26/01/2018

0:03:26 > 0:03:32Second reading of the Conscientious Objection (Medical Activities) Bill.

0:03:32 > 0:03:37My Lords, I beg to move that this bill now be read a second time. This

0:03:37 > 0:03:40bill is designed to afford protection to those in health care

0:03:40 > 0:03:45who object on grounds of conscience to being asked to participate in end

0:03:45 > 0:03:50of life treatment. It's about a human rights, the right to freedom

0:03:50 > 0:03:53of belief, religion and conscience. There have always been those who

0:03:53 > 0:03:57when faced with a call to participate or engage in the end of

0:03:57 > 0:04:02life, object to so doing. Conscientious objection was those

0:04:02 > 0:04:07provided for in 1757 in the United Kingdom. If we think back 100 years

0:04:07 > 0:04:12ago on this day, a la country was at war, the world was at war. But even

0:04:12 > 0:04:16at this most parlous time, 16,000 men were excused from constriction

0:04:16 > 0:04:26to military service on grounds of conscience. Some, such as Quakers,

0:04:26 > 0:04:28because of religious beliefs. Others such as radical socialists because

0:04:28 > 0:04:33of political principle. During World War II we accommodated 60,000

0:04:33 > 0:04:36registered conscientious objectors, not easy for them, maybe some would

0:04:36 > 0:04:40say not easy for others who fought. It was not simple but, my Lords, it

0:04:40 > 0:04:47was possible to accommodate conscientious objection. The United

0:04:47 > 0:04:50Kingdom therefore has a long and proud record of recognition of

0:04:50 > 0:04:55rights of conscience and respect for conscience. It is a principle

0:04:55 > 0:05:01recognised in international law as well as in domestic legislation. The

0:05:01 > 0:05:04European Court of Human Rights in 2011 interpreted the article nine

0:05:04 > 0:05:09right to freedom to manifest believed to include conscientious

0:05:09 > 0:05:12objection and overturned the conviction of an Armenian Jehovah's

0:05:12 > 0:05:15Witness to his refusal to perform military service at a time when

0:05:15 > 0:05:19there was no other option available to him.

0:05:19 > 0:05:22As respect for conscience applies to those who refuse to participate in

0:05:22 > 0:05:26the taking of life in the war, so it has been applied to those who refuse

0:05:26 > 0:05:31to be involved in what they see as the taking of life through health

0:05:31 > 0:05:36care practice. My Lords, in 1967 when the UK legislated to

0:05:36 > 0:05:41decriminalise abortion in certain circumstances, provision was made to

0:05:41 > 0:05:43conscientious objection because it was understood that what was being

0:05:43 > 0:05:50made legal was regarded by some as the taking of life. Were it not so,

0:05:50 > 0:05:56there would have been no need for protection of conscience. And in

0:05:56 > 0:05:591990 when the human fertilisation and the act was passed, there was

0:05:59 > 0:06:05again limited provision for conscientious objection. -- the

0:06:05 > 0:06:08human fertilisation and embryology act. Whenever Assisted Dying Bill is

0:06:08 > 0:06:12being discussed, there has been provision for conscientious

0:06:12 > 0:06:16objection. Where conscientious objection is permitted, it is not

0:06:16 > 0:06:21absolute. Medical practitioners must assess to save lives, prevent grave

0:06:21 > 0:06:26or complex injury. It is a complex peeled. Some have statutory rights,

0:06:26 > 0:06:30some like GPs have contractual rights not to engage, but it is

0:06:30 > 0:06:33contractual and not statutory and some have no rights at all.

0:06:33 > 0:06:40Why does it matter anyway, my Lords? Professor Dan Brock, a leading

0:06:40 > 0:06:44bioethicist at Harvard, describes conscience as the basis of an

0:06:44 > 0:06:48individual's moral integrity. Saying it defines who, at least morally

0:06:48 > 0:06:57speaking, the person is. Maintaining moral integrity, he asserts,

0:06:57 > 0:07:00requires a person does not violate their moral commitments and that is

0:07:00 > 0:07:02why, my lord, we allow conscientious objection in health care so that

0:07:02 > 0:07:06people can maintain moral integrity, without which major health and other

0:07:06 > 0:07:10problems will almost inevitably emerge. Through conscience, we each

0:07:10 > 0:07:18decide whether an action is right or wrong. Conscience is fundamental to

0:07:18 > 0:07:24moral agency and it is a proper feature of all areas of human

0:07:24 > 0:07:27endeavour, including professional practice. The provision of medical

0:07:27 > 0:07:33services is never value free. Health care practitioners make moral

0:07:33 > 0:07:38judgments all day every day. Very often very difficult judgments. In

0:07:38 > 0:07:452010 when the equality act was passed, freedom of religion or

0:07:45 > 0:07:50belief was awarded protected characteristic status. Like six, age

0:07:50 > 0:07:55and disability. And, my Lords, protection from discrimination, from

0:07:55 > 0:07:58exclusion on grounds of religion or belief, is provided for in section

0:07:58 > 0:08:0213 of that act which defines religion and belief as any religious

0:08:02 > 0:08:08or philosophical belief and says a reference to belief includes a lack

0:08:08 > 0:08:13of belief. Conscious, my lord, is not the preserve of the religious --

0:08:13 > 0:08:18conscience, my lord. Those who think it is wrong to end human rights do

0:08:18 > 0:08:22so for many reasons, scientific, philosophical, religious and other

0:08:22 > 0:08:26beliefs. The right to conscientious objection exists as a protection for

0:08:26 > 0:08:29medical professionals from the moral injury of being involved in actions

0:08:29 > 0:08:35which they believe destroy life. It exists too for the protection of

0:08:35 > 0:08:38patients, who can believe that the professional looking them can act in

0:08:38 > 0:08:43accord with their conscience. Conscientious objection, my Lords,

0:08:43 > 0:08:47operates at the margin of medical treatment, where the duty to do no

0:08:47 > 0:08:52harm moves to accommodate positive action to life. It is not just

0:08:52 > 0:08:56domestic law which recognises the right of conscientious objection.

0:08:56 > 0:09:02The Council of Europe's parliamentary assembly adopted

0:09:02 > 0:09:04resolution 1763 affirming the right of conscientious objection for

0:09:04 > 0:09:10medical professions. The resolution states no person, hospital or

0:09:10 > 0:09:14institution shall be coerced, held liable or discriminated against in

0:09:14 > 0:09:18any way because they refusal to perform, accommodate, assist or

0:09:18 > 0:09:23submit to an abortion. It is non-binding but its rear forms the

0:09:23 > 0:09:26normative understanding of freedom of conscience.

0:09:26 > 0:09:29Society has changed. The law has been interpreted differently in the

0:09:29 > 0:09:36United Kingdom. In 2014 the case of Greater Glasgow health board was

0:09:36 > 0:09:41heard by the Supreme Court. In this case, Team Gresini midwives

0:09:41 > 0:09:45conscientiously objected to having delegate tasks to supervise or to

0:09:45 > 0:09:50support those directly involved in abortion. -- in this case, two

0:09:50 > 0:09:56midwives. They were able to exercise this right of conscientious

0:09:56 > 0:10:00objection for their whole careers until Alan Malcolm -- until an

0:10:00 > 0:10:03amalgamation of hospitals led to them being able to do this work.

0:10:03 > 0:10:07Ultimately they could not in conscience have any role in the

0:10:07 > 0:10:11provision of abortion. They, skilled, compassionate, experienced

0:10:11 > 0:10:15midwives, were unable to continue to serve as midwives, doing what they

0:10:15 > 0:10:19had in all of their professional lives, helping women through the

0:10:19 > 0:10:23sometimes difficult process of carrying and bearing a child.

0:10:23 > 0:10:27I know that that is difficult, anybody who has carried a child

0:10:27 > 0:10:32knows the sensitivities attached to it, and those good women were lost

0:10:32 > 0:10:34in the profession because the Supreme Court decided that indirect

0:10:34 > 0:10:39routes taken by nurses and midwives were excluded from protection under

0:10:39 > 0:10:44section four of the Abortion Act. My Lords, it simpler, be consistent

0:10:44 > 0:10:49with conscience to say I cannot do this, but I will order you to do it.

