am merely saying that if the cases are so rare of a 51 per cent. chance of abnormality, then it is virtually the same as deleting paragraph (b). I am not arguing about it one way or the other. I am merely saying what the effects of the Amendment would be.

I feel very deeply about abnormal children, particularly mentally subnormal children. In the last 17 years I have had the privilege of working with and knowing a great many of them. For four years I had responsibility for 8,000 mentally subnormal children. Personally, from my own observations, I should find it very difficult to say, except in the case of a very small percentage of psychotics, that any of those handicapped children were unhappy. They have a limited range of life of course; but certainly, so far as one can see, they are not unhappy. But I should have thought it was quite impossible for a doctor to judge that there was more than a 50 per cent. chance that such a child would be born subnormal.

Therefore, although I think these children are happy, the real point that has to be considered in deciding for or against these Amendments is the position of the mother. The difficulty is not so much when the child is young. In the case of many families that I know, where the parents are now elderly and the child is middle-aged and still living at home, the difficulties are enormous. But suppose there is a mother with a handicapped child, who dearly loves that child and always will, but who is perhaps pregnant again and is alarmed at the prospect of the possibility of another child. Is it right for us to say that, unless one could argue that she was ill, she must have the child?

I think that these are the considerations; and it is not enough to say that these children can be cared for in other ways. All of us are to blame, successive Governments are to blame, in my view, for the fact that these children are the most neglected of the whole community, neglected not by their parents but by us, who are responsible for making the laws and making these provisions. But this is the world that we live in. I do not think a doctor can decide whether an eight weeks' fœtus will have a reasonable enjoyment of life, but I do think that in these matters we ought not to define it too clearly. I think we ought to give the doctor a chance to exercise his professional skill in good faith.

LORD BESWICK

We agreed to adjourn—

BARONESS ELLIOT OF HARWOOD

May I say just two words—

LORD BESWICK

I think there are several other noble Lords who also want to speak, and we had made arrangements to adjourn. I wonder, therefore, whether it would be to the convenience of the Committee if I now moved that we adjourn for one hour—that is to say, that we should return at 8.30 p.m.

Moved, That the Committee be adjourned until 8.30 p.m.—(Lord Beswick.)

[The Sitting was suspended at 7.33 p.m. and resumed at 8.30 p.m.]

BARONESS ELLIOT OF HARWOOD

I was about to make a few remarks just before we adjourned for dinner. I wonder whether I may say a few words now. I want to speak against Amendment No. 10 and against Amendment No. 11. Whether the noble and learned Viscount will move Amendment No. 12 I do not know—I might feel differently towards that—but I am definitely opposing Nos. 10 and 11. I do not quite see how you can separate the feelings or conditions or health of the mother from the subject matter of paragraph (b) of subsection (1). I do not think we ought to cut this paragraph out of the Bill. I think it is important that it should remain in. I do not think one can exaggerate the terrible anxieties and difficulties that come as a result of having mentally defective children.

As chairman of a Children's Committee I have had contact with families which contained one, two and sometimes three or four mentally-handicapped children. In many of these cases the mother would be only too anxious not to have another child. But in the present state of the law, we find many instances of a mother bearing more than one mentally-defective child. This I believe to be altogether wrong. From my own experience of contact with such families I know one cannot separate this particular happening from the health of the mother. Some noble Lords have said that the health of the mother is not involved in subsection (1)(b) as it is worded. But mothers cannot be so separated from their children. One cannot deal with the case of the mother as an entirely separate entity from the case of her giving birth to severely-handicapped or mentally-retarded or mentally-ill children. This does not tally with my own experience and is surely not according to Nature.

I think it will be disastrous if we were to allow paragraph (b) to be deleted from the Bill. It is an essential part of it; it is of vital importance to the family, to the mother and, what is more, to society—because no one can think it is good for the community that one mother should go on bearing mentally deficient children. I feel myself that this paragraph must be retained. It is in the interests of the community and the mother, and clearly it must be in the interests of unborn children, since no one could wish a child to come into the world very severely handicapped, either mentally or physically, in the way in which we know from long experience is often the case. Therefore I hope that we shall retain this paragraph. I shall vote against the Amendment of the right reverend Prelate the Bishop of Durham, and, if it is pressed, I shall vote against Amendment No. 11.

LORD GRENFELL

It is natural that I should think very carefully over these Amendments, being personally involved both in my private life and as chairman of a group of hospitals for mentally handicapped children. I have thought very carefully through to-day, and for the last few days, trying to make up my mind about the right course to take; and I have come to the firm conclusion that the right reverend Prelate has the right Amendment, as it links the abnormality with the mother and—dare I say it?—with the father, who has rarely been mentioned in these debates, and with the environment. I could not vote for the Amendment in the name of my noble and learned friend Lord Dilhorne, as in my experience it is impossible to say that a child who is born mentally handicapped or abnormal in any way will not have a happy life. From my experience in the hospitals, and in my private life, I have seen children who are mentally abnormal but who, I am delighted to say, are exceedingly happy; so I could not vote for that Amendment.

After careful thought I believe that we should have something in the Bill relating to subnormality, not only because I believe that the Amendment of my noble friend Lord Dundee would kill the Bill, but because I think that if parents could be sure that their child would be mentally handicapped they would have a right to an abortion. For these reasons I beg the right reverend Prelate to take his Amendment to the vote. With many years experience of this question, I feel that on the few occasions when it is possible for doctors to tell that a child will be abnormal we can at least leave it to their good judgment to tell the parents, and they can decide the issue between them. That is my firm conclusion. I feel sure that the right reverend Prelate's Amendment is the best we can do. I hope that he will press it, and I sincerely hope that the Committee will support him.

LORD BYERS

I rise to oppose what the noble Lord, Lord Grenfell, has said, although he has spoken sincerely and I am sure with the full respect of the Committee. I should like to support the noble Baroness, Lady Elliot of Harwood. She spoke to the point. I implore the Committee to consider seriously what we are in danger of doing. All these Amendments have been discussed with sincerity, but the effect of each one, as was made absolutely clear by the noble Lord, Lord Stonham, would be to weaken and narrow the Bill. This is the important point. No matter how sincerely we may feel about this, the Amendment in the name of the right reverend Prelate does nothing which cannot be done by paragraph (a). We ought to realise that, however, much we dress it up, it is nothing except a form of words. It denies the right of a mother to have an abortion if there is a substantial risk (as the Bill says) that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped", unless this can be tied in with the health of the mother. This is a very important point. Amendment No. 11 comes absolutely straight to the point with no beating about the bush at all, as one would expect from the noble Earl, Lord Dundee. The chance of handicapped children being born will be increased if we take paragraph (b) out of the Bill.

In my view, both these Amendments are cruel ones, weakening and narrowing the Bill. Those of your Lordships who have had experience of the anxieties of young women—women under the age of 30—know that they are really worried when they get German measles at a certain time during pregnancy, and realise that it is cruel to favour something of this sort which weakens the Bill in this respect. These Amendments are cruel because they introduce a prohibition on the doctor, whereas up to now a liberally minded doctor has been able to interpret the law as he thinks best for the mother and the family. I would plead that these Amendments should be withdrawn and that the Bill should be allowed to go forward as it stands. We are in grave danger of doing something absolutely wrong. I do not believe that the right reverend Prelate and the noble Earl would wish to do that, and I can see that in two years' time, if these Amendments go through, they will be the first to regret it.

BARONESS WOOTTON OF ABINGER

I am surprised that the noble Lord, Lord Byers, takes this line, because it seems to me perfectly clear, taking the German measles case, that this is pre-eminently a case which would be covered by the Amendment moved by the right reverend Prelate, a case in which the extreme distress and anxiety of the mother is deleterious to her own mental and maybe physical health.

LORD BYERS

It was the noble Baroness who moved an Amendment proposing that it should be a prolonged injury.

BARONESS WOOTTON OF ABINGER

The situation has now changed—I must accept the decision of the Committee that it has changed. In the present situation, I think it is important that we should not open the door more widely. The noble Lord, Lord Byers, spoke of the risk of the handicapped child being born. We all know that the medical profession can seldom prophesy even 50–50. It is more common for them to prophesy three favourable to one unfavourable result. If we accept the Bill as it stands, we are committing ourselves to saying that it is worth while destroying, where there is no injury to the health of the mother, the possibility of two or three chances of a normal child against one or two of an abnormal child. I think that it ought to be put dispassionately and calmly that these are the facts of the situation.

VISCOUNT WAVERLEY

Doubts have been expressed on various sides of the Committee about whether we in the medical profession are able to produce figures of any degree of exactitude. Unhappily, in a large number of cases we cannot, but there are circumstances in which we undoubtedly can. I support the Amendment of the noble Earl, Lord Dundee, to eliminate paragraph (b) because I firmly believe that the matter can be covered under paragraph (a), under the mother's mental health. But it would be much easier for the doctor to be able to use this clause and tell a mother that such and such was the actual risk of her child being affected. Then the mother would be confronted with the situation in which most mothers—not all, because women differ greatly in their reactions—would decide that they genuinely and honestly felt that they could not go on with the pregnancy.

May I give your Lordships the figures we have available? In the first six weeks rubella carries an over 50 per cent. risk of abnormality, but this varies with the strength of the virus, though this is not known at the time. After the first three months there is really hardly any risk at all. After the first six weeks, but within the first three months, the overall risk is 14 per cent. It falls rapidly after the first six weeks. Against this, I think it is only fair to tell your Lordships that it is virtually certain in the foreseeable future—certainly I hope within five years—that rubella will no longer be a problem, because it will be possible to carry out maternal immunisation. Thalidomide, and drugs having what are known as tetragenic effects of that kind, also carry a more than 50 per cent. risk of fœtal abnormality. One naturally hopes that the Dunlop Committee on Safety of Drugs will prevent these from getting through their net in the future, but that cannot be guaranteed. So this, too, would be a situation.

There are certain sex-linked genetically determined defects which carry a 50 per cent. risk. Hæmophilia, in the ordinary way, affects only males. So it would be necessary to have intra-uterine sex determination carried out to make certain the fœtus was a male; but this cannot be done with great precision at the moment, although it will certainly come very soon. There are certain of the muscular distrophies, so called, which carry a 50 per cent. risk of repeating themselves. And a disease known as Huntingdon's Chorea, which is a disease of involuntary movements and increasing mental deficit, and eventual dementia, also carries a 50 per cent. risk. I said that hemophilia normally affects men only, and this is true; but every now and again a woman may have hæmophilia, and if she should happen to marry a hæmophilic man and they had a child, there the risk would be 100 per cent. Then there are certain biochemical disorders with mental defects, phenylketonuria, galactosæmia so-called, which carry 25 per cent. risk. I thought it might be helpful against the background of this debate to give those figures, because these situations, to my mind, if they existed, would make it virtually certain that the mother would be justified in being aborted under paragraph (a).

LORD SOMERS

I should like to add a few words in support of what was said by my noble friend Lady Elliot of Harwood. I was quite astounded to hear my noble friend Lady Emmet of Amberley talk of paragraph (b) as isolating the children from the mother. How can you isolate the children from the mother? It is the closest relationship that exists in human experience. If the children are severely affected, then it is more than likely—in fact, it is practically inevitable—that the mother will be affected mentally. I know it is a fact that one cannot tell in more than about two in 100 cases whether a child is going to be abnormal in any way, certainly in the early stages. Therefore, this paragraph would be brought into use only rarely. I think that those who speak of the sanctity of life should stop to think a little about the effects of that life on those who have brought it into the world and who may have to live with it. I heard not long ago of a young couple who were very happy at just having had a young daughter, and they were asked: "Is this your only child?" The mother's face clouded for a moment, and she said: "No, no. We had one child, but he had to be rushed off to hospital at once, and there he will spend the rest of his life." That is a pretty severe blow to anybody. Even worse is it when perhaps the child is mentally abnormal and has to be cared for by the parent to such an extent that the other existing children are neglected.

A great deal of argument on sociological grounds has been made this evening about the question of the existing children. I agree there is not a great deal to be said on that question under this Bill. But, certainly looked at from this point of view, looked at from the point of view of the fact that the other children will be neglected, because the mother has to look after and devote her entire time to an abnormal child, this question seems to me much more potent. I therefore sincerely hope that the Bill will go through complete with paragraph (b).

BARONESS EMMET OF AMBERLEY

Before the noble Lord sits down, may I say that I do not know what proof he has that, because a mother has an abnormal child, she neglects the other children. That is not my experience.

LORD SOMERS

No, indeed, it may not always be the case. But if the child is so abnormal that it needs constant attention, it may in some cases occur. I do not say in all cases, but it is possible.

LORD GRENFELL

May I just say for the Record that my noble friend has made one or two statements and I think, on reflection, that he should not have said that parents of mentally handicapped children are mentally disturbed. I think he said that. The fact is that I know many, many of these people, and they are not mentally disturbed. They adore their children, and are doing everything they can to ensure that they have the best possible life, both from Government help and from the people who are so kind to them. They are not mentally disturbed. They are very fine people who know exactly what they are doing. They know what they are going for, and they are going to get it.

8.54 p.m.

VISCOUNT BARRINGTON

I find it extremely difficult to speak on this subject, which is the most important and the most moving of the subjects. I should like particularly to say the very few things I shall say to the noble Lord, Lord Segal, who is, of course, an authority on these things. My object is really to support the line that has been taken by the noble Lord, Lord Grenfell, without having been through any such experience myself, except that I have seen certain cases of abnormality. I have taken a certain interest in it. I think it would be better if I confined myself to quoting other people, first of all on the point of statistics.