0:10:49 > 0:10:52If one delegate, supervisors or support some activity, then one is

0:10:52 > 0:10:57not unreasonable in concluding that one shares moral responsibility for

0:10:57 > 0:11:02what happens. There is a lot of evidence that

0:11:02 > 0:11:04medical professionals are suffering serious disadvantage and

0:11:04 > 0:11:11discrimination for their beliefs. A 2016 at cross-party inquiry into

0:11:11 > 0:11:16freedom of conscience in abortion provision specifically received many

0:11:16 > 0:11:18accounts by medical professionals who have experienced discrimination

0:11:18 > 0:11:23during their worklife due to their beliefs. I have heard so many

0:11:23 > 0:11:27stories of young doctors and nurses contemplating their future who have

0:11:27 > 0:11:32decided that although they would dearly love to be involved in

0:11:32 > 0:11:34obstetrics and gynaecology, even though they are energised and feel

0:11:34 > 0:11:38vocationally called to the medicine of helping women through conception

0:11:38 > 0:11:42and childbirth, nevertheless they cannot do it because they could not

0:11:42 > 0:11:50in conscience: unborn child. That is why I have introduced this bill, it

0:11:50 > 0:11:54aims to seek as a matter of statute that nobody should be under any duty

0:11:54 > 0:11:58to participate in activities they believe involve resuming -- the

0:11:58 > 0:12:02taking of human life, either in the withdrawal of life-sustaining

0:12:02 > 0:12:09treatment or any activity authorised by the 19671990 acts. Such a reform

0:12:09 > 0:12:14would re-establish legal protection for medical conscientious objectors

0:12:14 > 0:12:17and reaffirmed the rights of health care workers. It would give reality

0:12:17 > 0:12:22to the protections afforded in the act. There is a serious shortage of

0:12:22 > 0:12:25health care professionals, we are having to bring doctors and nurses

0:12:25 > 0:12:30from abroad. We spent £100 million bringing 3000 GPs from other

0:12:30 > 0:12:35countries this year. We are short of 3500 midwives and we spend,

0:12:35 > 0:12:38according to the Royal College of Midwives, nearly 100 million for

0:12:38 > 0:12:42agency nurses. It is a problem. Many young doctors, midwives and other

0:12:42 > 0:12:50health care professionals are leaving the UK. Many reasons for

0:12:50 > 0:12:53this, one of them is that those who labour at the coal face cannot

0:12:53 > 0:12:55engage with certain activities. We invest in their training, we need

0:12:55 > 0:12:59their skills, it is time to accommodate them. I emphasise again

0:12:59 > 0:13:03that this bill is not about reducing access to the termination of

0:13:03 > 0:13:07pregnancy or the withdrawal of life-sustaining treatment. It would

0:13:07 > 0:13:10simply mean that health care workers of many different kinds in

0:13:10 > 0:13:15registering their objections to the procedures defined in to the bill

0:13:15 > 0:13:18must be reasonably accommodated by those managing them so that they may

0:13:18 > 0:13:26work without involvement in those areas. My Lords, 60% of abortions

0:13:26 > 0:13:30are religious and the provider by private companies. 2% privately

0:13:30 > 0:13:37funded. 30% take place in NHS hospitals, alongside all the other

0:13:37 > 0:13:43obstetric and biological procedures. 92% of abortions in 2016, 100

0:13:43 > 0:13:4770,000, were carried out at under 30 weeks gestation. Increasingly

0:13:47 > 0:13:51medical abortions involving the use of medication. That gives rise to be

0:13:51 > 0:13:54necessary to protect rights of conscience above GPs and pharmacists

0:13:54 > 0:14:04-- were carried out at under 13 weeks gestation.

0:14:04 > 0:14:08Rather than forcing staff are other reasons to engage in proceedings

0:14:08 > 0:14:12which those staff simply, for reasons of conscience cannot do.

0:14:12 > 0:14:19Reasonable accommodation my Lords is a matter of liberty and equality of

0:14:19 > 0:14:23individual freedom and social inclusion. That is why I believe

0:14:23 > 0:14:27this is important and timely legislation. I have heard that there

0:14:27 > 0:14:31is widespread support for this bill. I know it has attracted support from

0:14:31 > 0:14:36all sides of this House and from the Commons, but I hope that in moving

0:14:36 > 0:14:39and through second reading, we will enhance the quality of the service

0:14:39 > 0:14:43provided to all our people and the environment in which health care

0:14:43 > 0:14:49professionals work. I beg to move. The question is that this bilby

0:14:49 > 0:14:58ready second time?-- the question is that this bill be ready second

0:14:58 > 0:15:07time.I really do not believe that there are lots of professionals in

0:15:07 > 0:15:11this country that feel that their rights are insufficiently

0:15:11 > 0:15:14represented by the current law. The existing provisions for health care

0:15:14 > 0:15:17professionals to reject on the grounds of conscience in certain

0:15:17 > 0:15:22well-defined circumstances is currently sensible and balanced, and

0:15:22 > 0:15:27this bill is both unnecessary and potentially dangerous. Now, I very

0:15:27 > 0:15:31much respect the concerns of health care professionals to decline to

0:15:31 > 0:15:37participate in a hands-on capacity in specific medical activities. For'

0:15:37 > 0:15:42reasons, firstly, because they have that right to act in line with the

0:15:42 > 0:15:49police. But for a second reason, because in these often complicated

0:15:49 > 0:15:52and vulnerable situations, where patients themselves have had to make

0:15:52 > 0:15:58really difficult decisions about abortion, about IVF, about end of

0:15:58 > 0:16:05life care, those patients deserve to be treated by professionals who

0:16:05 > 0:16:08respect the treatment decisions. And so it is really important that

0:16:08 > 0:16:11health care professionals have a proper right to conscientiously

0:16:11 > 0:16:18object. I believe this is allowed for in the current legislation and

0:16:18 > 0:16:23in the guidance issued by the General medical Council the Nursing

0:16:23 > 0:16:25and Midwifery Council and under current employment law and under the

0:16:25 > 0:16:30Human Rights Act. But patients have very important rights as well and

0:16:30 > 0:16:34this bill would threaten the very principle of respect for the wishes

0:16:34 > 0:16:37of the patient and the right to exercise choice. This must not

0:16:37 > 0:16:43happen. If I was to be brutal, the bill to be seen as a tactic, to

0:16:43 > 0:16:47allow campaigning health care professionals to undermine the get

0:16:47 > 0:16:51it and indeed vital patients choices, and I would like to focus

0:16:51 > 0:16:56on three areas. Firstly, employment law. The bill has provisions for the

0:16:56 > 0:17:00employer not to discriminate against or victimise an employees for

0:17:00 > 0:17:06involving, invoking conscientious objection and in terms of their

0:17:06 > 0:17:11employment, the opportunities for promotion of transfer and training,

0:17:11 > 0:17:13dismissal by subjecting individuals to any other directorate. Now, that

0:17:13 > 0:17:21looks great. Motherhood and apple pie. But it is very unnecessary

0:17:21 > 0:17:27because the existing legislation defends the rights of employees in

0:17:27 > 0:17:31the circumstances already and I believe that we only hear of a very

0:17:31 > 0:17:34few cases that have come to law, where individuals appear to have

0:17:34 > 0:17:42been discriminated against because there are comparatively few cases. I

0:17:42 > 0:17:47believe that a change of provisions in the bill have the potential to

0:17:47 > 0:17:53undermine the occupational requirement exemption under the

0:17:53 > 0:18:00equality act of 2010, which allows, for example, an oncology hospital

0:18:00 > 0:18:03ward not to employ a part of Ciaran Norris under the conscientious

0:18:03 > 0:18:08objection for caring for patients whose life-saving treatment is by

0:18:08 > 0:18:12agreement with the patient and family Ron. The provisions in the

0:18:12 > 0:18:14bill to extend the right of objection by health care

0:18:14 > 0:18:20professionals to activities required to delegate or prepare for support

0:18:20 > 0:18:24such activities which are subject to the bill, would make this rest even

0:18:24 > 0:18:28worse, and that we could see a situation where a range of health

0:18:28 > 0:18:33care professionals dotted across the health care system and the care

0:18:33 > 0:18:35pathway, in delegating and revising and planning entire aspects of

0:18:35 > 0:18:41health care and exercising the conscience, could make it impossible

0:18:41 > 0:18:43for the patients to achieve their rights and the employer would have

0:18:43 > 0:18:48no ability to prevent that. The second point I would like to raise

0:18:48 > 0:18:54is that the bill makes no obligation on the individual to refer the

0:18:54 > 0:19:00patient for the care that they need and are entitled to. Some patients

0:19:00 > 0:19:03who are less informed about their entitlements, more vulnerable

0:19:03 > 0:19:05patients, could simply failed to secure a service that they should

0:19:05 > 0:19:10have received, this inequity is unacceptable. The third issue I

0:19:10 > 0:19:13would like to cover its scope, extending the scope of conscientious

0:19:13 > 0:19:18objection puts us on a path towards a living professionals to opt out of

0:19:18 > 0:19:25providing even the basic end life care. It elevates the important

0:19:25 > 0:19:29personal beliefs of a health care professional up to the patient, it

0:19:29 > 0:19:34puts the needs and the wishes of the patient at last, it is the very

0:19:34 > 0:19:39opposite of patient centred care. We know that 60% of Britons want more

0:19:39 > 0:19:44control over decisions about their health. The source global trends

0:19:44 > 0:19:49survey in 2017 showed that very clearly. We know that 82% of UK

0:19:49 > 0:19:52citizens do not want doctors to make decisions about end of life

0:19:52 > 0:19:57treatment on their behalf. And the Royal College of physicians,

0:19:57 > 0:20:02national institute for clinical excellence, and the public Health

0:20:02 > 0:20:04Service Ombudsman has recognised that more must be done to support

0:20:04 > 0:20:08and people, particularly to exercise their right to make decisions that

0:20:08 > 0:20:14are right for them. So I believe that this bill is impractical. I

0:20:14 > 0:20:19respect entirely the noble baroness, Baroness O'Loan's concern about

0:20:19 > 0:20:25health care professionals' ability to put this into practice, but I

0:20:25 > 0:20:27believe the balance between the rights of the health care

0:20:27 > 0:20:31professional and the rights of the patient would be fatally skewed by

0:20:31 > 0:20:35this bill. Just last week the US administration announced plans for a

0:20:35 > 0:20:38conscience and religious freedom division within the Department of

0:20:38 > 0:20:42Health and human and this, together with new rules that would

0:20:42 > 0:20:46dramatically expand the ability of health care institutions and workers

0:20:46 > 0:20:51to refuse to provide medical care on the basis of conscientious

0:20:51 > 0:20:57objection. We are not living in the land of Donald Trump, our laws

0:20:57 > 0:21:00rightly put the needs of patients at the centre, that is what our health

0:21:00 > 0:21:06care system is for. I would urge my fellow peers to this bill.Lost, I

0:21:06 > 0:21:12am pleased to speak in support of this bill. The issue raised by the

0:21:12 > 0:21:17bill is simple. -- Lords. If someone objects to abortion or assisted

0:21:17 > 0:21:24dying on the grounds of conscience, how far should we be entitled to opt

0:21:24 > 0:21:31out? The issue is simple, but the solution is difficult. The Supreme

0:21:31 > 0:21:34Court held that as a matter of construction, the conscience clause

0:21:34 > 0:21:42provisions of the 1967 abortion act should be interpreted narrowly, so

0:21:42 > 0:21:48that Mary Dougan was not entitled to refuse to help facilitate abortions

0:21:48 > 0:21:54by organising other nurses for the purpose of providing abortions. The

0:21:54 > 0:21:59aim of this bill is to change the wording so that freedom of

0:21:59 > 0:22:04conscience will be able to be invoked as a grounds for refusing to

0:22:04 > 0:22:07do acts which are less directly connected to the abortion itself

0:22:07 > 0:22:13than is presently the case. I think that is a good thing and I shall

0:22:13 > 0:22:19endeavour to explain why. The first reason why it is a good thing is

0:22:19 > 0:22:25because a significant number of dedicated health care professionals

0:22:25 > 0:22:31have profound moral objections to both abortion and assisted suicide.

0:22:31 > 0:22:38The role of the state is not to sit in judgment on this moral

0:22:38 > 0:22:42objections, it is not the role of the state to coerce people into

0:22:42 > 0:22:48acting against their conscience. Therefore, it is a good thing and a

0:22:48 > 0:22:51reasonable thing that the state should make conscientious objection

0:22:51 > 0:22:57provision sufficiently broad to excuse acts which genuinely found

0:22:57 > 0:23:07the conscience. I think the state should air on the side of respecting

0:23:07 > 0:23:11conscience, rather than placing valuable medical staff any position

0:23:11 > 0:23:16and nursing staff as well any position where they have to choose

0:23:16 > 0:23:24on the location and the conscience. My Lords, I have a number of friends

0:23:24 > 0:23:29who when they were applying for consultant posts in obstetrics would

0:23:29 > 0:23:35be asked the question, "Are you prepared to take your share of the

0:23:35 > 0:23:39abortions?" And if they said yes, they would be considered for the

0:23:39 > 0:23:44appointment. If, on the other hand, they said, "Yes, I am prepared to

0:23:44 > 0:23:53take my share of abortions within the 1967 act," they were not

0:23:53 > 0:23:58considered for the consultant post and many of them had to emigrate.

0:23:58 > 0:24:03And they were very good clinicians and it was a great loss. The second

0:24:03 > 0:24:10reason I support this bill is because there is no evidence

0:24:10 > 0:24:13whatsoever that if this bill is passed, it will detrimentally affect

0:24:13 > 0:24:20anyone seeking an abortion. The third reason I support the bill is

0:24:20 > 0:24:28that it is both unwise and unnecessary to force medics and

0:24:28 > 0:24:33nurses to act against their conscience in any sphere whatsoever.

0:24:33 > 0:24:39If we train them to do that in one sphere of work, we have only

0:24:39 > 0:24:46ourselves to blame if they do that in other aspects of their work. For

0:24:46 > 0:24:52these reasons, I support this bill. My Lords, I am only sorry to

0:24:52 > 0:24:57disagree with my noble friend, Baroness O'Loan, but I cannot

0:24:57 > 0:25:02support this bill. Of course, all of us will agree that a proper account

0:25:02 > 0:25:06must be taken of a person's conscientious objection to

0:25:06 > 0:25:09participation in medical treatments, which, they believe, friend against

0:25:09 > 0:25:14the principle of the sanctity of life, but what amounts to

0:25:14 > 0:25:20participation, how we should the statutory exemption go? The

0:25:20 > 0:25:27treatments or non-treatments hair under consideration to do with the

0:25:27 > 0:25:30withdrawal of racist engagement to fertility treatments and treatments

0:25:30 > 0:25:35corrected to the termination of pregnancies and it is about the last

0:25:35 > 0:25:39of these, abortion, that I presently want to focus, and in particular,

0:25:39 > 0:25:48have only 2014 unanimous decision of the Supreme Court. In her article,

0:25:48 > 0:25:54and lastly's house Magazine, the noble baroness said that the Supreme

0:25:54 > 0:25:59Court interpreted participation in the abortion act conscience clause

0:25:59 > 0:26:08to mean only direct performance. All right for surgeons, but must mean

0:26:08 > 0:26:10that nurses and midwives who conscientiously object to the

0:26:10 > 0:26:16material involvement in enabling the procedure were stripped off formal

0:26:16 > 0:26:22statutory protections and a little later in the article, she suggested

0:26:22 > 0:26:26that are bill would, "Re-establish legal protections for medical