It is hardly necessary, after the speech of the noble Viscount, Lord Waverley, to mention that, but I have had to-day a letter from a gynæcologist, whom I do not know. I know four eminent ones now, who are in a society I am connected with. This is a non-Roman Catholic gynæcologist living in York. His name is Mander. I have made inquiries, and he is a man of the highest reputation. I should like to read one of the sentences he says about this Bill, which he heads, "The eugenic clause". He says: This is the most disturbing aspect of the Bill, and is medically quite unjustifiable. No obstetrician, faced with a Mongol at birth or say ten weeks before birth, would envisage destroying it rather than caring for it. The same applies to a spastic baby, or a rhesus baby (with its known high risk of permanent brain damage in the severe case) or the thalidomide baby, or the accidentally irradiated baby, or the deaf baby from rubella. Even worse, these conditions are not predictable and some not yet diagnosable before birth so that the condition is a statistical risk implying the destruction of more normals than abnormals. This clause worries a large number of us more than any other. May I now go on to one general point which has arisen out of this discussion, and which to me is an important one because it raises the whole question of whether or not life is worth living. To my mind, every child is born with at least two handicaps, one of which I think is unfair and one which we have to presume, if one believes in a planned and fair universe, is fair. The handicap which is fair is a conscience. I think almost everyone is born with a conscience in some form or another. I know from experience that conscience is a very easy thing to kill, and one is much happier when one has killed it. I imagine that that was particularly the case if one lived in a place like Nazi Germany. Without a conscience, gradually one can tell oneself that life is really not so bad; and one can live a much happier life without a conscience. I do not know whether any noble Lord would dispute that. But the point about the conscience is not that it makes one happy, but that it makes one human.

The other handicap, which I say is an unfair one on the unborn child, is of course its name. It is called a "fœtus", which gives it a very bad start, because we all think in terms of names. I have made the point before, I believe, that "fœtus" occurs in the medical dictionary between a disease called "œtor", or something like that. It suggests all sorts of ideas of fœtidity and monstrosity, and what I believe it means is the present case, roughly, of which the past case in Latin is "fui" and the future is "futuris". "Futuris" is something which is going to happen, and the fœtus is something which is happening.

I believe that that is an important point, because so many people think of the unborn child as something which does not in fact have life. I measure it by the words in this Bill. Sometimes the fœtus is called a "child" and sometimes it is compared with existing children. I find it difficult to believe that it does not exist and live. I have probably talked for too long already, and this is not the time of night to ask for some sort of evidence for the fact that not only is it a human being but that at a very early age it looks like a human being, which I believe is why this particular operation is so extremely unpleasant to the gynæcologists who have to perform it, and to the nurses, who are not often allowed to see it. I have been told by a doctor (who certainly was not a Christian as a young man) that it is the only operation he knows which, instead of becoming accustomed to it and making jokes about it, the medical practitioners find becomes more and more unpleasant, because it is doing—and clearly doing—the one thing that doctors are not intended to do.

If a human being has any purpose in this world it might be said that the easiest way of making him happy is to treat him, as we may all be treated soon, by having our consciences extracted. We are told that memory is a chemical. We may be told: "Conscience is a chemical. Have it taken out." There are all kinds of ways, by drugs and other things, of making people happier and they are certainly justified in short cases, but in all this I go back to a point I made the first time I spoke in this House. I do not believe we know enough to know who would be happier alive or dead. I think it was the President of my College at Oxford who was interviewed by the Ambassador of the Emperor of Japan, whose son was to go there, and it was pointed out that he was a very important person; in fact that he was the Son of God. The President of my College said "That is quite all right. We have the sons of many distinguished persons here".

If my life had to be taken without trial and against my will, I cannot think of any three people in this House whom I would more trust to do it than the noble Baroness, Lady Summerskill, the noble Lord, Lord Segal, and the noble Lord, Lord Platt. They are, in the best sense of the word—I am not being sarcastic—very distinguished persons, but they are not the three persons of the Trinity. And it is on these grounds that I think we ought to be chary about taking life when we do not know it is not viable.

9.3 p.m.

LORD SEGAL

I had not intended to intervene in this discussion, but since my name has kindly been mentioned by the noble Viscount, Lord Barrington, I would only say this. I am quite convinced, after spending a good part of the last three years working on behalf of mentally handicapped children and their parents, that every parent of a mentally handicapped child would be inclined to vote in favour of the wording of this Bill as it now stands and to vote against any of these three Amendments.

LORD BOOTHBY

I want to make only one remark. I think this discussion that we have had, which is of extreme interest, can be summed up in a sentence: the fewer babies that are born into this ghastly world, the better.

LORD LEATHERLAND

The noble Lord, Lord Boothby, speaks for himself, of course. Let me speak for myself. The noble Viscount, Lord Barrington, quoted to us a statement from a gynæcologist which was in support of the line he takes in connection with this Bill. There are, of course, many other gynæcologists who could be quoted in support of my noble friend, Lord Silkin. The noble Viscount told us that his gynæcologist said this was something that worried him very much indeed. Of course, it worries us all; we are not entering into this matter in any light-hearted spirit. It is one of the greatest tragedies of human existence. The noble Baroness, Lady Emmet of Amberley, said she spoke as a Christian. So do I. I am as mindful of the sanctity of life as anybody in this Chamber. But I recall that we are the people who participated in two world wars, who participated, either actively or passively, in the slaughter of scores of millions of people; and we were sent into our battles with the prayers of the Bishops ringing in our ears. So please let us keep a sense of proportion when we are speaking not in terms of scores of millions of people slaughtered but in terms of a few hundreds, perhaps a few thousands, each year.

I am not one of those polemical abortionists. I am a normal pampered husband, four times a happy grandfather—quite a normal kind of person. I feel some abhorrence at the possibility that if these Amendments are carried we shall be countenancing the bringing into the world of children who are destined to be malformed from the moment of their birth and who are likely to be a great problem and a great worry to their parents. I am not disputing for a moment statements that have been made on behalf of parents who say that they love those children. I know they do, but I know also the other side of the question. The girl that my son married—he is not sitting on the Steps tonight, so I can go into family affairs—was for some years a nurse in a hospital where these little malformed children are cared for. I always thought that she was doing most noble work. But these were little children in respect of whom the parents had said, "We do not want to continue caring for them, no matter how much we love them. Let us get them off our hands."

Paragraph (b) is one of the main points of this Bill. We have already passed two Amendments which have struck at some of the important clauses of the Bill. But I think that everybody has brought a most human point of view to bear on paragraph (b). Those of us who are lined up with the noble Lord, Lord Silkin, feel that this is one of the main points of the Bill, and that to delete it would strike at the heart of the whole of this reform of a cruel law, a reform which we want to see brought about.

The noble and learned Viscount, Lord Dilhorne, has told us that in certain eventualities he may move the Amendment standing in his name. I do not like that Amendment. It says that you shall conduct this operation only if there is a 51–49 chance of the child's being deformed. I think that is going to be cruel to the expectant mother. If I may bandy words with the noble and learned Viscount, which I hesitate to do, I do not like that expression of his which talks about "reasonable enjoyment of life", because those of us who have lived in villages have seen that sad institution, the village idiot. That young boy is usually the happiest person in the village. He may not be able to appreciate some of the niceties of modern civilisation, but he is also unable to appreciate the worries that curse so many of us; and really, I should not like to be bound by the words "reasonable enjoyment of life" that the noble and learned Viscount includes in his Amendment.

There has been reference to German measles. Having quite recently become a grandfather once again, I remember that in the district where my daughter was living there had been outbreaks of German measles. I do not know how much my daughter worried during those nine months, but, believe me, I worried very much indeed. Fortunately, everything went well; but this menace of German measles exists. We have heard from one of the learned medical authorities in this House that shortly some treatment will be devised that will protect expectant mothers against the consequences of German measles. But that remedy is not here, and if this Bill passes into law, if it bridges the period between now and the time when that remedy will be available, it will have done good work.

We were all shocked by the results of the thalidomide treatment which was given to so many young mothers-to-be. And it is not only thalidomide, for many new drugs are being given at present for all kinds of illnesses, some of which are peculiar to expectant mothers and some of which are of general application. We never know which one of those drugs will turn out in a year or two's time to be one of those drugs that has the same effect on mothers-to-be as thalidomide had. If an expectant mother has been taking some drugs the side-effects of which she does not know, or if she has been exposed to German measles, it is a sin to compel her to carry on for nine months with the threat hanging over her that her baby may in some way be abnormal.

We are not dealing here in medical science with something which is exact. There is nothing sure about medical science as to the present state of knowledge or as to future knowledge. We have even had during this Committee stage two of the most eminent doctors in the country disagreeing fundamentally on some provisions of this Bill. I think that all the Amendments which have been discussed this evening have had the intention, in effect, of weakening the major premise of this Bill. If I may quote paragraph (b), it says that an abortion shall be permitted where there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped. In view of that, I feel, as one of those normal human beings who is not a "crank", that we should give the woman the benefit of the doubt.

9.12 p.m.

THE EARL OF PERTH

I am worried about one or two things. I think that the House has possibly been led astray, and I seek guidance. For example, the noble Baroness, Lady Elliot of Harwood, said that she was going to vote against the two Amendments which are being moved. I understand that the noble and learned Viscount, Lord Dilhorne, has said firmly that he is not going to move his Amendment. The reason the noble Baroness gave, I understand, was that if a mother had had two or three abnormal children who were mentally handicapped and then found that she was having a fourth child, if these Amendments were carried, she would be unable to have an abortion. I should like to ask—perhaps I might ask the noble Lord, Lord Stonham—whether this is true. As I read subsection (1)(a) surely such a case would be, or could be interpreted, as one of injury to the mental health of the pregnant woman. If that is the case, the ground which I understood Lady Elliot of Harwood to give for refusing to support the Amendment is not a good one. I should like to ask the noble Lord, Lord Stonham, whether I have correctly understood the position on this point.

LORD STONHAM

May I interrupt the noble Earl to tender my sincere apologies that I did not hear the first words of his reference to myself. I am not therefore clear as to the question which he addressed to me.

THE EARL OF PERTH

I apologise for having to repeat this. What I said was that I understood the noble Baroness, Lady Elliot of Harwood, to give as her ground for opposing the Amendments the fact that if the mother had had three or four mentally deficient children and was then pregnant a fourth or fifth time, if the Amendments were successful, she would not have grounds for an abortion; whereas if I read subsection (1)(a) correctly, even if paragraph (b) is removed, there is still ground, under the provision relating to injury to the mental health of the pregnant woman, for such an operation to take place.

LORD STONHAM

I can give a categorical answer to the noble Earl. If that mother could convince the doctor, or if the doctor was convinced, that the birth of any child likely to be abnormal would affect the mother's health to such a degree that it would be unwise to continue the pregnancy, then the pregnancy could be lawfully terminated without paragraph (b). But if the doctor thought it would have no effect on the mother's health, then if paragraph (b) were removed from the Bill there could not be a lawful termination of the pregnancy.

THE EARL OF PERTH

I thank the noble Lord very much. I think his statement helps on one point. Now I should like to ask yet another question of those who are supporting the Bill at the present time and are wishing that it stands in its present form. Paragraph (b) says: that there is a substantial risk that if the child were born it would suffer from such … abnormalities as to be seriously handicapped. We heard the noble Viscount, Lord Waverley, give some specific figures on the probabilities in the case of a pregnant woman who has caught rubella. In the first six weeks the chances of deformity are very great, and in the next six weeks the chances are one in seven. Is one in seven a substantial risk, and would it be the belief of those moving this Bill that you should kill six children to ensure that the seventh was not born? Is that "substantial", or what is? It is all very well for people to say that the doctor can decide this. I do not think a doctor can decide what is "substantial". I think it is for the movers of the Bill to help us.

Then, apart from "substantial risk", there are the words "seriously handicapped". What is "seriously handi- capped"? Is the probability of a club foot "seriously handicapped"? I believe that these are matters about which the movers of this Bill have a responsibility to tell us, and if they cannot satisfy us on these points at this stage the Amendments should be pressed.

LORD SILKIN

If I can satisfy the noble Earl, will he oppose the Amendments?

THE EARL OF PERTH

Yes, I shall, but for quite different reasons. This should be clarified for the Committee generally. I think the noble Lord knows my own personal and quite different reasons, and that is why he asked the question. But my answer is, Yes.

LORD BYERS

May I ask the noble Earl whether he voted for the Bill on Second Reading?

THE EARL OF PERTH

No, I did not.

VISCOUNT DILHORNE

I voted for the Bill on Second Reading and I raised these questions. I am very glad that the noble Earl, Lord Perth, has raised them now because, before we let paragraph (b) into the Bill, we surely ought to know what it is intended to cover. If "substantial" is so vague, as I think it is, that no one really knows what it is intended to cover, at least we can ask the promoters what they intend it to cover. Then we can see if the wording is apt. I raised on Second Reading the question of what is meant by "seriousiy handicapped" and we ought to be told about that. But if the noble Lord, Lord Byers, wants to know whether, having raised these questions, I voted for the Second Reading, the answer is, Yes, because I hoped to see this Bill improved.

VISCOUNT NORWICH

There was one point and one point only which I wished to make, although since the noble Earl, Lord Perth, spoke a moment or two ago I feel I must add one more. Even if the probability of a child's being born mentally or physically disabled is as low as one in seven, it is terribly misleading to say to ourselves, "We are killing six innocent children." We are not. We are possibly killing one innocent fœtus, which is not the same as six innocent children. We are not even doing that, really, because what we are doing if a woman has had rubella is allowing a high probability of her immediately starting another pregnancy which will not carry with it the same risk as the previous one. In fact, all we are doing is ensuring that she will have a pregnancy which will not be darkened and overshadowed by a totally unnecessary risk.

The only other point I want to make now is one which I recognise has already been made, in a slightly different form by my noble friend Lord Byers. It is that all three Amendments before your Lordships this evening have the same basic effect. Any single one of them, if passed, must inevitably result in there being more maimed and more handicapped children in the world from the moment this Bill is passed and into the indefinite future. Any one of your Lordships who votes for any of these three Amendments will, to some extent, when he sees a maimed or handicapped child, have that child, in some minute degree, on his conscience. This is a responsibility which I personally do not wish to accept, and I shall therefore vote against all three Amendments.

VISCOUNT DILHORNE

If I may say so, I shall not have it on my conscience. I think that is a complete nonsense and an absolute non sequitur.

LORD SILKIN

I think it is perhaps time the promoter had a word. Some noble Lords have made four, five or six speeches on these Amendments, and it seems that if we are going to get through this in reasonable time, then we must ration our own speeches. The Amendment that is actually before us is the Amendment of the right reverend Prelate the Bishop of Durham. That is the only Amendment that we have actually before us, although we have agreed to discuss Amendments Nos. 11 and 12 at the same time. They, however, are not formally before us.

What Amendment No. 10 provides, or is intended to provide, is this. I am not sure that it actually provides it, for the wording is not very clear and I believe may be defective, but that is not the point; the right reverend Prelate has made quite clear what he meant by it. What he meant by it was that there should be no abortion in the case where there is a substantial risk of the child being born defective unless it is going to affect the life or health of the mother.

I would agree that in the great majority of cases it will affect her. There will be the apprehension of the mother; the fear that she is going to give birth to a child of that kind—and, of course, it is a fear which will in most cases have some justification behind it. She may have had several children of that kind already; there may be something in the family of that kind; it may be hereditary, or there may be other reasons which make her fear. If in fact that fear has a physical or mental effect on her, then I agree that it is already covered. But what we are seeking to do in this clause is to cover those cases where two doctors are not in a position to say that it will affect the life or health of the mother. The right reverend Prelate is saying that in that case the pregnancy must go through, and that there can be no abortion. That is the difference between us.

Of course, behind it all is the basic assumption that the fœtus has life, and that it has life even from the very start. Even among the right reverend Prelates that is not accepted in all quarters. Some say that that is so; some say that it is not. But, generally speaking, I think most people will agree that there is not a case for saying that the fœtus has life right from the time of conception. There may be periods when one can say that it becomes alive, but I would say there is no evidence that in the normal period during which an abortion takes place—say, 12 to 14 weeks—the fœtus has life, consciousness or anything else. Therefore to say that we are destroying life when we carry out an abortion is in my view—and it is just my view—a fundamental error, and quite misleading, because you then introduce the concept of murder.

In fact, this argument has been used on a number of occasions. It has been said that you are taking four or five lives (though in my view you are not taking lives at all) because of the danger of one life being born in the conditions that are laid down in the Bill. So I feel that the right reverend Prelate has not made his case. It is not that he objects to an abortion being carried out because of the danger of a child being born in the conditions in subsection (1)(b). He has no objection to that. What he is concerned with is that at the same time it should have an effect on the life and health of the mother. The principle remains the same.

I want to put one or two facts. I think this matter has been argued at such length and in such detail that there is not much more that I can add. But I will say—and the noble and learned Viscount will not like it when I repeat it—that this has been discussed in another place for many hours. There is really nothing more to be said. They have come to a very firm and definite conclusion about it. We have to be very careful of our ground if we are to differ from the other place—

SEVERAL NOBLE LORDS: Why?

LORD SILKIN

—and kill the Bill. And that is what we should do if this Amendment were passed. Last May there was a National Opinion Poll in which 80.5 per cent. supported this particular provision in the Bill. I know that you can ridicule opinion polls—especially when they are going against you, although you are glad to use them when they are on your side—but 80.5 per cent. is a very substantial majority. May I say that the votes of the men and women in the poll were about equal.

The noble Earl asked questions about the wording of the provision—what is a "substantial risk"? Is it one in three, or one in four? I am not a mathematician—at least, not now; I used to be. It is difficult to evaluate these things on probabilities but I would say that a risk of one in seven or one in eight is not substantial; I would say that one in three or one in four might be a substantial risk. It would be for the doctor to decide. He would have all the facts before him. He would have discretion to agree in a particular case that there is a substantial risk.

VISCOUNT DILHORNE

I hope the noble Lord will not mind my interrupting. This is quite important. Is he saying that the clause is so drawn that although he thinks that only one in three is a substantial risk some doctors might take this view and others in other parts of the country are entitled to take the view that one in seven is substantial. If that is so, then the clause is not very satisfactory.

LORD SILKIN

I would say that if the doctor was able to evaluate a risk of one in seven, he would not be justified in calling that a substantial risk.

BARONESS GAITSKELL

May I interrupt my noble friend? I should like to ask the doctors in this House whether they do not consider that one in seven is a substantial risk. They certainly considered, so far as the Pill is concerned, that a 3 in 100,000 was a risk worth thinking about.

LORD SILKIN

My noble friend is even more extreme than I am. But my own view is that a risk of one in seven would not be substantial.

9.30 p.m.

LORD BOOTHBY

But, my Lords, we have a doctor in the House—Dr. Summerskill. Cannot we have her opinion?

THE EARL OF LONGFORD

May I interrupt for a moment?—not on the merits of the subject, but to say that I think it is out of order for anyone to ask a question of someone who is not addressing the Committee. With great respect to the noble Lord, Lord Boothby, the noble Lord, Lord Silkin has the Floor.

LORD BOOTHBY

Yes, but the noble Baroness knows the answer.

LORD STRANGE

And there is a doctor in the House sitting near to me.

SEVERAL NOBLE LORDS: Order!

LORD SILKIN

They have all had their say, and some of them, as I have said, have spoken half a dozen times.

VISCOUNT DILHORNE

I hope that the noble Lord, Lord Silkin, will not mind if I put a question to him on this.

LORD SILKIN

The noble and learned Viscount, Lord Dilhorne, is the worst offender.

VISCOUNT DILHORNE

I hope I am not. I am not asking other noble Lords to answer questions; I am asking what the Bill is intended to do. The noble Lord, Lord Silkin, is the sponsor of this Bill and he has given his own interpretation. What I want him to say, quite frankly, as sponsor of the Bill, is what risk is this Bill intended to cover?

LORD SILKIN

I would give the doctor a good deal of discretion as between the kind of risk that I have said is not a substantial risk and something more. I cannot put it higher than that. I would say that one in seven is not a substantial risk: that is my intention and my belief. Anything higher than that might well be a substantial risk, but the doctor would have to consider each case on its merits. For instance, one might even say that where a woman had given birth to three handicapped children, such as is contemplated by the Bill, nevertheless, the risk of the next one being the same is one in seven, or one in eight. Or, where there is a family history, a doctor might very well say that the risk is not more than one in seven. Nevertheless, I feel that in that case he would be fully justified in agreeing to an abortion. It would depend on the circumstances of the case.

I think one must allow a certain amount of elasticity in this. The noble Earl asked (I am trying to get him on my side now) how I would define "seriously handicapped"? On the spur of the moment I would say that a serious handicap is a handicap such as would make a person incapable of carrying out any normal activity. I do not know whether your Lordships saw on television the other day a programme depicting a day in the life of "James Egg". It was an extract from a play being produced at the Comedy Theatre at the present time. "James Egg" is one of the children we are talking about, and "James Egg" was shown on television. It was a most terrible sight. I think it was shown on Monday, but I have still not got it out of my mind. It concerned a child of three or four who had no brain at all. He looked normal but was crying the whole time, day and night—just crying; and almost driving his mother and father mad. Yet the mother says she can "take it". She is not a woman who would be covered by that. This was not a propaganda film; it was shown in order to give us an idea of what the play is like. I would say that that kind of child is seriously handicapped.

Years ago I was chairman of a committee of a hospital at Margate for children of this kind. Some of them had been lying on their backs for many years and were never able to move. They were suffering from various defects. I would say that children like that are seriously handicapped. There were something like 100 of them at that hospital. I wondered what happened to them when they left. I would say that a child who is incapable of thinking or doing anything for himself is seriously handicapped. That is the kind of children one has in mind. There is really nothing more that I can say. I hope that your Lordships are in a position to deal with Amendment No. 10 and dispose of it, one way or the other.

LORD CARRINGTON

I wonder whether I may say one word. I do not think that the noble Lord, Lord Silkin, can accuse me of having spoken a great deal on this Bill. I am inclined to agree with him about this Amendment. I say this with all frankness to him. I wish he would stop saying that, because the House of Commons have discussed something in this Bill for four or five hours, and have decided on a particular course of action, we in this House are not entitled to take our own view. This is a Private Member's Bill. This is a Bill on which we all have to make up our own minds how we shall vote, and it is quite a wrong argument for a promoter of this Bill to say that unless we take a certain course of action, this Bill will not become law. I hope that your Lordships will take no notice of this argument and will vote according to your consciences.

LORD SILKIN

I am glad that the noble Lord has raised this point, because it raises an interesting question as to what is the function of this House. Is it primarily, as has been the case right through this Bill, to go into every single Amendment that has been moved in another place, which has been discussed for hours and days there—or are we a Revising Chamber? As I understand the function of a Revising Chamber, it is not to do the work of the other place all over again, particularly in cases where they have literally spent days on particular Amendments. I am not saying that this is conclusive, but I do say it is a fact that we ought to take into account.

LORD CARRINGTON

I do not think the noble Lord is at all right about this. Certainly this House has a definite course of action which it should follow on Government legislation, for which the Government have a mandate and for which they have been elected, but a Private Member's Bill puts this House in an entirely different position. None of the Members of another place were elected to decide what was going to happen on an Abortion Bill and their view is no more important than that of any Member of this House. I think that the noble Lord is quite wrong in what he is suggesting.

THE LORD BISHOP OF DURHAM

I am sorry that to some noble Lords it seems that I was beating about the bush. This is only spelling out in words what the noble and learned Viscount, Lord Dilhorne, said in calling my speech ecclesiastical. It seems to me that the present Bill is so direct as to fail to be incoherent and to separate the mother from the fœtus and then to decide to do something to the mother to the second fœtus, which does not seem to hang together at all. If I can use a different metaphor, I have tried to grasp the nettle. Here we have an extremely complex problem. What I have tried to do, helpfully or otherwise, as some may think, is to try to unite sensitivity and compassion with the broadest kind of social concern by focusing the whole attention on the mother.

The noble and learned Viscount, Lord Dilhorne, and the noble Lords, Lord Stonham and Lord Byers, were perfectly correct. Certainly I do not want to decide the matter on the question of the unborn child by itself. I want to unite the child and the mother. The noble Lord, Lord Stonham, said I put the mother first, the child second and the doctor third. Rather, as the noble Baroness, Lady Elliot of Harwood, said, I put the child and mother together.

Then comes the criticism that this Amendment is not necessary because it is covered by the word "environment". I think that that would have been a better argument if the word "total" had been included before environment, if total had the meaning which the noble and learned Viscount gave to it earlier of "all relevant circumstances". I think that more than ever we need to spell out what we desire, and that this Amend- ment is still necessary, to avoid quibbles and by being explicit about the matter, helping a doctor's conscience.

Does all this come to cruelty? With respect to the noble Lord, Lord Byers, I find it difficult to see where the cruelty comes in. I cannot see that it is cruel to the child, tragic and sad though he or she is when he or she is born. Like other members of this Committee, I have spent days, and sometimes many days, in the company of deformed and defective children. It is difficult to know what they are feeling and thinking, and there is a tremendous sadness when we are with them. But I find it difficult to say that it is cruel to have these children alive.

LORD BYERS

May I ask the right reverend Prelate, in order to clarify this matter, whether, if his Amendment is passed, I am right in saying that a doctor will not be allowed to terminate a pregnancy if there is a substantial risk of a handicapped child being born but the mother will not suffer serious injury mentally or physically? If that is so, I cannot see how he does not say it is cruel to the mother.

THE LORD BISHOP OF DURHAM

If it is cruel to the mother, then presumably, being cruel to the mother, it is having an adverse effect on her, and it is in fact going to affect her physical and mental health. That is the point I was coming to. If, indeed, it is going to be cruel, I think her case is covered. If, in the phrase noble Lords have used, it is a threat hanging over the mother if she is overshadowed by risk, well, here is the case.

LORD BYERS

Could we get this right? Is the right reverend Prelate saying that cruelty is the same as physical or mental injury?

THE LORD BISHOP OF DURHAM

No. What I am saying is that cruelty does cause and result in mental and physical injury. Anyone who has had to do with families where the husband has been cruel to the wife should know that cruelty inevitably results in physical and mental injury. That is the case I am trying to make out.

The noble Lord, Lord Silkin, raised, if I may say so, one of the clearest issues that has been before us to-day when he said that the assumption behind my argument was that the fœtus had life. With great respect to the noble Lord, Lord Silkin, I do not use that argument at all, and it is just about as worthless as he himself thinks it is. I do not say that my argument depends on the fœtus having life. I do not want to bandy about words like "murder". My whole case rests on the fœtus having rights; the fœtus having rights as the correlate of the mother having the duty, broadly, to bring the fœtus to birth. I take it that we all recognise that the mother has a duty to bring the fœtus to birth. In such a case, it seems to me that, because the mother has a duty to the fœtus, the fœtus has rights. I do not talk about its life; I think that is semantically as scandalous and problematic as things can be.

LORD SILKIN

Could the right reverend Prelate explain how an object which has no life can have rights?

THE LORD BISHOP OF DURHAM

If the noble Lord, Lord Silkin, agrees that

the mother has a duty to bring the fœtus to birth, then I think he is committed to saying that the fœtus has rights. If he wants me to spell it out further, I can say that the fœtus has rights because it is potentially a human life, on the basis of my claim that the mother has a duty, which I take it we all recognise, normally to bring the fœtus to birth. I did think at one time that I ought to withdraw the Amendment, but I will let it go forward.

LORD BOOTHBY

I want to say only one sentence, and that is the right reverend Prelate—

SEVERAL NOBLE LORDS: Divide!, divide!

LORD BOOTHBY

I should like to say just this. Many things and cruel things have been done in His name, but Jesus Christ was not a cruel man.

9.45 p.m.

On Question, Whether the said Amendment (No. 10) shall be agreed to?

Their Lordships divided:—Contents, 32; Not-Contents, 75.