0:26:26 > 0:26:33conscientious objections and reaffirm, of health care workers." I

0:26:33 > 0:26:38must tell you, I profoundly disagree with that analysis of the Mary

0:26:38 > 0:26:41Dougan case and I will make three basic points. Firstly, there is

0:26:41 > 0:26:49simply no question of Mary Dougan having changed the law on the rights

0:26:49 > 0:26:52of conscientious objection in this context, no question the four of the

0:26:52 > 0:26:58day's bill re-establishing reaffirming anything. The Supreme

0:26:58 > 0:27:04Court, they were simply construing section 4.1, the conscience clause

0:27:04 > 0:27:08in the 1967 abortion act on the ordinary principles of construction,

0:27:08 > 0:27:15declining to give its either a particular wide or a particularly

0:27:15 > 0:27:18narrow meaning. And on this construction they held the two

0:27:18 > 0:27:25practitioners, as you have heard, experienced midwives, employed as

0:27:25 > 0:27:29labour ward coordinators were exempted by the conscience clause

0:27:29 > 0:27:35from many of the tasks involved in that. Including any medical, nursing

0:27:35 > 0:27:40care connected with the purpose of undergoing labour and giving birth,

0:27:40 > 0:27:46but they are not exempted from the managerial and supervisory tasks,

0:27:46 > 0:27:52which are carried out by hospital ward coordinators, such as picking

0:27:52 > 0:27:59patients into the hospital ward, allocating staff to the patients on

0:27:59 > 0:28:04the hospital ward, communicating with other professionals, for

0:28:04 > 0:28:16example, paging anaesthetists. Baroness talks about very compelling

0:28:16 > 0:28:19judgment, considered how the conscience clause applies to each of

0:28:19 > 0:28:27an agreed list of 13 specified tasks, or set out in the judgment

0:28:27 > 0:28:32and it is good but it is not the same as reading the judgment. This

0:28:32 > 0:28:37bill is, of course, designed to overturn the judgment. See the end

0:28:37 > 0:28:40of clause 1.2, and of course, Parliament is entitled to change the

0:28:40 > 0:28:47law to widen vary considerably, as this would, the definition, the

0:28:47 > 0:28:55approach to participation, what a change it would be, but not the

0:28:55 > 0:28:59restoration of Pavon's original decision. My Lord's the second point

0:28:59 > 0:29:05arising directly with these concerns of article nine of the human rights

0:29:05 > 0:29:09Convention, which also was dealt with by the Supreme Court, as indeed

0:29:09 > 0:29:13was the Equality Act 2010. With regard to discrimination on grounds

0:29:13 > 0:29:19of

0:29:19 > 0:29:23Now, as to these principles, the court recognised an employer's duty

0:29:23 > 0:29:29to make reasonable adjustments to the requirements of a job to cater

0:29:29 > 0:29:33to religious beliefs. But it pointed out that the extent of the duty is

0:29:33 > 0:29:39context specific and it added that to some extent this would release

0:29:39 > 0:29:44depends on issues of practicability. And the court said much better

0:29:44 > 0:29:49resolve those in employment tribunal proceedings in the context of a

0:29:49 > 0:29:55particular case than by an overall declaration of the law, in either

0:29:55 > 0:30:01judicial review or, as I would suggest, the present bill. My Lords,

0:30:01 > 0:30:08the third point is this, the Royal College of Midwives and the British

0:30:08 > 0:30:13pregnancy advisory service both intervened in the Supreme Court

0:30:13 > 0:30:17proceedings and argued against the petitioners that to give a broad

0:30:17 > 0:30:22scope to the right of conscientious objection would put at risk the

0:30:22 > 0:30:27provision of a safe and accessible abortion servers and furthermore

0:30:27 > 0:30:32might encourage other employers to adopt the policy of refusing to

0:30:32 > 0:30:38employ anyone who has any conscientious objection to abortion.

0:30:38 > 0:30:43This would reduce the job opportunities available for highly

0:30:43 > 0:30:47skilled and experienced midwives, perhaps with less -- with less

0:30:47 > 0:30:52extensive objections than these particular petitions. In short, the

0:30:52 > 0:30:58bill I suggest takes altogether too absolute and extreme a position and

0:30:58 > 0:31:06it would be unwise to adopt it. I add this finally, to invoke in

0:31:06 > 0:31:12support of this bill, as the noble Baroness did in her Haas magazine

0:31:12 > 0:31:18article and has again done today, the appalling treatment of

0:31:18 > 0:31:22conscientious objectors who resisted fighting in the First World War, I

0:31:22 > 0:31:27suggest it is really over the top, rather like the bill itself is lax,

0:31:27 > 0:31:33I suggest, the balanced approach that these present issues deserve. I

0:31:33 > 0:31:38am against this bill. -- rather like the bill itself, its lacks.

0:31:38 > 0:31:42As a precursor to this debate I read with great interest the article from

0:31:42 > 0:31:47the baronet in the House journal. Let me first declare my interest, I

0:31:47 > 0:31:51am a member of the all-party, and regroup for choice at the end of

0:31:51 > 0:31:58life. I am concerned about the application of bill, especially as

0:31:58 > 0:32:01existing medical and legal regulations work well, striking a

0:32:01 > 0:32:05sensible balance between allowing health care professionals to

0:32:05 > 0:32:09conscientiously object without abandoning the patients and causing

0:32:09 > 0:32:13distress to patients and families. My Lords, I support the rights of

0:32:13 > 0:32:20health care professionals to refuse to participate in a hands-on

0:32:20 > 0:32:23capacity in certain medical activities and I'm confident that

0:32:23 > 0:32:25this right to conscientious objection is well established within

0:32:25 > 0:32:31current medical laws on protocols. I am very concerned that this bill,

0:32:31 > 0:32:35which aims to expand existing sensible provisions unclench inches

0:32:35 > 0:32:39objection, as it relates to the withdrawal of life-sustaining

0:32:39 > 0:32:45treatment, will have a detrimental effect on comprehensive person

0:32:45 > 0:32:51centred care currently provided by multidisciplinary teams. In some

0:32:51 > 0:32:54situation I fear the bill, if enacted, could lead to patients

0:32:54 > 0:32:57being abandoned by health care professionals.

0:32:57 > 0:33:00This could also have the berry detrimental impact on the families

0:33:00 > 0:33:04and loved ones of patients approaching the end of life at what

0:33:04 > 0:33:08is already a difficult time. My Lords, this bill would undermine

0:33:08 > 0:33:14the medical capacity act of 2005, existing legal provisions and

0:33:14 > 0:33:19guidance on conscientious objection strike the right balance between

0:33:19 > 0:33:23respect the health care professionals' belief and the best

0:33:23 > 0:33:26interests of the patients. As an example, this bill threatens

0:33:26 > 0:33:30to undermine the entire degree is double provisions of the Mental

0:33:30 > 0:33:37Capacity Act code of practice 2007, which is very clear that health care

0:33:37 > 0:33:40professionals do not have to do something that goes against their

0:33:40 > 0:33:46beliefs, but they must not simply abandon patients or cause their care

0:33:46 > 0:33:50to suffer and should refer their patients to another colleague

0:33:50 > 0:33:53willing to participate. I am not aware that the national

0:33:53 > 0:33:58mandatory capacity Forum has expressed a view on this particular

0:33:58 > 0:34:02bill but I hope that organisations with interest in and advancing

0:34:02 > 0:34:07patients' capacity to make decisions over their health and care will

0:34:07 > 0:34:11ensure that conscientious objection should not become a limit on

0:34:11 > 0:34:14patients' ability to decide for themselves.

0:34:14 > 0:34:19My Lords, this bill would negatively impact patients and their families.