CONTENTS
Barrington, V.	Durham, L. Bp. [Teller]	Perth, E.
Boston, L.	Emmet of Amberley, Bs.	Sandford, L.
Brock, L.	Exeter, L. Bp.	Sempill, Ly.
Canterbury, L. Abp.	Ferrers, E.	Strang, L.
Carnock, L.	Grantchester, L.	Strange of Knokin, Bs.
Carrick, E.	Grenfell, L. [Teller.]	Thurlow, L.
Colyton, L.	Gridley, L.	Vivian, L.
Cork and Orrery, E.	Hylton-Foster, Bs.	Walston, L.
Crook, L.	Longford, E. (L. Privy Seal)	Wootton of Abinger, Bs.
Derwent, L.	Monckton of Brenchley, V.	Ypres, E.
Dundee, E.	Oakshott, L.
NOT-CONTENTS
Addison, V. [Teller.]	Ferrier, L.	Moynihan, L.
Airedale, L.	Gaitskell, Bs.	Noel-Buxton, L.
Albemarle, E.	Gardiner, L. (L. Chancellor.)	Norwich, V.
Amulree, L.	Greenway, L.	Platt, L.
Archibald, L.	Grimston of Westbury, L.	Ponsonby of Shulbrede, L.
Asquith of Yarnbury, Bs.	Hayter, L.	Raglan, L.
Balerno, L.	Henderson, L.	Rea, L.
Beswick, L.	Henley, L.	Rowley, L.
Boothby, L.	Hilton of Upton, L.	St. Davids, V.
Bowles, L.	Hughes, L.	St. Just, L.
Byers, L.	Inglewood, L.	Segal, L.
Caldecote, V.	Kahn, L.	Shackleton, L.
Carrington, L.	Kennet, L.	Sherfield, L.
Champion, L.	Killearn, L.	Silkin, L.
Chorley, L. [Teller.]	Kirkwood, L.	Somers, L.
Collison, L.	Lambert, V.	Sorensen, L.
Cooper of Stockton Heath, L.	Leatherland, L.	Stamp, L.
Craigavon, V.	Listowel, E.	Stocks, Bs.
Cranbrook, E.	McCorquodale of Newton, L.	Stonehaven, V.
Darwen, L.	Massereene and Ferrard, V.	Stonham, L.
Drumalbyn, L.	Monson, L.	Stow Hill, L.
Elliot of Harwood, Bs.	Morrison, L.	Strabolgi, L.
Falkland, V.	Moyne, L.	Strathcarron, L.
Summerskill, Bs.	Terrington, L.	Wade, L.
Swanborough, Bs.	Vernon, L.	Winterbottom, L.

Resolved in the negative, and Amendment disagreed to accordingly.

THE CHAIRMAN OF COMMITTEES (THE EARL OF LISTOWEL)

Before I call Amendment No. 11, I think I should point out to the Committee that if this Amendment is agreed to I shall have to call Amendment No. 12, by reference to the decision taken on Amendment No. 11.

10.5 p.m.

VISCOUNT DILHORNE

had given notice of his intention to move, in sub-

THE EARL OF DUNDEE: I beg to move Amendment No. 11.

Amendment moved— Page 1, line 17, leave out paragraph (b).—(The Earl of Dundee.)

9.55 p.m.

On Question, Whether the said Amendment (No. 11) shall be agreed to?

Their Lordships divided:—Contents 40; Not-Contents 81.

CONTENTS
Audley, Bs.	Derwent, L.	Lytton, E.
Barrington, V.	Dinevor, L.	Monckton of Brenchley, V.
Boston, L.	Dundee, E. [Teller.]	Oakshott, L.
Brock, L.	Durham, L. Bp.	Perth, E.
Brooke of Ystradfellte, Bs.	Effingham, E.	St. Helens, L.
Buckton, L.	Emmet of Amberley, Bs. [Teller.]	Sandford, L.
Canterbury, L. Abp.		Sempill, Ly.
Carnock, L.	Exeter, L. Bp.	Strange of Knokin, Bs.
Carrick, E.	Ferrers, E.	Vaux of Harrowden, L.
Clifford of Chudleigh, L.	Gridley, L.	Vivian, L.
Colyton, L.	Hylton-Foster, Bs.	Walston, L.
Cornwallis, L.	Iddesleigh, E.	Waverley, V.
Craigmyle, L.	Longford, E. (Lord Privy Seal.)	Ypres, E.
Crook, L.	Lothian, M.

NOT-CONTENTS
Addison, V. [Teller.]	Greenway, L.	Raglan, L.
Ailwyn, L.	Grenfell, L.	Rea, L.
Albemarle, E.	Grimston of Westbury, L.	Rowley, L.
Amulree, L.	Hayter, L.	St. Davids, V.
Archibald, L.	Henderson, L.	St. Just, L.
Asquith of Yarnbury, Bs.	Henley, L.	Segal, L.
Balerno, L.	Hilton of Upton, L.	Shackleton, L.
Beswick, L.	Hughes, L.	Sherfield, L.
Boothby, L.	Jellicoe, E.	Silkin, L.
Bowles, L.	Kahn, L.	Somers, L.
Byers, L.	Kennet, L.	Sorensen, L.
Caldecote, V.	Killearn, L.	Stamp, L.
Carrington, L.	Kirkwood, L.	Stocks, Bs.
Champion, L.	Lambert, V.	Stonehaven, V.
Chorley, L. [Teller.]	Leatherland, L.	Stonham, L.
Collison, L.	Listowel, E.	Stow Hill, L.
Cooper of Stockton Heath, L.	McCorquodale of Newton, L.	Strabolgi, L.
Craigavon, V.	Massereene and Ferrard, V.	Strang, L.
Cranbrook, E.	Monson, L.	Strathcarron, L.
Darwen, L.	Morrison, L.	Summerskill, Bs.
Drumalbyn, L.	Moyne, L.	Swanborough, Bs.
Elliot of Harwood, Bs.	Moynihan, L.	Terrington, L.
Falkland, V.	Noel-Buxton, L.	Thurlow, L.
Ferrier, L.	Norwich, V.	Vernon, L.
Gaitskell, Bs.	Platt, L.	Wade, L.
Gardiner, L. (L. Chancellor.)	Plummer, Bs.	Winterbottom, L.
Grantchester, L.	Ponsonby of Shulbrede, L.	Wootton of Abinger, Bs.

Resolved in the negative, and Amendment disagreed to accordingly.

section (1), to leave out paragraph (b) and insert: (b) that it is more likely than not that if the child were born it would suffer from such physical or mental abnormalities as to deprive it of reasonable enjoyment of life.

The noble and learned Viscount said: At this late hour I do not propose to move this Amendment, but I give the noble Lord notice that I shall probably move Amendments dealing with this subject in the light of his interesting definition of "substantial hardship" and "serious risk".

LORD SILKIN

This comes as no surprise at all to me.

LORD SEGAL

had given notice of his intention to move, after subsection (1), to insert: ( ) Where the pregnancy is known to be of more than sixteen weeks duration, it shall only be terminated by or under the supervision of a consultant holding an appointment under a hospital board, being an appointment involving the practice of gynaecology. The noble Lord said: Although I regard this Amendment as important, I should like to ask the leave of the Committee, also because of the lateness of the hour and because I do not believe in legislation by attrition, to withdraw the Amendment standing in my name, as well as all my Amendments on "conscience" Clause 4 but to reserve the right to bring them forward on another occasion. At this time I do not move this Amendment.

10.8 p.m.

BARONESS WOOTTON OF ABINGER moved, in subsection (3), to leave out "or mental". The noble Baroness said: This is simply a probing Amendment. I should like to ask my noble friend Lord Silkin what are the circumstances in which there could be "grave permanent injury" to the mental health of a pregnant woman in the time it takes to get a second medical opinion. I can understand that there might be grave risk to physical health in cases where there has perhaps been attempted suicide, but I am puzzled whether in the short time it takes to get a second medical opinion there could be grave permanent injury to a woman's mental health. I ask this purely for information. I beg to move. Amendment moved—Page 2, line 7, leave out ("or mental").—(Baroness Wootton of Abinger.)

LORD SILKIN

It has been assumed that that is quite a possibility in the case of pregnancy, and I think the records show that there have been a number of mental illnesses, I do not say necessarily permanent, but certainly quite strong cases of mental disease. I think it is far better in the Bill—at any rate, it cannot do any harm.

BARONESS WOOTTON OF ABINGER

My noble friend says "not necessarily permanent", but "permanent" is the language of the Bill. In the circumstances, I am prepared to beg leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

On Question, Whether Clause 1, as amended, shall stand part of the Bill?

BARONESS WOOTTON OF ABINGER

In spite of the lateness of the hour, I wonder whether the Committee will allow me to say one or two words about this clause, because it is clearly much the most important clause in the Bill. I have found myself to-day in the position of differing from a number of my noble friends with whom I am accustomed to be associated, and I should like to take the opportunity of saying a few words why this is so.

There are two reasons. I think it is very important to restrict very closely the opportunities for medical termination of pregnancy. The first is the reason, which is familiar to everybody, of the importance of human life, and I make no apology for emphasising that in the present state of the world to-day. I know that it often causes surprise among my Christian friends that someone who, like myself, believes that this life is all that any of us will ever know should attach so much importance to the preservation of life, but to me this appears to be entirely logical. I do not know what the attitude of the churches may be as to the eternal future of a fœtus which is aborted, but if I believed that a fœtus which was aborted was spared the pains and tribulations of earthly life and entered immediately into heavenly bliss, I think I should be very much less inclined to stiffen the laws about abortion than if I believed that that fœtus was deprived of the only enjoyments which, so far as I can see, our race is capable of having.

I should also like to say that I know this leads to arguments, theological and other, as to when a human being is not a human being, and when a life is not a life. There have been discussions in another place, and they were followed up in this House, about the size of a fœtus. A fœtus was displayed and it was shown, I think, that it was only 1½ inches long at the beginning; and further figures were given on the stages at which it would be 4½ and 5½ inches. It is a very profound thing in human psychology, that it is very much easier to kill a small thing than a big thing. Many of us who can squash flies would find it very difficult to drown puppies or cats, although sometimes exceptions are made about killing foxes, otters and hares. But let those pass.

In the case of squashing flies, we are able to persuade ourselves that these are creatures of low sensibility and that, in any case, flies are all they will ever be. In the case of a human fœtus, the fœtus is not all that it will ever be. It is a potential human life and, therefore, it seems to me that whether it starts originally as something which is only an inch or so long is totally irrelevant. It seems to me quite as irrelevant as to argue that it is less wicked to kill a baby which is only 12 inches long than to kill a baby which has attained a length of 24 inches. So my first principle in relation to this clause has been throughout that I think this is the day and age in which we ought to emphasise, whether we are Christians or whether, like myself, we are not, the importance of the preservation of human life, and that we should not lightly destroy it.

My second reason is that, while some of your Lordships regard contraception, also, as of dubious value and perhaps a practice not to be adopted, I think that we should all be united in the view that if we have to choose between abortion and contraception, contraception to many of us is not an evil at all; and those who regard it as an evil would regard it as a lesser evil than abortion. What I am concerned about is that if we open the door too widely there will be a very large number of people who will say, "There is no ideal method of contraception"—and this is indeed still true—"There is nothing which is no trouble and with no conceivable risk; nothing which does not raise perhaps esthetic difficulties". A very large number of people will say, "Let us not bother about this because, after all, if the worst happens it will always be possible for you"—it is the man speaking—"to obtain an abortion". It is for this reason that I think it is very unwise that we should open the door too widely. I have said this because I wanted, even at this late hour, to explain to many of my noble friends why it is I have found myself separated from them to-day.

LORD CONESFORD

May I indicate just one point so that the noble Lord, Lord Silkin, may consider it? In the Bill as it is now printed, what is printed as (a)(ii) quite obviously does not belong there; it should be printed elsewhere. It is printed at the moment as though it was something about which the doctors have to be satisfied. It has nothing to do with the doctors. It is a general requirement on how this is to be worked. I believe the authorities in the House think that this can be put right in the printing without amendment, but the point is of some importance, and I think the noble Lord, Lord Silkin, may like to consider it.

LORD SILKIN

The noble Lord has put his finger on a misprint. I was aware of it, and I wondered whether I ought to draw the attention of the Committee to it. I had hoped that nobody would spot it, but the noble Lord has done so. As to the noble Baroness, of course I shall always fully respect her views. They have been expressed from time to time, both explicitly and implicitly, in the course of our discussions. I do not think, with great respect, that she has said anything very new, but we all respect what she has said and quite understand the line she has taken, even though we very much regret we have not been able to agree with her.

Clause 1, as amended, agreed to.

10.17 p.m.

BARONESS WOOTTON OF ABINGER moved, after Clause 1, to insert the following new clause:

Application for termination

". Except in a case when the woman is incapable of making application, a pregnancy shall only be terminated under this Act on the written application of the woman concerned attested by two witnesses."

The noble Baroness said: This is a Bill which is ostensibly for the protection of women who find themselves pregnant in circumstances in which it is dangerous to their health, physical or mental. It is an extraordinary thing to me that throughout the Bill the woman nowhere appears as anything but a passive lump about whom other people will make decisions and upon whom other people will perform operations.

At an earlier stage my noble friend Lord Stonham spoke with great force about this Bill being a Bill in the interests of women, and he even banged on the Despatch Box to assure us that the measures proposed are for the benefit of women. If so, I think it might be quite a good thing if that appeared somewhere in the Bill, and not merely when my noble friend speaks in Committee in your Lordships' House.

I know that I shall be told that this clause is unnecessary for the reason that whenever a surgical operation is performed the person who is to undergo that operation is required to give consent in writing. I also know that that obligation is not always carried out, for the best of all possible reasons, because on the only occasion on which I have myself had a surgical operation nobody suggested that I should ever give my consent in writing, although it was not a matter of urgency and I was quite capable of giving it. I also know from what I have seen in hospitals that this kind of consent, in the pressure under which hospitals work, is very often given in a very casual way. I feel quite certain—and this is based upon experience of cases of unwanted pregnancies; pregnancies unwanted by somebody, sometimes by husbands—that women in this position who are pregnant may often be subject to very considerable pressures from within the family and sometimes, I think, from doctors who have their own ideas about who ought to have children and who ought not.