0:34:19 > 0:34:23Let me explain. Providing care for those approaching the end of life

0:34:23 > 0:34:27care can be challenging for health care professionals, but the

0:34:27 > 0:34:31well-being of the patients must be of the first concern. If the patient

0:34:31 > 0:34:36has capacity and wishes to do so, they are entitled to make their own

0:34:36 > 0:34:39decisions about consent or refusal of treatment and should be supported

0:34:39 > 0:34:46to do so. Equally, under the Mental Capacity Act 2005 in England and

0:34:46 > 0:34:52Wales, if the patient has decision to refuse treatment or appointed a

0:34:52 > 0:34:57lasting power of attorney for health and welfare, their decision or that

0:34:57 > 0:35:00of their attorney must be respected. Those decision should be respected

0:35:00 > 0:35:06in a timely manner. It would be completely unacceptable for a

0:35:06 > 0:35:09patient approaching the end of life to have to continue treatment they

0:35:09 > 0:35:14did not want whilst awaiting transfer to palliative care or

0:35:14 > 0:35:16another team of health care professionals that did not object to

0:35:16 > 0:35:20their decision. It would be completely unacceptable for the

0:35:20 > 0:35:25patient's family to have to watch them receiving unwanted treatment,

0:35:25 > 0:35:28and I'm afraid that could be the implication of this particular bill.

0:35:28 > 0:35:32Let me site a couple of examples relating to this particular

0:35:32 > 0:35:43argument. This case relates to Paul Briggs ant Mrs N, the decision on

0:35:43 > 0:35:46withdrawing treatment to people in a persistent vegetative or minimally

0:35:46 > 0:35:55conscious state. In several of these cases such as that of Paul Briggs,

0:35:55 > 0:36:00the policeman who suffered a brain injury in a car crash on his way to

0:36:00 > 0:36:04work, and Mrs N, a woman who was in a minimally conscious state over a

0:36:04 > 0:36:09period of many years, due to advanced multiple sclerosis, it has

0:36:09 > 0:36:14taken huge efforts by their family members, sometimes in the face of

0:36:14 > 0:36:19objection by professionals, to get their cases heard by the Court of

0:36:19 > 0:36:24Protection. Mrs N's daughter heard the judge, -- told the judge, who

0:36:24 > 0:36:29eventually heard the case, I cannot emphasise enough how the indignity

0:36:29 > 0:36:33of her current execs and says the greatest contradiction to how she

0:36:33 > 0:36:39lived her life, and if she was able to express this then she would. --

0:36:39 > 0:36:44the indignity of her current existence. Paul Briggs' wife wrote,

0:36:44 > 0:36:49and echoes, I love my husband but he is dead in all but his body. I don't

0:36:49 > 0:36:53know when I will ever laying him to rest in peace. That is a limbo

0:36:53 > 0:36:58nobody should be in. It must have been incredibly difficult for them

0:36:58 > 0:37:02to see their loved ones suffer over a period of years, receiving

0:37:02 > 0:37:08treatment they did not believe was wanted. Even where the Court of

0:37:08 > 0:37:11Protection has decided that withdrawing treatment is in the best

0:37:11 > 0:37:16interest of the patient, some families have them struggle to find

0:37:16 > 0:37:18health care facilities where staff members do not conscientiously

0:37:18 > 0:37:25object to that particular decision. Let me conclude existing rules allow

0:37:25 > 0:37:28for any health care professional to conscientiously object to withdraw

0:37:28 > 0:37:31life-sustaining treatment as long as they find another health care

0:37:31 > 0:37:34professional to take over the care of the patient. I fear the bill

0:37:34 > 0:37:40would cause additional unnecessary strain at an already distressing

0:37:40 > 0:37:45time for people at the end of life, and their families. In doing so it

0:37:45 > 0:37:50would encounter the principles of patient centred care. I hope the

0:37:50 > 0:37:55bill is substantially amended at a committee stage.

0:37:55 > 0:38:00My Lords, yesterday the River restaurant downstairs helped us to

0:38:00 > 0:38:06celebrate Burns night all day. I thoroughly enjoyed the Scotch broth

0:38:06 > 0:38:10at lunchtime, but I resisted the main course as I was eating out in

0:38:10 > 0:38:14the evening. I even resisted the whiskey bread-and-butter pudding.

0:38:14 > 0:38:23The main course which I resisted was vegetarian haggis, celebrating Burns

0:38:23 > 0:38:25in a way which respected the consciences of those who didn't want

0:38:25 > 0:38:34to eat meat. A very proper and good thing to do. No legal requirement to

0:38:34 > 0:38:38provide vegetarian haggis, but welcome to many, and I think I would

0:38:38 > 0:38:45have enjoyed it. Clearly Lord Cormack did enjoy it. Yesterday was

0:38:45 > 0:38:50not just Burns night, it was also, for church people, the Festival of

0:38:50 > 0:38:56the conversion of Saint Paul. In simple's teaching he is very strong

0:38:56 > 0:39:02in asserting that Christians, although they are free to make many

0:39:02 > 0:39:06decisions morally, must always respected the conscience of those

0:39:06 > 0:39:13who are weaker, those with a tender conscience -- in St Paul's teaching.

0:39:13 > 0:39:17That is an absolute requirement in the Christian faith, that those

0:39:17 > 0:39:21whose consciences are more tender all week than our own must be

0:39:21 > 0:39:26respected and not forced to go against those consciences. We have

0:39:26 > 0:39:32the same teaching in other areas of religion as well. In real testament

0:39:32 > 0:39:36it is very clear that the vulnerable and the weak are to be supported and

0:39:36 > 0:39:43helped. In the teaching of Jesus he criticises those leaders who lay

0:39:43 > 0:39:50burdens too heavy for people to bear upon ordinary folk. As we have seen

0:39:50 > 0:39:55the history of the world since the time of Christ, and particularly our

0:39:55 > 0:40:00own country, we have seen, I believe, do a great deal of

0:40:00 > 0:40:06influence from the Judaeo-Christian tradition, the development of free

0:40:06 > 0:40:10societies, of what we now tend to call liberal democracies.

0:40:10 > 0:40:15And in those societies there has always been a great deal of

0:40:15 > 0:40:22attention paid to the rights of conscience, even though they go

0:40:22 > 0:40:25beyond and are more tender and sensitive than the views of many

0:40:25 > 0:40:30other people. Every free society respects the rights of conscience to

0:40:30 > 0:40:35a great extent, and we have heard some of that already in this debate.

0:40:35 > 0:40:39The societies which restrict the rights of conscience tend to be

0:40:39 > 0:40:46those which are tyrannical, the extreme left or the extreme right of

0:40:46 > 0:40:52politics is where we find conscience restricted. In free societies a

0:40:52 > 0:40:58great deal of tolerance is given to those with conscientious objections

0:40:58 > 0:41:05to all sorts of things. Now, this is not just a matter of religion.

0:41:05 > 0:41:10Conscience is a very, very deep part of what it means to be human. It is

0:41:10 > 0:41:15not just religious rights we are talking about, it is very deep human

0:41:15 > 0:41:18rights that people should not be forced to go against what they

0:41:18 > 0:41:26believe to be right or wrong. In this particular bill, which I

0:41:26 > 0:41:33support strongly and look forward to seeing further debated and possibly

0:41:33 > 0:41:38amended, it recognises some changes since the Abortion Act. Most

0:41:38 > 0:41:42abortions now have far more involvement from nurses and

0:41:42 > 0:41:47pharmacists than they did in the early days. Methods of doing

0:41:47 > 0:41:53abortions have changed. I believe it is right to extend the conscience

0:41:53 > 0:41:57clause, for example, to pharmacists since their involvement is greater

0:41:57 > 0:42:08than it used to be. We need as a society to find ways to modify the

0:42:08 > 0:42:15law as it was set out in 67, nudges to affirm the conscience clause

0:42:15 > 0:42:20there. I believe this is a matter of public concern. -- not just to

0:42:20 > 0:42:24affirm the conscience clause there. It is a matter for public policy and

0:42:24 > 0:42:30public debate. If the 67 act needs to be clarified, that should be done

0:42:30 > 0:42:35not just in courts but in Parliament on behalf of the people of the

0:42:35 > 0:42:38country. If the 67 act is breathing in some

0:42:38 > 0:42:46way unsatisfactory in that some people's consciences are not being

0:42:46 > 0:42:50allowed then we need to do something to modify it, not to reduce the

0:42:50 > 0:42:55possibility of abortion, not to reduce people's freedom to seek

0:42:55 > 0:43:01medical treatment, which I want to underscore, but to allow those which

0:43:01 > 0:43:04have a tender conscience to exercise that conscience. My Lords, I support

0:43:04 > 0:43:09this bill.