I cannot believe that to dispose of one's unborn fœtus is a less important matter than to dispose of one's property by a will. When one disposes of one's property by a will, one is required to make a document which has to be attested by two witnesses, and I should feel extremely uneasy if any less precaution was required before a woman parts with her unborn child.

I hope that my noble friends on both sides of this House—those who are in the very great majority—will forgive me if I say that when I find this total absence of reference to the active initiative of the woman I become a little suspicious. I am always highly suspicious when I find a very large body of men who are enthusiastic about something which is said to be in the interests of women. I sometimes find individual men, and small numbers of men, whose motives in this case I should never dream of calling in question for I know that they are on the side of women. But when a mass of men show this enthusiasm, I ask myself: What is behind it? And I am not so sure that this Bill is conceived in the interests of women—unless that is, the woman is given the explicit right formally to say that it is she who wants the abortion; and not her husband or the well-meaning doctor or the admirable and well-meaning social worker, or the admirable and well-meaning Members of your Lordships' House. For that reason I attach great importance to this and I am not prepared to see this Bill go through unless there is a specific requirement that the woman shall give her consent in a formal way. I beg to move.

Amendment moved— After Clause 1, insert said new clause.—(Baroness Wootton of A binger.)

LORD SILKIN

Let me assure the noble Baroness that it was not the deliberate intention to permit of an abortion being carried out without the written consent of the woman. I cannot say why it is not in the Bill; it was in the previous edition. I am prepared to give an assurance that at a later stage something will be inserted. What I cannot agree to is that the consent should be made in the presence of two witnesses. I think that this makes far too legalistic an approach to things and may create difficulties. But if the noble Baroness is concerned to ensure that the woman who wants an abortion really wants it, and will be satisfied with her signature, then I think I could agree that something of that sort will be introduced at a later stage.

BARONESS WOOTTON OF ABINGER

I cannot agree that it is an unnecessary legalistic procedure that a woman's consent should be witnessed; and I do not undertake that I shall not raise the matter again if my noble friend does not put a very clear and explicit clause into the Bill requiring the woman's written consent to be obtained. I am not content to rest on the consent which it is said is always given to any surgical operation. On my noble friend's assurance that there will be an explicit statment that it is on the application of the woman—and I would make some distinction between "application" and "consent", because the initiative should lie with the woman—I am prepared to withdraw my Amendment.

LORD STONHAM

Before my noble friend Lord Silkin commits himself too implicitly on this Amendment—and I agree in principle that we should agree with my noble friend Baroness Wootton of Abinger—I should say that there are cases where the word "woman" (and the word "woman" is printed at least five times in the Bill, quite apart from the use, several times, of the word "patient" and the "person who is pregnant") would, in some cases, include a child of 12. Is a doctor going to be subject to committing a criminal offence, if there has not been consent, signed in the presence of two witnesses, by a child of 12? I am not objecting at all to the principle. Without thumping the Despatch Box I should like to say again, in all sincerity, that this is a Bill about women; and women must decide. There is no insincerity about that when I say it. My noble friend Baroness Wootton of Abinger says that she will not be content without this or that, but I am bound to say at this stage that these things have to be viable. Although the principle is conceded, we are not in a position to say that a woman is incapable of giving consent just because two witnesses are not available at the time.

BARONESS WOOTTON OF ABINGER

If my noble friend will forgive me for interrupting, I would say that I have already made clear that I am not stressing the particular point of witnesses. I am waiting to see what my noble friend Lord Silkin produces, so I think we need not argue that point.

LORD STONHAM

I am grateful for that intervention, but it is not only a question of two witnesses. The matter needs to be looked at carefully to ensure that we do not put doctors in a position where they might be committing a criminal offence, and not necessarily only a criminal offence but one which involves a punishment of life imprisonment at the maximum, when in fact they are not really committing anything that we should consider as a fault.

LORD SILKIN

My noble friend Lord Stonham need not have any apprehension. Of course, the case of a girl of 12 would have to be taken into account, and one would have to provide for signatures by somebody, either the parents or somebody else to speak on their behalf with authority. That is why I was not prepared to accept this Amendment on the spot.

10.28 p.m.

BARONESS WOOTTON OF ABINGER

I was prepared to withdraw the Amendment, but I will say that I was much shaken by the contributions which have been made by my noble friend Lord Stonham and, subsequently, by my noble friend Lord Silkin. If a child of 12 is pregnant, she has a right to say what is to be done in relation to her pregnancy. I am not prepared at the present stage to give a parent or guardian a barring right. This is a matter of vital importance to the child; and if a child is pregnant even at the age of 12—which does happen, though it is not very common—I think it is the child's consent that matters. I think it should be a criminal offence for any medical man to perform, without the consent of the child concerned, an operation of this gravity which would affect her life and the life of the unborn child as well. However, I am prepared to see what my noble friend, Lord Silkin produces, and at this stage I will withdraw the Amendment, though I very much wish my noble friend Lord Silkin had not made his contribution. I ask leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

10.27 p.m.

VISCOUNT BARRINGTON moved, after Clause 1, to insert the following new clause:

Fees

A registered medical practitioner shall be guilty of an offence if he performs, assists or advises in the termination of a pregnancy permitted by this Act in consideration of a fee and shall be liable on conviction to a fine of £500 and in the case of a second or subsequent conviction to a fine of £1,000.

The noble Viscount said: I shall be as short as I can in moving this Amendment, and I may say that, as it has been rather hastily drafted, if I am assured that there are technical faults which make it impossible to accept it I shall be very ready to withdraw it and produce it again, as I think I have a right to do, at Report stage. The purpose of the Amendment is plain and I do not think it is one with which any of your Lordships would quarrel. It is designed to do one of the three things that this Bill sets out to do and with which we all sympathise. I am not sanguine enough to say that it will abolish the black market or abolish back-street abortionists—which in fact means the Harley Street abortionist, more often than not, because Harley Street is a "back street" sometimes—but it will make it a great deal more difficult for abortionists to increase their income.

I shall be very brief, because an Amendment of this sort was introduced in slightly different terms in another place recently. It was debated in unavoidably difficult circumstances, and I do not think it got an entirely adequate debate. But one argument brought up against it, as well as a number of rather, I think it fair to say, legalistic arguments which do not arise on this Amendment, was that, after all, this was concerned with something that a registered practitioner is allowed by the Bill to do. It is therefore nothing illegal, and it is unfair to prevent his taking money for doing something legal.

I shall say only three things, and then I shall hear with interest any comments. The first is that of course for a great many legal things we do we do not feel that necessarily we ought to take money. There was a period some time ago when I used to have a cold bath in the morning, and I never accepted money for doing that. That was irrelevant, because I think nobody would have offered me money to take one. On the other hand making a speech in your Lordships' House, which to some of us is still rather like taking a cold bath, would be slightly undesirable if speakers in your Lordships' House were paid by the line, paragraph or word, as I know writers in Punch were a long time ago—probably they are not now. I think that some noble Lords, given an option, might suggest that speakers should be paid not to speak, on the Chinese method of paying doctors.

To come to a more serious question, it was not long ago that for serious offences High Court Judges had to condemn human beings to death: not a pleasant thing to do. A little before that, there were offences such as the stealing of a sheep, which though regarded as less serious carried the death penalty. In those days it would have been highly undesirable for a judge to have received payment in proportion to the number of executions that he ordered. That is not entirely hypothetical or imaginary, because the last predecessor of the noble and learned Lord on the Woolsack who became sainted, Sir Thomas More, was regarded as eccentric, as many saints are, because he did not accept money when, in weighing in the balance which of two decisions was right, it might possibly have influenced his decision.

In this Bill there is always the risk of that, because we are legislating not about the average doctor who has a very high standard, but about those doctors who are tempted on what must necessarily be, even in this restricted form, slightly elastic terms, to do more for money than they would for the health of their patients. I should like to hear any comments that noble Lords have to make, and of course those of the noble Lord, Lord Silkin, who must have had enough now, as we all have. I will gladly withdraw this Amendment if I am satisfied that its object is understood. I beg to move.

Amendment moved— After Clause 1, insert the said new clause.— (Viscount Barrington.)

LORD SILKIN

I can assure the noble Lord that I do understand what he is after and I have great sympathy with him, but this would involve a major reform of medical practice in this country and I do not see how it can be done under this Bill. We must have two doctors. One of them may be, or may not be, the pregnant woman's own doctor. If he is hex own doctor and she is on the panel, then she will not pay, but she may have to pay something for the second doctor. As things stand at the moment, there is no way by which we can impose on any doctor other than the woman's own doctor an obligation to give a certificate or see a patient at all. If it were possible to prevent a woman's having to pay fees in respect of a pregnancy, I should be all for it, but I cannot see how that could be done without a fundamental alteration in the rules of medical practice.

VISCOUNT BARRINGTON

I quite understand that this is a difficult subject, which I do not think it would be possible to discuss now. I do not believe it is impossible to get over the difficulty, and if I may reserve my right to return to the subject and perhaps produce a suggestion for an Amendment on the Report stage, I now beg leave to withdraw the Amendment.

Amendment, by leave, withdrawn.

Clause 2 agreed to.

Clause 3 [Application of Act to visiting forces, etc.]

LORD SILKIN

This is little more than a drafting Amendment. It is to put in order the relationship between the doctor who might be carrying out an operation under the Visiting Forces Act in respect of a person who is visiting as a member of visiting forces. I can explain this at much greater length if your Lordships would like me to, but I can assure you that it is purely a drafting Amendment. I beg to move.

Amendment moved— Page 3, line 3, leave out from ("body") to end of line 5 and insert ("appointed as a medical practitioner for that body by the proper authorities of that body").—(Lord Silkin.)

On Question, Amendment agreed to.

Clause 3, as amended, agreed to.

Clause 4 [Conscientious objection to operation]:

10.37 p.m.

LORD SILKIN moved to leave out Clause 4 and insert the following new clause:

Conscientious objection to participation in treatment

".—(1) Subject to subsection (2) of this section, no person shall be under any duty, whether by contract or by any statutory or other legal requirement, to participate in any treatment authorised by this Act to which he has a conscientious objection:

Provided that in any legal proceedings the burden of proof of conscientious objection shall rest on the person claiming to rely on it.

(2) Nothing in subsection (1) of this section shall affect any duty to participate in treatment which is necessary to save the life or to prevent grave permanent injury to the physical or mental health of a pregnant woman."

The noble Lord said: This is partly a redrafting of the original Clause 4—the conscience clause—and I hope that it is an improvement. It also adds a new subsection (2). Under the clause as it stood there was nothing to compel a doctor to carry out an emergency operation if that doctor had a conscientious objection. There are certain emergency operations which have to be carried out to save the life of the patient, where abortion may be involved although it is not the purpose of the operation.

What we are proposing (certain representations were made about it in another place and on Second Reading here) is that, while conscience may be put forward as an argument for not carrying out a normal abortion, it should not be available where an operation has to be carried out to save the life of the person, even if the operation does involve an incidental abortion. That is the purpose of this Amendment. There is also the question of the burden of proof, but that was in the original clause. I beg to move.

Amendment moved— Leave out Clause 4 and insert the said new clause.—(Lord Silkin.)

THE CHAIRMAN OF COMMITTEES

I will now call the Amendments to this Amendment. I understand that Amendments Nos. 22A and 22B, in the name of the noble Lord, Lord Segal, are not moved.

LORD SEGAL

Perhaps I may, with permission, say a few words.

THE CHAIRMAN OF COMMITTEES

Then I will call on Amendment No. 22A.

LORD SEGAL

had given Notice of an Amendment to the Amendment, in the proposed new subsection (1) to leave out "person" (where that word first occurs) and insert "registered medical practitioner". The noble Lord said. If I may be allowed to say a word at this late hour, I should like to say that Clause 4 as redrafted by my noble friend Lord Silkin is far more acceptable to me than the original Clause 4 in the Bill. I should have much preferred to have, instead of "doctor, nurse, hospital employee", simply the word "doctor" included. I should also have preferred that this Clause 4 confined itself to "any person who has to perform an operation" instead of "any person required to participate in an operation". But I fully realise, especially at this late hour—and, in common with many of your Lordships, I am very anxious to see the Committee stage of this Bill concluded tonight—that it can give rise to a great deal of difficulty and a great deal of controversy among professional bodies outside those of the medical profession. In these circumstances. I feel that at this stage it would be right to accept the Amendments in the name of my noble friend Lord Silkin and not to move my own Amendments.

10.40 p.m.

LORD BROCK

I beg to move the Amendment to the Amendment in my name on the Order Paper. I think this is a "blunderbuss" clause as it at present involves all sorts of personnel, non-medical as well as medical. The position of the surgeon or doctor is a special one and demands special notice and consideration. In a recent debate in your Lordships' House I drew attention to the fact that, in my opinion, a conscientious objector might be of many kinds—political, intellectual, moral, religious or medical. I think that the medical conscience of the doctor should be specifically recognised. I wish to make it clear that his medical conscience is primarily and always guided by the absolute rule never to withhold or refuse help to a patient in need. I beg to move.

Amendment to Amendment moved— Line 4, after ("a") insert ("medical or").(Lord Brock.)

LORD STONHAM

I think that the Amendment of the noble Lord, Lord Brock, is based on a misconception. It appears to fear that the Bill may call on a doctor to do an abortion for other than purely medical reasons. Under the Bill, abortion is permissible only where there is a risk of injury to the health of the pregnant mother, or on grounds of abnormality in the fœtus. These grounds involve a medical assessment of the risks, and there could be no question of an abortion where, on assessing such risks, the doctor considers that there are medical objections to terminating the pregnancy.

The Bill does not impose on anyone a duty to perform or participate in an abortion operation. It does not impose that on any doctor. The whole Bill says that the doctor may carry out the operation lawfully if he and another doctor are of the opinion, formed in good faith, that it comes within the grounds set out in the Bill. Since the Bill says that a doctor may carry out abortion, it is implicit that he is free, if he so thinks, not to carry it out. It is therefore very difficult to see how the fears of the noble Lord, Lord Brock, are justified.