0:43:09 > 0:43:14My Lords, I am pleased to follow the reverend who spoke about the burden

0:43:14 > 0:43:18to bear. I would point out that sometimes when you are member of a

0:43:18 > 0:43:24minority, it is a burden that you must bear. Indeed, it is a burden

0:43:24 > 0:43:34that are sometimes reinforced by

0:43:35 > 0:43:38religious and beliefs. I respect and defend the right of religion and

0:43:38 > 0:43:41belief that freedom but I do not, my Lords, respect the rights to impose

0:43:41 > 0:43:43religion on others who do not share them and therefore diminish the

0:43:43 > 0:43:46rights of others. I rise to speak against this bill which I find

0:43:46 > 0:43:50deeply worrying and troubling. It is an attempt to rewrite laws which

0:43:50 > 0:43:54respect conscientious objection and which, my Lords, have been working

0:43:54 > 0:43:59well. Working well, my lords. It is an attempt to rewrite laws in light

0:43:59 > 0:44:06of the 2014 Supreme Court judgment, delivered by the noble Lady Hale and

0:44:06 > 0:44:15tears of greater Glasgow health board in Mary Doogan versus law. I

0:44:15 > 0:44:19believe if this bill was to become law, we would seek on changes

0:44:19 > 0:44:25objections for Waverley against the wise and learned words and judgment

0:44:25 > 0:44:30of the deal as to make services such as IVF treatment come end of life

0:44:30 > 0:44:34care treatment and abortion is difficult to excess and sustain

0:44:34 > 0:44:40nationally. -- access. And we would witness, my Lords, the curtailing of

0:44:40 > 0:44:45the legal choices and options of others. There have been many changes

0:44:45 > 0:44:49in the last 50 years and particularly since the 1967 Abortion

0:44:49 > 0:44:56Act. Positive changes that have been vigorously fought for and vigorously

0:44:56 > 0:45:02fought against. Women's rights, the right to abortion, fertility

0:45:02 > 0:45:05treatment, IVF for married, non-married and same-sex partners.

0:45:05 > 0:45:10Equality and rights for LGBT people, rights and the qualities which some

0:45:10 > 0:45:15people, organisations and religious bodies still refuse to accept and

0:45:15 > 0:45:21still do their best to hold back. Indeed, my Lords, a woman's right to

0:45:21 > 0:45:24choose is shamefully denied in Northern Ireland and same-sex

0:45:24 > 0:45:29marriage is still not available, and all of this is connected, my Lords,

0:45:29 > 0:45:33as I have said, I defend the right to freedom of religion or belief but

0:45:33 > 0:45:37not the right to impose it, whereby some posing you reduce the rights of

0:45:37 > 0:45:43others. I sure the deep concerns of Doctors for choice in UK, who write

0:45:43 > 0:45:47that they support the current legal provisions that allow medical

0:45:47 > 0:45:50practitioners to opt out of providing treatment that conflicts

0:45:50 > 0:45:55with the personal and religious beliefs. But that extending the

0:45:55 > 0:45:59activities to which a health care professional could claim a

0:45:59 > 0:46:06conscientious objection from, hands-on treatment to any

0:46:06 > 0:46:10supervision, delegation, planning or supporting staff, in respect of that

0:46:10 > 0:46:14activity, could have a huge the adverse effect on health care

0:46:14 > 0:46:19provision in the United Kingdom. The British pregnancy advisory service

0:46:19 > 0:46:25are of the same opinion. They also believe, my Lords, that by extending

0:46:25 > 0:46:28conscientious objection in these ways, again, as outlined by the

0:46:28 > 0:46:35noble and learned Lord, Lord Brown of Eaton-under-Heywood, this could

0:46:35 > 0:46:38cause a staffing crisis, in particular areas of health and this

0:46:38 > 0:46:43is particularly true in the National Health Service, where a hospital

0:46:43 > 0:46:50wards and disciplines simultaneously cover a number of procedures and

0:46:50 > 0:46:52conditions. I thank these organisations and particularly the

0:46:52 > 0:46:57dignity in dying, who maintain that as an unintended consequence, the

0:46:57 > 0:47:02bill could undermine that might undermine the principle of person

0:47:02 > 0:47:07centred end of life care and drive a wedge between health care

0:47:07 > 0:47:12professionals and their patients. The bill would allow any health care

0:47:12 > 0:47:16professional, any health care professionals, my Lords, to refuse

0:47:16 > 0:47:22to participate in the supervision, delegation, planning or support of

0:47:22 > 0:47:27any activity which they do not agree. And nothing any bill as had

0:47:27 > 0:47:30been set earlier but it is worth repeating, would obligingly

0:47:30 > 0:47:35objecting health care professional to develop that patient's care to

0:47:35 > 0:47:41another. For example, if someone with advanced care has the

0:47:41 > 0:47:44artificial nutrition and hydration water drawn, a health care

0:47:44 > 0:47:49professional could reject to providing basic care. They could

0:47:49 > 0:47:54include providing Mulcaire, managing a syringe driver for pain relief and

0:47:54 > 0:47:59the alleviation of terminal agitation, prevention of pressure

0:47:59 > 0:48:04wins, coordinating spiritual and family support and, if appropriate,

0:48:04 > 0:48:11arranging to discharge the person to die at home or in a hospice. My

0:48:11 > 0:48:16Lords, having witnessed my own partner died of cancer in the Royal

0:48:16 > 0:48:19Marsden Hospital, and in light of the debate yesterday, led by the

0:48:19 > 0:48:26noble and reaches Baroness Jay Howell, for the reasons outlined

0:48:26 > 0:48:34today and for many others, I cannot and will not support this bill.My

0:48:34 > 0:48:39Lords, I should probably declare an interest as an only fellow of the

0:48:39 > 0:48:42Royal College of Obstetricians and Gynaecologists, and they have also

0:48:42 > 0:48:48had some responsibility in connection with the other matters

0:48:48 > 0:48:54that are referred to in this bill. My Lords, the simple analysis, as

0:48:54 > 0:49:00far as I am concerned, is this... If a person has an objection, let me

0:49:00 > 0:49:04take it to abortion, for example, someone objecting to abortion thinks

0:49:04 > 0:49:10that it is wrong to carry out an abortion. Generally speaking, there

0:49:10 > 0:49:17is, of course, a provision limiting that in connection where the life of

0:49:17 > 0:49:24the mother is at risk. The present law does not allow conscientious

0:49:24 > 0:49:33objection in that respect, and that, I believe, is a very general

0:49:33 > 0:49:36realisation of what they conscientious objection will be. But

0:49:36 > 0:49:40the basic conscientious objection is that it is wrong in the general case

0:49:40 > 0:49:47to perform an abortion. And the question is, to what extent only

0:49:47 > 0:49:57should be required to do what is contrary to one's belief. To do what

0:49:57 > 0:50:04one's conscience requires that they believe to be wrong. Therefore, in

0:50:04 > 0:50:09my submission to your Lordships, it would be right that they are

0:50:09 > 0:50:14protected from doing what they think is wrong. Now, of course, I am very

0:50:14 > 0:50:19familiar with the judgment of the Supreme Court and Baroness Hale,

0:50:19 > 0:50:27whom I respect particularly because of various reasons, which I will not

0:50:27 > 0:50:33go into at the moment, but I respect her judgment very much indeed. And

0:50:33 > 0:50:40it is a judgment on the Act of Parliament as it was. The Scottish

0:50:40 > 0:50:46court, the judges of the Court of Session, decided that the wider

0:50:46 > 0:50:56interpretation was possible and they were in favour of Mary Doogan and

0:50:56 > 0:51:03the other lady. The situation was a particular one that these ladies had

0:51:03 > 0:51:07been in the health service for a considerable time and they were

0:51:07 > 0:51:11happy to do what they were doing and they did not have to do anything

0:51:11 > 0:51:17that they thought was wrong. The arrangements were changed and then

0:51:17 > 0:51:22they were required to do something that they thought was wrong, and

0:51:22 > 0:51:28that was where the matter came into the courts. Now, my Lords, I have

0:51:28 > 0:51:32been in correspondence with the doctors for choice, the kindly sent

0:51:32 > 0:51:40me an e-mail explaining what they thought, and it is ask more detail

0:51:40 > 0:51:46of what they were thinking. And what it comes to is this, that they

0:51:46 > 0:51:52believe that the National Health Service depends, to a substantial

0:51:52 > 0:51:56extent, on people doing what they believe to be wrong. Now, I really

0:51:56 > 0:52:03find it very hard to see that that can be right. On the other hand, I

0:52:03 > 0:52:06do not think and the minister might be able to tell us, I do not think

0:52:06 > 0:52:11that the amount of conscientious objection to these various items

0:52:11 > 0:52:17referred to in this bill is very large. The numbers, I do not think,

0:52:17 > 0:52:22are all that large. But let us assume that there is a substantial

0:52:22 > 0:52:26number, then what they are saying is that it is necessary under present

0:52:26 > 0:52:32circumstances to depend on people who are serving in the health

0:52:32 > 0:52:37service to do what they think is wrong. So, as far as I am concerned,

0:52:37 > 0:52:42that is precisely what the conscientious laws of this country,

0:52:42 > 0:52:47for many years, have been, that it is not necessary and not right to

0:52:47 > 0:52:50force people as part of their employment to do what they believe

0:52:50 > 0:52:57to be wrong. Now, it has been said and many of your Lordships have

0:52:57 > 0:53:03mentioned this, that, of course, it will cause some problems for some

0:53:03 > 0:53:08people. The point I think that we must make is that the obligation to

0:53:08 > 0:53:14provide these services is not only employee, but on the health service

0:53:14 > 0:53:19itself, and therefore, we have the responsibility of making the

0:53:19 > 0:53:24necessary arrangements to accommodate the views of those who

0:53:24 > 0:53:27think that these particular activities are wrong. And they do

0:53:27 > 0:53:32not believe it is right that the health service or, indeed any other

0:53:32 > 0:53:38service, should rely to a substantial extent for its success

0:53:38 > 0:53:43on requiring any of its employees to do what these employees think to be

0:53:43 > 0:53:50wrong. For that reason, I support this bill. Of course, the bill the

0:53:50 > 0:53:54subject, the detail of it, to amendment if necessary, but as far

0:53:54 > 0:53:59as I can see, the actual phraseology is not far from that which was

0:53:59 > 0:54:02adopted by the Court of session in Scotland, that was the

0:54:02 > 0:54:05interpretation that they thought should be placed on the Act of

0:54:05 > 0:54:14Parliament as it was. I oppose this bill, but it was great

0:54:14 > 0:54:17to have the article which has been referred to in the House magazine by

0:54:17 > 0:54:23the noble lady, to provide the background as to how she got to this

0:54:23 > 0:54:28point. As well as having the excellent Lords library note which

0:54:28 > 0:54:33expanded on some of the references that the article mentioned, in

0:54:33 > 0:54:35particular, the Supreme Court judgment, all of which I will

0:54:35 > 0:54:43shortly come to. One might ask as they do more robustly in the House

0:54:43 > 0:54:46of Commons, on private bills, what is the need for this particular

0:54:46 > 0:54:55private bill legislation? Given that the first appearance we saw of it, a

0:54:55 > 0:55:01similar Help to Buy to this was in June 2015 when it only had time for

0:55:01 > 0:55:07a first reading. -- bill. I wondered if there was need for this

0:55:07 > 0:55:10legislation in order to meet popular demand and contempt that the current

0:55:10 > 0:55:14law or if it was created by a small group of the well-intentioned for

0:55:14 > 0:55:21the betterment of mankind? I believe that I have here is that the

0:55:21 > 0:55:26direction is top-down and that there may not be the popular clamour for

0:55:26 > 0:55:31more statute law to do with what is before us. As we have been made

0:55:31 > 0:55:35aware in meetings and briefings we have received, the four councils

0:55:35 > 0:55:41referred to both the registers in clauses one and two all have their

0:55:41 > 0:55:44own procedures for dealing with conscientious objection when it is

0:55:44 > 0:55:50not covered by statute law, and I was not sure if Lord Mackay of

0:55:50 > 0:55:54Clashfern was fully aware of that, and that is why I mention it now in

0:55:54 > 0:55:59more detail. These are slight variations but cover broadly the

0:55:59 > 0:56:04same areas, particularly in passing on the other that one individual can

0:56:04 > 0:56:09reject for reasons of conscience the particular needs of each of these

0:56:09 > 0:56:16four councils. I noticed the one major change to the early 2015 Bill,

0:56:16 > 0:56:22there is a new addition in clause 1.2 p to the pharmaceutical Council.

0:56:22 > 0:56:25That edition adds to the numbers that could be directly or indirectly

0:56:25 > 0:56:33affected by this bill by the 53,000 members on that register. I would

0:56:33 > 0:56:36therefore have thought that at least some sort of proper consultation but

0:56:36 > 0:56:41that council should have taken place before incorporating them into this

0:56:41 > 0:56:44bill, but understand that that has not happened, that is very much from

0:56:44 > 0:56:49the top down. It also may have been thought that the pharmacist could

0:56:49 > 0:56:54become a major channel for the distribution of medical abortion

0:56:54 > 0:56:59pills and the noble baroness in her speech made the connection. But as I

0:56:59 > 0:57:01explained, without any further statute law, the pharmaceutical

0:57:01 > 0:57:07Council already have a perfectly good provision in place for

0:57:07 > 0:57:12conscientious objection by the members, which is framed for the

0:57:12 > 0:57:17particular professional circumstances. To try to put all of

0:57:17 > 0:57:21this council is under a common straitjacket of statute provisions

0:57:21 > 0:57:25would be counter-productive and require extensive, continuing legal

0:57:25 > 0:57:33dispute on the interpretation. I believe that the deal's Supreme

0:57:33 > 0:57:38Court judgment, already mentioned, particularly in paragraph 38 and her

0:57:38 > 0:57:41interpretation of the word participate is a very good addition

0:57:41 > 0:57:46of the existing position as the water suitable for statute law and

0:57:46 > 0:57:50what can be fairly achieved by individual guidelines, which, as the

0:57:50 > 0:57:58noble lord, Lord Brown, said Candy context specific or decided by

0:57:58 > 0:58:01unemployment tribunal. Also from a practical point of view we have

0:58:01 > 0:58:04learned from the various submissions we received on this bill from

0:58:04 > 0:58:08organisations, it is a very complex medical procedures and specialised

0:58:08 > 0:58:14man's. How much uncertainty this bill would cause in the day-to-day

0:58:14 > 0:58:19running of various organisations. Malia never been quite sure what

0:58:19 > 0:58:24staff are going to be available to meet ever-changing needs in the

0:58:24 > 0:58:27process of the patient wants to suffer. In the article I mentioned

0:58:27 > 0:58:34at the beginning and end the debate today, the apparently simple phrase,

0:58:34 > 0:58:37the taking of human life occurred twice, which most of us hear no is

0:58:37 > 0:58:43the beginning of divergent views in the fields we are addressing today.

0:58:43 > 0:58:48And I believe the noble Baroness, Baroness O'Loan, used the same

0:58:48 > 0:58:54phrase in her speech today.