There are other difficulties about the Amendment the noble Lord proposes. The decision whether or not there are medical objections to an abortion is essentially one for a doctor. Clause 4 refers to a "person", and that covers not only doctors but also nurses and hospital employees, and so on. The Amendment which he proposes could therefore have the effect of allowing a nurse to refuse to participate in an abortion operation which two doctors consider to be medically desirable, but to which the nurse considered there were medical objections. I hardly think that that is what the noble Lord, Lord Brock, intended.

LORD BROCK

I find it difficult in my own mind to separate my Amendment from the next Amendment in my name, No. 24; and, if it would be your Lordships' pleasure, I should like to deal with that to clarify the issue, because I feel that my reservations are directly connected with the next two lines in the clause. May I have your Lordships' permission?

THE CHAIRMAN OF COMMITTEES

Does the noble Lord wish to withdraw this Amendment and speak to his subsequent Amendment?

LORD BROCK

No. I should prefer to retain this Amendment, with the permission of the Committee, and speak also to the subsequent Amendment. I am asking for the permission of the Committee to speak to my Amendment No. 24. I find it difficult to dissociate the implications of the omission of "medical" with these two lines I wish to have deleted. My objections to these words rest on what I consider the absolute need for recognition of the ethical code or medical conscience that should guide and direct a doctor; namely, that his conduct towards a fellow being is influenced only by his duty to care for and guard his patient's life and health and that it is equally wrong and a misuse of his profession if he uses his skill, power and specialist experience for interference on non-medical grounds.

It is therefore unacceptable, intolerable and even insulting to a dignified, responsible profession to suggest that it might be called upon to defend its ethics in a court of law. I repeat what I said earlier, in order to make it quite clear: medical ethics are primarily influenced by the overriding obligation never to withhold or refuse treatment to a patient in need. Put simply, the patient's interests always come first. I realise that there may be an overlap between the conscience of the nurse, for instance, and the doctor, but I am concerned that the doctor's medical conscience in this matter should be clearly stated. I am less concerned with the presentation of the nurse's conscience because I think there are plenty of other people to look after her interests in this matter.

LORD SEGAL

I should like to be allowed to endorse the remarks made by my noble friend Lord Brock. My object in supporting his Amendment to leave out lines 5 to 7 relates specifically to the requirement that the burden of proof of a conscientious objection should rest on the doctor who wishes to make this objection on conscientious grounds. Now that the Amendment in my name has been withdrawn, I would ask my noble friend Lord Silkin to take these considerations into account and to make it not obligatory upon a doctor to give proof of his conscientious objections. I fully agree with my noble friend Lord Brock that it is highly derogatory and almost insulting that doctors should be required to make that stipulation, and I trust that the noble Lord, Lord Silkin, will consider the point when this Bill comes up for further consideration.

BARONESS WOOTTON OF ABINGER

It seems we are now discussing matters that fall within Amendment 25 as well as Amendment 24. Therefore perhaps it might be appropriate if I were to say what I intended saying on Amendment 25. It seems to me to be quite extraordinary that we should be proposing that where a conscientious objection is asserted by some responsible person, either a doctor or someone else who is a hospital employee, the presumption should be that this objection is not genuine. Surely the presumption should be that the objection is genuine and that the burden of proof must rest upon anyone who disputes it. I cannot see how the Bill has got this way round, and when we come to Amendment No. 25 I would stress strongly that the burden of proof should lie on the person who disputes the objection. It seems to me to be quite insulting to a distinguished profession to assert that the probability is that a person making a conscientious objection is a "phoney" unless he proves the contrary.

LORD SEGAL

With great respect to the noble Baroness, Lady Wootton of Abinger, I would point out that this phrase also embraces hospital employees. I can quite conceive of a situation where a hospital orderly refuses on conscientious grounds to wheel a trolley containing a patient who was about to undergo an operation for abortion, and all the time he may be using that as a pretext to go to the Cup Tie.

BARONESS WOOTTON OF ABINGER

I am very much surprised to find that my noble friend Lord Segal does not ascribe to those hospital employees who perform in humble capacities the same standard of integrity as those who perform in his own profession. I am shocked that he should think there is a presumption of argument that a hospital orderly, when he says he has a conscientious objection, probably wants to go to the Cup Final. I am very particularly surprised that that argument should be put forward by somebody who sits on these Benches.

LORD SEGAL

I take full note of my noble friend's objection, but I believe such cases have been known to occur. I greatly regret if any remarks of mine have caused offence in any direction whatsoever.

LORD CONESFORD

May I put one point to the noble Lord, Lord Silkin, about this proviso? There are Amendments down to omit the proviso, and in the case of the noble Baroness she has an Amendment to reverse the proviso. I was wondering whether the noble Lord, Lord Silkin, would tell us what in his opinion would result in law from the simple omission of the proviso and leaving the question of burden of proof to the court.

LORD STONHAM

Before my noble friend Lord Silkin tells us what he means by this proviso, I should be grateful to the noble Lord the Lord Chairman of Committees if he could tell us which Amendment we are discussing. I understood that we were discussing Amendment No. 23 moved by the noble Lord, Lord Brock, to which, if I may say so with respect, I thought I gave a fairly conclusive answer. I am confirmed in that view because the noble Lord, Lord Brock, then said, "I can deal with this much better if I deal with another Amendment further on". After that, and the speech of my noble friend Lord Segal, the noble Baroness, Lady Wootton of Abinger, said that she would like to talk about another Amendment. This places me, inexperienced as I am, in a position of great difficulty, and I should be grateful if we could resolve the position so that we know what we are talking about.

THE CHAIRMAN OF COMMITTEES

The noble Lord, Lord Stonham, is right. The Amendment moved is No. 23, moved by Lord Brock, and that is the Amendment now before the Committee. Noble Lords are in order in speaking to as many Amendments as they like, but they can move only one Amendment at a time.

LORD BROCK

I have read the whole of the first part of this clause, and I realise that it is unsatisfactory in a number of ways. I think that on the whole it would be better if I asked leave to withdraw Amendment No. 23.

Amendment, by leave, withdrawn.

10.53 p.m.

LORD CRAIGMYLE moved as an Amendment to the proposed new clause, in subsection (1), immediately before that proviso, to insert: nor shall any claim for negligence lie against a registered medical practitioner who refuses to perform a termination of pregnancy authorised under this Act if he is of the opinion formed in good faith that such termination would not be in the best interests of the patient.

The noble Lord said: This is a rather technical Amendment, and I move it with some diffidence because the technicality lies in the realm of law in which I am not learned. My understanding is that the new Clause 4 will protect the doctor who has a conscientious objection in all matters of his contractual duty. But it does not protect the doctor—and I think this is, at least in part, what the noble Lord, Lord Brock, is getting at—who is simply, not as a matter of conscience, but in a particular case, of the opinion that a termination is not the right treatment for a particular patient.

It is not clear to me to what extent such a case would be covered as to the contractual liabilities under Lord Silkin's redrafted clause, and it is reasonably clear to me that in so far as there may be a claim for negligence against him it is not covered at all. It seems quite possible that a claim for negligence might arise either way round, if I may put it so. A woman who has been aborted may later regret it and sue her doctor for negligence in not prescribing some other treatment for the trouble she complained of which led to the abortion. Or, on the other hand, a woman who had not been aborted may regret that. Something could go wrong, and she may pursue the doctor who refused to abort her for damages on the grounds that he was negligent in not performing the abortion which was authorised under this Act.

As to the first case, I think that if there had been serious danger of that arising probably the promoters of the Bill would themselves have taken steps by now to look after it. But as to the second case, the case of the doctor who in good faith declines to perform an abortion and is then sued for damages, I think he should be put on the same sort of ground as the doctors who give their opinions under Clause 1; that is to say, it should be an opinion formed in good faith, and provided that the good faith is not challenged, or not successfully challenged, then no claim for negligence should lie. I hope that any noble Lords who are learned in the law will let us have the benefit of their advice on this point. I beg to move.

Amendment to Amendment moved— Line 4, at end insert the said words.—(Lord Craigmyle.)

LORD SILKIN

These words will add nothing whatever to the liability of the doctor or the benefit of the patient. No doctor is obliged to carry out an operation which he does not think is necessary, and there cannot possibly be any action for negligence against him. I cannot see the point of putting these words in. I can assure the noble Lord that it is quite unnecessary. No doctor who in good faith refuses to carry out an operation because he does not think it is in the patient's interest has anything to fear.

LORD CRAIGMYLE

If the noble Lord assures me in such strong terms that there is no legal need for this, I will ask leave of the Committee to withdraw the Amendment.

Amendment to Amendment, by leave, withdrawn.

LORD BROCK

I beg leave to move the Amendment standing in my name, to leave out the proviso to the proposed new subsection (1) about which I have already spoken.

Amendment to Amendment moved— Leave out lines 5 to 7.—(Lord Brock.)

LORD SILKIN

The noble Lord asked me what would be the effect of leaving out these words. I speak in the presence of much greater legal authorities than I can claim to be, but I believe that if the words were not included in the Bill then the ordinary law would take its course. If there is a prosecution, the prosecution will have to prove its case. But in the case of a doctor who pleads a conscientious objection it is quite impossible for the prosecution to prove a case, to prove that he has not a conscientious objection; and these words were presumably inserted in order that he may state on oath that he has a conscientious objection and be subject to cross-examination. I think that that is the only possible way in which the matter can be brought before the court. But I am perfectly willing to think about this again, and to discuss it with my friends, the sponsors of the Bill in another place, and see how far they attach importance to those words.

LORD CONESFORD

I had hoped to be of a little assistance to the noble Lord and would suggest that we have the advantage of a reply by the noble Lord, Lord Stonham, who, I should have thought, would have the benefit of the advice of high legal authority. I think that a serious question is involved here. I am not sure where the court would say the burden of proof resided in such a case.

11.0 p.m.

LORD STONHAM

I think it would be fair to say that there is no need for a conscience clause in this Bill at all; that these matters could be settled as they have been settled for one hundred years, I suppose—by the normal good sense of the medical and other staffs in hospitals. Very strong views were put forward both by supporters and opponents of the Bill in favour of a conscience clause. The conscience clause was therefore devised in another place. The last part of it was somewhat hurriedly devised, as it seems, on the last day of the Report stage in another place. The main effect of the new clause which my noble friend has moved, and which has now been incorporated in the Bill, is to restore to the Bill the position which now exists where if a doctor negligently performs an operation, particularly an operation where he might be liable to a criminal charge, the conscience clause as it stood when it came to this House from another place would have removed any responsibility. My noble friend has now restored that responsibility, and I am sure that the noble Lord, Lord Brock, and all medical men would agree that that is right. We have made no difference at all.

The only remaining point which has been moved by the noble Lord, Lord Brock and supported by my noble friend, Lord Segal—and I think that it would be supported by my noble friend Lady Wootton of Abinger—is that the doctor concerned should not have to prove that he had a conscience but it would have, as it were, to be proved the other way round. The purpose of having the words in the Bill as proposed by my noble friend Lord Silkin in his Amendment is to deal with the risk that a doctor who was simply negligent might seek to excuse himself retrospectively by putting forward a spurious conscientious objection which it might be impossible to disprove, and also with the position that if the words were the other way round the prosecution might be in the impossible position of having to prove a negative. I do not know whether that has answered the noble Lord's question, but I think that the offer made by my noble friend Lord Silkin to look at the matter is all that noble Lords ought to expect in this regard. They have expressed their views and they will be able to see in discussion with him whether anything further is needed. My own view is that the clause now incorporated in the Bill which was moved by my noble friend, and which was most carefully drafted, meets all possible circumstances, and meets far better than when the Bill came to this House the demands of another place and here and by the medical profession for a conscience clause.

THE MARQUESS OF LOTHIAN

May I ask the noble Lord, Lord Silkin, when he is considering this Amendment on Report, to bear in mind particularly the position of the nurses and the midwives? Under the Bill as it stands it is going to be very unpleasant and difficult for a young student nurse to put forward her conscientious objections, if she has any. As noble Lords know, the recruitment position of nurses and midwives is not good, and anything which tends to make life more difficult for them in this respect should be avoided. If a young nurse makes things slightly difficult for herself for one reason or another, possibly by raising a complaint and in this case possibly even by objecting, she may find herself in difficulties with her superiors. I would ask the noble Lord to bear in mind problems of this sort when he is considering these Amendments.

THE EARL OF CRANBROOK

I hope that when consideration is being given to this Amendment, as well as the one which follows, which is very much the same, the noble Lord, Lord Silkin, will bear in mind the fact that this is intended to hold the balance between the doctor who claims that he was conscientiously unable to do something and a patient who has been aggrieved by that doctor's refusing to do it. I had some experience of a similar sort when I was a member of a conscientious objectors' tribunal before the last war. The Committee will remember that such tribunals we set up in 1938 or 1939, when one had to hold the balance between the demands of the State upon some young men and the conscientious feeling which the young men had that the State was demanding too much of them. I think the two positions are exactly comparable, and if noble Lords who are skilled in medicine do not mind my saying so, I hope we shall bear in mind that there are people other than doctors to be considered when we are considering this problem.

I am quite certain from my experience of those tribunals—and I imagine that the courts will be in a similar position—that had the boot been on the other foot in that case, with the State constantly trying to prove that a young man was not conscientious, it would have been much more difficult to do justice to the young man, which I have always hoped and trusted we did. I believe quite sincerely that if it is left to the courts to deal with the matter in exactly the same way as the tribunals did in those days, justice would more easily be done if the man who claims he is conscientious has to prove it than if the patient who feels aggrieved has to prove that he is not. I would earnestly ask noble Lords to bear that in mind.

LORD BROCK

I should like to ask a question on this matter. As I understand it, I have been told that the reason for the inclusion of these two lines which I wish to delete is that they are designed to meet negligence on the part of a medical practitioner, or an allegation of negligence. I should have thought that the Common Law permitted an action for negligence to be taken against him. I do not see why it is necessary to mention this specifically in this new Bill. But perhaps I can be informed whether or not that is so. If it is not so, then I repeat my former comment that it is undesirable and insulting to suggest that a doctor has to prove his objection.

LORD STONHAM

I am sorry if I misled the noble Lord, Lord Brock, but what I said was that the proviso in the conscience clause, and the proviso to which I understand he objects, was put into the present conscience clause in this Bill during the Committee stage in another place. As I understand it, it was then put in to deal with the risk of the doctor who was simply negligent, and might excuse himself retrospectively by putting forward a spurious claim to a conscientious objection. My noble friend's new clause preserves the existing criminal liability, and there is no need for a proviso about the question of proof in relation to criminal proceedings. But he is not wholly certain whether, in the absence of an express provision, the burden of proving conscientious objection in civil proceedings would rest on the defendant, so the proviso would still serve a useful purpose in making the onus clear. This is all these words do, and I do not think the matter can be pursued further at this stage. I would ask the noble Lord, Lord Brock, to consider to-morrow, when we begin, what has been said. I think he will find his objections are covered.

As I have risen to my feet again, perhaps I may refer to one other point with regard to what the noble Earl, Lord Cranbrook, said. This clause now, as moved by my noble friend, covers any person, so that all he said in relation to nurses, quite apart from doctors, is covered. The noble Marquess, Lord Lothian, spoke as if there were something new about abortion in hospitals. There are annually some 3,000 therapeutic abortion operations in National Health Service hospitals, quite apart from a far larger number of casualties who come into the hospitals as a result of back-street tragedies. I was chairman of a group of five East and North-East London hospitals with over 1,000 beds, where we handled between 30 to 40 of those cases every week. I do not remember during six whole years, however, ever hearing the slightest objection from any member of the staff—and one of the hospitals was a mission hospital, where all the members of the staff (the doctors and nurses, and even the porters) were people who were serving the hospital only because of their devotion to the Christian religion. Do not let us imagine difficulties which have never existed all this time, and which it is scarcely conceivable will arise now.

LORD CONESFORD

I feel a little embarrassed, because the many eminent legal authorities who were here at an earlier stage are not here now. I think that the noble Lord, Lord Silkin, has put in, in perfect good faith, a useful conscientious objection clause, and I am sure that the clause is in general to be welcomed. I think there is a point of a little interest about this question of the burden of proof, and I am not myself convinced that the burden of proof would not rest where he says it ought to rest, even in the absence of these lines. But, if that is the case, that would not make these lines objectionable in themselves.

The only reason I intervene now is because the clause, as I understand it, deals with the question of the duty to take part in one of these operations, but the noble Lord, Lord Stonham, and others have mentioned the question of negligence. My own first impression is that there is very little to do with negligence in this particular clause. The noble Lord, Lord Silkin, gave an answer of the greatest confidence to my noble friend Lord Craigmyle, and his answer may indeed be perfectly correct, though I think it will be well to look into it a little further. I think it may be necessary to consider whether it is necessary to provide anything about possible actions for negligence against doctors which may result from this measure. I make no particular forecast of what the result of that investigation may be, but I think it has not very much to do with the clause we are now considering.

LORD SILKIN

I have offered to reconsider this. I offered this about a quarter of an hour ago, and I cannot see the point of further discussion on it. Either it is accepted or not. Still less do I see the point of going back to previous Amendments which have been withdrawn.

LORD BROCK

In view of what the noble Lord, Lord Silkin, says, and in view of the fact that, as negligence would appear to me to be covered by Common Law, I beg leave to withdraw this Amendment.

Amendment, by leave, withdrawn.

11.13 p.m.

BARONESS WOOTTON OF ABINGER moved, as an Amendment to the proposed new clause, to omit the proviso and to substitute: ("Provided that in any legal proceedings in which the genuineness of a conscientious objection is disputed, the burden of proof shall rest on the person disputing it.")

The noble Baroness said: A certain amount of discussion on this Amendment has been prematurely conducted. My noble friend Lord Stonham pointed out that the words which I am proposing to omit are inserted in the Bill for the purpose of clarification, for making clear where the onus of proof lies. That I entirely accept. They make it abundantly clear where the onus of proof lies: but I wish to say very strongly that they in fact make it clear that the onus of proof lies in the wrong place, and my Amendment is designed to shift it to the opposite place.

I still feel that it is extraordinarily cynical that we should be passing into an Act of Parliament a statement that when a conscientious objection is asserted by a person employed in the service of a hospital, be he a doctor or be he or she employed in a humbler capacity or in a different specialisation, the assumption should be that, unless it is otherwise proven, this claim to conscientious objection is fraudulent. I think that is a very low depth of cynicism for your Lordships' Committee to fall to, and I would strongly urge that we ought to put the onus of proof on the person who disputes the genuineness of an objection. I beg to move.

Amendment to Amendment moved— Leave out lines 5 to 7 and insert the said new proviso.—(Baroness Wootton of A binger.)

LORD AIREDALE

I do not quite understand this. I think it follows from what the noble Earl, Lord Cranbrook, said just now, that if a doctor objected on conscientious grounds to service in the Armed Forces, the doctor would have to prove his conscientious objection just like anybody else. I do not believe the doctor or anybody else would feel insulted at being required to establish the proof of his conscientious objection to service in the Armed Forces. I should have thought that what is sauce for the goose is sauce for the gander. If the doctor's conscientious objection is to something other than serving in the Armed Forces I do not see why he should feel insulted at the burden of proof being the same as if it were the familiar form of conscientious objection to service in the Armed Forces.

LORD ARCHIBALD

May I make a point on this subject? Is there really any way in which anyone can either prove or disprove conscientious objection? The noble Earl, Lord Cranbrook, referred to his position as chairman of a tribunal. I think he recognised the difficulties of accepting proof or disproof. My association with this question goes back to World War One when I was a conscientious objector. I could not get a tribunal to accept the genuineness of my conscience. I submit that there is no way of proving or disproving conscientious objection. I do not think either the Bill as written or the Amendment really goes to the root of the matter. We have to accept that if the person claiming to have a conscientious objection is prepared to swear so on oath, that is as far as you can go. There is no possible proof one way or the other.

THE LORD BISHOP OF DURHAM

Difficult though it is for a man to prove his conscientious objection, I should have thought it impossible for someone else to prove that he had no conscientious objection. In my speech last week I made the suggestion that perhaps before "conscientious objection" the word "declared" might be added. This might meet the noble Lord's point. He would then have to swear on oath. Perhaps in due course an Amendment may be produced to cover that.

LORD STONHAM

I think the right reverend Prelate has put the thing in a nutshell, as did my noble friend Lord Archibald. But the point about onus is that we imagine a case, for example, where a woman—the person we should always consider first—has sued a doctor on the grounds that his negligent failure to carry out an abortion had caused danger to her health. He sets up a defence that he had a conscientious objection to performing the operation. The onus would then be on the woman to prove he did not have such an objection. As I understand the right reverend Prelate, he said that would be virtually impossible. It is not virtually impossible the other way round: for the doctor to prove it. Because in almost every case there would be a record at the hospital, as I know the noble Lord, Lord Amulree, would agree. It would be something known about the doctor. There would be no difficulty in proving it at all. It would be known. That is why it is in the Bill in those words. When my noble friend, Baroness Wootton of Abinger, asks in her Amendment for the burden of proof to rest on the person disputing it, in many cases it is virtually asking the impossible. Often the plaintiff would be a woman who had alleged negligence and who is met by this defence, and she would be virtually unable to prove it.

LORD CONESFORD

If the doctor had performed the operation and had performed it negligently, how can this clause be relevant at all? Is the noble Lord assuming that the operation has been performed or that it has not been performed?

THE LORD BISHOP OF DURHAM

I assume that if the doctor had a conscientious objection he would not perform the operation, let alone be negligent in doing it. It seems to me that the concept of negligence and the concept of conscientious objection do not match up.

LORD STONHAM

It is the doctor's negligent failure to carry out an operation. This is quite a point. I am stating a position which has occurred. A doctor negligently failed to carry out an operation for abortion which was medically necessary: it had nothing at all to do with this Bill. He is then sued by the woman patient for the damage to her health, and he sets up the defence that he has a conscientious objection. That is the position I cited.

LORD BROCK

I think this shows the state of confusion that exists. If the operation was necessary on medical grounds, then this is related to his medical conscience. This is exactly what I was trying to say, that there are various forms of conscience, and it is the medical conscience that I wish to have acknowledged—the man who says, "I did not do this because I had conscientious grounds". If the operation was medically desirable, his conscientious grounds would rest on something else. They might be religious, moral, intellectual or what-not, but they would not be related to what 1 wish to have recognised: that if the operation is medically desirable or undesirable, it should be treated in that way.

LORD MOYNE

A doctor should declare his conscience when he is consulted. I do not quite see how this can be brought in, but it seems a practical point. If the patient knows that the doctor has a conscientious objection, she could go to another doctor. But this is far from the actual words that we are discussing.

BARONESS WOOTTON OF ABINGER

I should feel very much happier if this clause were entirely redrafted in the sense that the noble Lord, Lord Moyne, has just suggested, to make it perfectly clear that any person who had a conscientious objection should be required to record it at the time. I think the Committee is getting somewhat confused, and I include myself in that category. But I am perfectly clear that the analogy which has been used of conscientious objectors' tribunals dealing with objections to military service is totally irrelevant. I had always supposed that tribunals which dealt with military service approached the matter impartially, neither biased to believe that the objector was genuine, nor biased to believe that he was not. At least I thought that that was what was required of them, even though that requirement was not always fulfilled.

In this case my noble friend Lord Stonham is drawing a very curious analogy. He is suggesting that a doctor can retrospectively produce a conscientious objection. If you pursue the analogy of military service tribunals, it is equivalent to saying that when a soldier has run away from battle, he is entitled to say, "I had a conscientious objection to fighting". This analogy is neither here nor there. I still feel very strongly that we ought to accept in good faith—we speak elsewhere about the good faith of the medical profession—that when doctors say they have conscientious objections, they have conscientious objections, and that it is for those who dispute it to establish that the objection is false. This would be entirely met if the conscientious objection had to be registered at the time of the operation. I earnestly hope that my noble friend Lord Silkin will consider the Bill on those lines.

LORD SILKIN

I promised to look at this again a long time ago. I do not know what all this talk is about—

BARONESS WOOTTON OF ABINGER

If my noble friend—

LORD SILKIN

No, I have not given way. May I say that my noble friend is merely coming back to the same point that was raised about three-quarters of an hour ago, this question of whether the burden of proof should rest on the doctor or not. I have undertaken to look at this again and, incidentally, I suppose I shall have to look at the whole clause. If that is acceptable to the Committee cannot we bring an end to this discussion and go on to the next Amendment?

BARONESS WOOTTON OF ABINGER

My noble friend is not quite correct.

LORD SILKIN

I withdraw my offer, and I shall leave it to the Committee.

BARONESS WOOTTON OF ABINGER

My noble friend said that I have come back to the point which was raised three-quarters of an hour ago. I have raised a new point. Perhaps he did not listen to it. The clause will be satisfactory if it requires a conscientious objection to be registered at the time of the operation. I asked him to reconsider that point. I have listened to the whole of the discussion and I have not heard this point raised before.

On Question, Amendment negatived.

LORD SEGAL

In view of the Amendments already moved by my noble friend Lord Silkin and accepted by the Committee, I feel that my Amendment, No. 25A, to the proposed new Clause 4 is now completely irrelevant and I do not wish to move it.

11.26 p.m.

LORD CRAIGMYLE moved, as an Amendment to the Amendment, to add to the proposed new Clause 4: ( ) No person shall be disqualified from holding a medical or nursing appointment under a hospital board by reason of his having a conscientious objection to participating in any treatment authorised by this Act, and no person holding such an appointment shall receive any less emolument or be deprived of, or be disqualified from, any promotion or other advantages by reason of the fact that he has such conscientious objection.

The noble Lord said: I hope that the noble Lord, Lord Silkin, when he is having a new look at this clause, will consider putting in either this set of words or something to the same effect. My Amendment seeks to ensure that no one shall be put in a less advantageous position in his profession because he has a conscientious objection to abortion than he would be if he had no such objection. The wording is based entirely on Section 30 of the Education Act, which deals with conscientious objection to conducting religious services in schools. That is for the benefit of atheist teachers, or teachers who happen to be teaching in a school conducted by a denomination other than their own. The cases are to some extent comparable, though not exactly so, but I think that the same form of words is reasonably effective for the purpose.

The only difficulty I see in this new clause is that I am not by any means convinced that it would be effective. It is easy to say that we make no discrimination in promotion on grounds of conscientious objection, or anything like that, and yet to carry on doing just that. The nasty example that comes to mind is the ineffectiveness of the anti-discrimination clauses in the Constitution of Northern Ireland. However, I will not go into that at this late hour. Nevertheless, I think that if some antidiscrimination clause such as this were inserted, either as a separate clause or in the conscientious objection clause itself, it would at least show that Parliament intended that there should be no discrimination. I beg to move.

Amendment to Amendment moved— Line 11, at end insert the said subsection.—(Lord Craigmyle.)

BARONESS STOCKS

I beg your Lordships to leave a certain freedom in this respect to hospital boards. May I give an example of the kind of thing that could happen? Some time ago I happened to sit on a committee with the matron of a large maternity hospital who arrived in a state of some fury because, she said, she had spent the last week-end "scratching the backs" of a non-Catholic surgeon, a non-Catholic anaesthetist and a non-Catholic theatre sister. All three had refused to officiate in the case of a woman who had been ordered to have a sterilisation, following a dangerous Caesarean section, and the matron was put to considerable difficulty to replace them. I think that hospitals, especially maternity hospitals, ought to be allowed to exercise a certain amount of discretion against getting too many members of their staff who are not prepared to carry out what is part of the medical policy of the hospital. In the same way, it would be rather dangerous to get a large proportion of nurses and doctors who were Jehovah Witnesses, in view of the fact that any moment they might be required to give blood transfusions, which would be against their conscience.

I suggest that this Amendment is unnecessary. I do not think there is any great likelihood of discrimination being widespread, but I think that in certain cases some freedom should be allowed to refuse to appoint to certain posts persons who are not prepared to carry out medical duties connected with those posts.

On Question, Amendment to Amendment negatived.

On Question, Amendment agreed to.

Clause 5 agreed to.

11.32 p.m.

Lord Strange moved, after Clause 5, to insert the following new clause:

Duty of registered medical practitioner on refusal to terminate pregnancy.

". When a registered medical practitioner refuses to carry out treatment for the termination of a pregnancy, he shall sign an official form to an approved welfare officer, who, if the pregnant woman desires, shall help her towards parenthood or adoption of her child."

The noble Lord said: In moving this Amendment, I should like to say first what nobody else has said, and that is how pleased I am to see the noble Lord, Lord Silkin, here in such good form, as I understand that he has had a little trouble with hospitals—though not over abortion. I remember the noble Lord, Lord Silkin, moving the Second Reading of his Bill on November 11, 1965 (which now seems quite a long time ago), and as he made his speech I knew that I had objection to the Bill. I felt at the time that I had to move this Amendment, and I moved it the whole way through the Bill at every stage until it faded out in the House of Commons.

I am moving the Amendment again now, and I will tell your Lordships why. I told earlier a story which interested me, and I am going to tell it again. I know it is late, and I am as bored and tired as your Lordships are. But this will take only a short time, and it is important. It was the case history of a young girl who was working in an hotel and who tried to commit suicide. She was put in hospital to be looked after. She was given needles and thread, and told to mend linen. After two or three days she confessed to the nurse that she had been swallowing the needles. The nurse got the doctor, and the doctor ordered her to be fed on margarine and cotton wool until they got the needles back. When they got the needles back, he examined her, and found that she was pregnant. She had been trying to create an abortion on herself.

The history of this young girl was that she had always been with her mother. She knew nothing of anything. She went out to work in this big hotel. They took her out to a party; she had drink—which she had never had before—and got rather "tight". She did not know what happened until she found that she was pregnant. I have since checked this case, and it is true. I thought of the incredible agony that young girl's mind went through to make her swallow eight needles, day after day—I think it was for three days. I came to the conclusion then that men cannot understand the mental agony a woman can go through. I knew that under this Bill, whatever the fancy title (it has a rather fancy title at the moment, but it will always be known to the general public as the Abortion Bill), a great many women, for various causes, would be refused an abortion. Many of them will be in the state of this young girl—ignorant, hopeless, in despair—and I do not know what they will do with themselves.

This is a huge clause in the Bill. Objections were raised that it is difficult to construct the form. If you sit at any desk in this country forms come down on you every day like brown snow. We can print forms in this country, and it is easy to make out a simple form which ensures for the woman that it is secret and confidential. That is the first thing: she must be sure of that. It is very simple for the local authority to put a rubber stamp on it, with the name of the welfare officer and the address she can go to. It is very simple, if a doctor refuses an abortion, to hand a woman this form and say to her: "This is confidential. You can use it or not. But if you want to use it, go to this address, where you will find a very good friend who will guide you and help you". All he has to do after that is to sign his name. That is not much.

I have heard before the objection that it will be too much work for the welfare officers. Well, we live in a Christian country. We are full of churches; we are full of nice women; we are full of associations. Surely we can get volunteers to act as these women's friends. Surely a local authority can pick out the right people, who will be human and really guide these women through: people who have a moral appreciation that people who live in stone houses cannot throw glass; who will not preach to them but see them out to the very end. It is not an unreasonable Amendment.

I know that with regard to this Bill there are a number of noble Lords who have terrific principles. I very much admire anybody who has a principle of any sort. I myself have principles—but I did not get them in a very honourable way. I was just taught them when a child. They were all given the Strange strength, the same force. They are very small. I knew that I must never shoot a fox; I knew I must never be a bore; I knew that I must never show photographs of my family to strangers in rail- way carriages; I knew that I must never take human life—except in a war, when I must kill everybody I possibly could, though I must first make quite sure which side they were on. So my principles as regards abortion are quite simple. I think if it has got to the stage of what we used to call a Caesarian (though a different name is used now), and a live child is taken out of a woman and killed, it just cannot be right. But in the first stage, in the "wishy-washy" stage, I wonder how right or wrong it may be.

Just think how many women have miscarriages. Nobody knows how many have them. They are having them the whole time; they are having them now, as I am talking to your Lordships. Life is a funny thing. It is like the wind: we do not know where it comes from or where it goes. But we do know that we cannot stop it when it has gone too far. In the first stages, however, I should not think it matters very much. But what I am asking the people with principles like mine—arrived at, of course, in a much better way—is this. Surely what they want is that the rejected women should go to a welfare officer, who will guide them to pregnancy, to motherhood or to adoption. There are a great number of people in this country who want to adopt children. Get this Amendment through this time. It is the last time I shall move it. Be with me. I await your Lordships' wisdom, and I beg to move.

Amendment moved— After Clause 5, insert the said new clause.—(Lord Strange.)

BARONESS STOCKS

The noble Lord, Lord Strange, has told us what is in fact a most distressing story about a pregnant woman, and the needles. But I suggest that his Amendment is quite unnecessary, because there is already ample provision for informing unmarried mothers, and other mothers, of opportunities for abortion and care. It is already done in most hospitals; I should think probably in all hospitals.

BARONESS ELLIOT OF HARWOOD

May I say one word? The whole of our child care service throughout the country is geared to help exactly these people. It is dealing continually with unfortunate cases; pregnant women who perhaps have babies and then want to get them adopted, and so on. We now live in a world in which all this is done.

The noble Baroness, Lady Stocks, has said that it is done in hospitals. For 16 years I have been the Chairman of a children's committee and we are continually doing this sort of thing all over the country. While I entirely sympathise with everything the noble Lord, Lord Strange, has said it is quite unnecessary in this day and age to put this Amendment into the Bill because it is being done the whole time, and there is nobody who has a child, illegitimate or otherwise, who cannot get from welfare officers or children's officers—in fact the whole gamut of welfare services—just the kind of help for which the noble Lord has asked.

CONTENTS
Balerno, L.	Craigmyle, L.	Monckton of Brenchley, V.
Barrington, V.	Strange, L. [Teller.]	Moyne, L.
Carnock, L.	Durham, L. Bp.	Sempill, Ly.
Clifford of Chudleigh, L.	Lytton, E. [Teller.]

NOT-CONTENTS
Addison, V. [Teller.]	Gaitskell, B.	Rea, L.
Airedale, L.	Grenfell, L.	St. Davids, V.
Amulree, L.	Hayter, L.	Sandford, L.
Archibald, L.	Henley, L.	Segal, L. [Teller.]
Beswick, L.	Hilton of Upton, L.	Silkin, L.
Boston, L.	Kennet, L.	Sorensen, L.
Bowles, L.	Killearn, L.	Stocks, B.
Byers, L.	Lambert, V.	Stonham, L.
Cranbrook, E.	Listowel, E.	Stow Hill, L.
Elliot of Harwood, B.	Lothian, M.	Strabolgi, L.
Emmet of Amberley, B.	Noel-Buxton, L.	Swanborough, B.
Ferrers, E.	Plummer, B.	Terrington, L.

Clause 6 agreed to.

Clause 7 [Short title and extent]:

LORD SILKIN moved, in subsection (1), to leave out "Medical Termination of Pregnancy" and insert "Abortion". The noble Lord said: This is a very simple Amendment to change the Title of the Bill from "Medical Termination of Pregnancy Bill", which always struck me as a rather clumsy phrase, to "Abortion Bill". The fact is that this Bill is known as the Abortion Bill. The whole of the Press refers to it as the Abortion Bill. Whenever anybody talks about it, they never talk about the Medical Termination of Pregnancy Bill. When it is discussed on television or on

LORD STRANGE

I would say to the two noble Baronesses on my right and left that what they say is very kind but it is quite untrue. What will happen is that a wretched woman, who has perhaps never been to a hospital before, will go for an abortion, and will be told, "I am very sorry, I cannot give it to you". She does not know about welfare; she is terrified; she is a pathetic creature who might swallow needles. All I am asking for is a form to introduce her to two charming Baronesses on my right and left who will help her. That is not much to ask. My Lords, I am going to take this Amendment to a Division; support me.

11.42 p.m.

On Question, Whether the said Amendment (No. 26) shall be agreed to?

Their Lordships divided: Contents, 11; Non-Contents, 36.

sound radio it is always referred to as the Abortion Bill, and it is one word instead of four, which is certainly an advantage. Therefore, I hope that the Committee will agree that we change the Title to that by which this Bill is really already known. I beg to move.

Amendment moved— Page 4, line 15, leave out ("Medical Termination of Pregnancy ") and insert ("Abortion").—(Lord Silkin.)

11.51 p.m.

LORD BROCK

I suggest that the term "Termination of Pregnancy" in this sense is incorrect, and that it would be more correct to say "Abortion". The term "Termination of Pregnancy" can be, and is used up to full term, and it is quite incorrect in the way that it is used in the Title of the Bill. If we replace the phrase "Termination of Pregnancy" by "Abortion" then the qualification "Medical" should be retained. It is a natural and inevitable accompaniment. I beg to move.

Amendment to Amendment moved— Before ("Abortion") insert ("Medical").—(Lord Brock.)

LORD SILKIN

Why not "Surgical"? It is just as much a surgical operation as a medical operation. I do not see a need for any adjective at all. One day it may be possible to do this by the simple operation of taking a pill, and what you would call that I do not know. But I hope that the noble Lord will agree that the simpler the better, and let us settle for "Abortion".

LORD BROCK

I should like to know why the original Title was "Medical Termination of Pregnancy"?

LORD SILKIN

I may say that originally the Title was "Abortion". In the two Bills that came before this House it was "Abortion". When it went to another place, for some reason which I do not know and I cannot understand, they thought it would sound better to cover up "Abortion" and call it by some other name.

LORD BROCK

I am glad to hear that even at this late hour Lord Silkin is no longer putting forward the views of the other place in support of the Bill. I think that at this late hour it would be improper for me to press this, and therefore I beg leave to withdraw the Amendment.

Amendment to Amendment, by leave, withdrawn.

VISCOUNT BARRINGTON

I think I can move this Amendment to the Amendment quite shortly. I suggest that we should add the words "Law Reform" after the word "Abortion", so that it becomes the Abortion Law Reform Bill. I suggest this on the ground that it is not a Bill for abortion, but a Bill for the reform of the law about abortion, whether it is done with a scalpel or with some undiscovered chemical. I beg to move.

Amendment to Amendment moved— After ("Abortion") insert ("Law Reform").—(Viscount Barrington.)

LORD SILKIN

This is something more than merely law reform abortion. We have agreed to extend, though not as far as I should have liked, the grounds on which abortion can be carried out. It is true that the Bill as it now stands has reformed the law, but it goes beyond that, and it would not be really an explanatory title to call it merely "Law Reform Abortion".

VISCOUNT BARRINGTON

I am afraid at this late hour the words have been put in the wrong order. I suggested Abortion Law Reform Bill.

THE CHAIRMAN OF COMMITTEES (THE EARL OF LISTOWEL)

Does the noble Lord wish to withdraw his Amendment?

VISCOUNT BARRINGTON

I have made clear that it was not, as Lord Silkin said, in the opposite order and that my suggestion was "Abortion Law Reform Bill". I beg leave to withdraw my Amendment to the Amendment.

Amendment to Amendment, by leave, withdrawn.

On Question, Whether the Amendment (No. 28) shall be agreed to?

THE EARL OF IDDESLEIGH

It gives me particular pleasure to be able to support Lord Silkin in this Amendment. Two years ago it was agreed between the noble Lord and myself that we should pay each other respect for our sincerity. I do not think that in the controversies over this Bill we have failed to pay each other that tribute of respect which we then promised. On this matter I am perfectly certain that the noble Lord, Lord Silkin, is entirely right. He calls the operation which we are discussing by its proper name, and I trust that the House will give him this Amendment.

LORD SEGAL

Before the Committee finally decides on the rights or wrongs of this Title, it is only fair to point out that the law of this country bristles with euphemisms. This House has recently passed the Sexual Offences Act. That was on more than one occasion called by at least one noble Lord by a single word instead of two words, yet we prefer to retain its original Title, although it does not necessarily convey to everyone the actual meaning of the Act. We still retain a Vagrancy Act of 1851 which comprises a whole collection of various offences which would not be pleasantly translated into ordinary terminology. There is no point in pressing this matter and retaining the title Medical Termination of Pregnancy Bill, and we should all be well advised to accept my noble friend's suggestion and change the Title to the "Abortion Bill."

LORD SILKIN moved to add to the clause: ( ) This Act shall come into force on the expiration of the period of six months beginning with the date on which it is passed.

The noble Lord said: I am sure that this Amendment will commend itself to the noble Earl, Lord Iddesleigh, because it proposes to postpone the operation of this Bill for six months. That, from his point of view, is better than its coming into operation at once. The purpose of this Amendment is merely to enable the Ministry of Health to make the necessary preparations in order that the Bill may get off to a good start. They have to do certain things in the hospitals, and so on, and I am sure that if those of us who have been strong supporters of the Bill can actually get it through this Session, we shall restrain ourselves and be patient and be quite prepared to wait six months before it comes into operation. I beg to move.

Amendment moved— Page 4, line 16, at end insert the said subsection.—(Lord Silkin.)

LORD CRAIGMYLE

Could we have an assurance from the Front Bench that, in the course of this six months the regulations necessary under Clause 2 will be prepared?

LORD STONHAM

This period of six months is necessary if this Bill becomes an Act, and obviously it cannot become an Act until the very end of the Session. So in effect it will become operative some time in March or April of next year. By that time it is thought that all the necessary preparations could be made so that the Act could be fully implemented, and all the necessary preparations could be made in hospitals and in the Service as a whole.

House resumed: Bill reported with Amendments.