0:58:54 > 0:58:59For example, when exactly did human life start? When is withdrawing

0:58:59 > 0:59:02life-saving treatment or turning off a machine justifiable? Many more

0:59:02 > 0:59:09questions are baked... Begged by that simple phrase. My Lords, I hope

0:59:09 > 0:59:13I have highlighted some of the potential difficulties of this bill,

0:59:13 > 0:59:21which I oppose. My Lords, I congratulate the

0:59:21 > 0:59:26baroness on bringing forward this bill, which sheds a welcome

0:59:26 > 0:59:32spotlight on a very important area. If I can be very brief, I think most

0:59:32 > 0:59:36of the main arguments have been made. I start from the position that

0:59:36 > 0:59:41nobody should be obliged to participate in a procedure to which

0:59:41 > 0:59:45they have a conscientious objection. Lord Mackay has already spoken with

0:59:45 > 0:59:51his usual eloquence and power on that aspect. The issue, however,

0:59:51 > 0:59:56turns on what you mean by participation. The draft bill is

0:59:56 > 1:00:02very wide indeed on that subject and Lord Cashman has referred to it

1:00:02 > 1:00:08twice. Let me read the keywords again. Participating in an activity

1:00:08 > 1:00:16includes any supervision, delegation, planning or supporting

1:00:16 > 1:00:22of staff in respect of that activity. That is very, very wide,

1:00:22 > 1:00:27as Baroness Young pointed out. For my part, I find myself in agreement

1:00:27 > 1:00:32with Lady Hale's judgment that it is unlikely that Parliament originally

1:00:32 > 1:00:36intended to include a host of ancillary and administrative and

1:00:36 > 1:00:41managerial matters in the coverage of this bill. On the other hand, I

1:00:41 > 1:00:49think she went too far in confining the application to those taking part

1:00:49 > 1:00:54in, quote, a hands-on capacity. That seems to me to be far too narrow. I

1:00:54 > 1:00:58hope that in further discussions, perhaps that committee stage, Common

1:00:58 > 1:01:05cause can be found. My Lords, the situation in respect

1:01:05 > 1:01:08of the withdrawal of life-saving treatment, life-sustaining

1:01:08 > 1:01:12treatment, appears to be different in respect of nurses who cannot

1:01:12 > 1:01:16lawfully raise a conscientious objection. Their professional code,

1:01:16 > 1:01:20as I understand it, calls for them to arrange free suitably qualified

1:01:20 > 1:01:26colleague to take over. This, of course, is a hugely

1:01:26 > 1:01:31sensitive area. As a layman, it seems to me that the present formula

1:01:31 > 1:01:36is about the right balance in this field. To extend the widest

1:01:36 > 1:01:40definition in this bill to issues arising from life support seems to

1:01:40 > 1:01:47need to be a step too far. My Lords, for my part this bill

1:01:47 > 1:01:52would needs and amendments before I could support it.

1:01:52 > 1:01:57I speak as a layman and someone who feels it a privilege, and indeed

1:01:57 > 1:02:02refreshing, to be able to take part in such a debate, nonpartisan and

1:02:02 > 1:02:07with so many experts leading lawyers, leading medics in this

1:02:07 > 1:02:11field. It is indeed the House of Lords at its best.

1:02:11 > 1:02:21But I put on record immediately that I am not with the noble lady Lady

1:02:21 > 1:02:28O'Loan in terms of abortion, which I see is justified in terms of social

1:02:28 > 1:02:33concerns, but I agree with her conscientious objection. For me, the

1:02:33 > 1:02:37recognition of a conscientious objection is something which is the

1:02:37 > 1:02:44sign of a civilised society as against a non-civilised society. And

1:02:44 > 1:02:49my presumption always would be in favour of looking at conscientious

1:02:49 > 1:02:54objection. The problem here, of course, as I think my noble friend

1:02:54 > 1:03:00Lady Young says, if one agrees that the Court of sessions was correct

1:03:00 > 1:03:04and the current law needs to be extended, as I do, where does one

1:03:04 > 1:03:14draw the line? How does one find some position of defining what is

1:03:14 > 1:03:17participation, that participation can be extended so far as to be

1:03:17 > 1:03:24ridiculous. There is, of course, much learning both in respect of

1:03:24 > 1:03:27participation and in respect of remoteness. I think many people

1:03:27 > 1:03:32would agree on grounds of conscientious objection that we need

1:03:32 > 1:03:35to go beyond a very narrow interpretation which a number of

1:03:35 > 1:03:44colleagues here have put on the relevant clause of the 1967 act.

1:03:44 > 1:03:49Yes, to extend, but also perhaps by amendment in committee to say how

1:03:49 > 1:03:57one defines the extent of participation so as not to make it

1:03:57 > 1:03:59absolutely ridiculous. The importance of freedom of conscience

1:03:59 > 1:04:05is recognised in so many international instruments. I know

1:04:05 > 1:04:10that the noble lady Lady O'Loan has gone through a number from the

1:04:10 > 1:04:15universal declaration, articles one and 18, which is accurate in article

1:04:15 > 1:04:20nine of the European Convention on human rights. I may say, for the

1:04:20 > 1:04:25rest of the week I have been in Strasbourg sitting on the legal

1:04:25 > 1:04:29affairs and human rights committee and indeed on the committee

1:04:29 > 1:04:34responsible for the selection of judges to the court. As Lady O'Loan

1:04:34 > 1:04:39said, our own Equalities Act has religion and belief as protected

1:04:39 > 1:04:42characteristics and includes a reference to, quotes, lack of

1:04:42 > 1:04:50religion or belief. And freedom of conscience, conscientious objection,

1:04:50 > 1:04:57surely it should not just be a wish but also something that is relevant

1:04:57 > 1:05:04in practice. Relevant in practice also in the workplace. The European

1:05:04 > 1:05:12Court of Human Rights interprets the Convention rights, or has

1:05:12 > 1:05:16interpreted in a case against the UK, it was a strong chords and this

1:05:16 > 1:05:23is the case of the Coptic Christian who wished to wear a cross working

1:05:23 > 1:05:30for British airway 's, and the Court held in her favour, a strong chords,

1:05:30 > 1:05:35on the basis of her freedom of religion. There have been some

1:05:35 > 1:05:39concerns expressed both in the assembly of the Council of Europe

1:05:39 > 1:05:44and here that the unregulated use of a conscientious objection clause

1:05:44 > 1:05:49could limit a woman's right of access to lawful medical care. I

1:05:49 > 1:05:57think there would be taking a too far. The noble Baroness Baroness

1:05:57 > 1:06:03O'Loan has already mentioned the resolution 1763 passed by the

1:06:03 > 1:06:08Parliamentary assembly of the Council of Europe in 2010, so I

1:06:08 > 1:06:12shall not quotes what is already on record.

1:06:12 > 1:06:17It is surely wrong to deter individuals from entering and

1:06:17 > 1:06:24remaining in the medical profession, particularly in this case of Dougan

1:06:24 > 1:06:27where the circumstances of employment of this two women had

1:06:27 > 1:06:30changed from the time where they first entered and employment.

1:06:30 > 1:06:35Particularly, of course, the question about recruiting and

1:06:35 > 1:06:41retaining is relevant at a time of the current crisis in the National

1:06:41 > 1:06:45Health Service, not just during this current winter crisis. And we should

1:06:45 > 1:06:52be very well conscious of any deterrent which might be put in the

1:06:52 > 1:06:57way of people who are very caring individuals and who might be

1:06:57 > 1:07:00inclined to apply for work in the health service.

1:07:00 > 1:07:09But clearly the NHS is struggling at the moment to hire and retain GPs.

1:07:09 > 1:07:13The number of surgeries, which I accept is a wider matter, dropped

1:07:13 > 1:07:21from around 8500 to eight decades ago to 7500 today. And we all want

1:07:21 > 1:07:29to see a GP when we need to -- from around 8501 decade ago to 7500

1:07:29 > 1:07:35today. There should not be a way where we cannot accommodate as far

1:07:35 > 1:07:37as possible conscientious objection while finding appropriate lines of

1:07:37 > 1:07:43half -- of how far one can go. Perhaps the president might be in

1:07:43 > 1:07:50the way that the committee of ministers dealt with the prisoners

1:07:50 > 1:07:56voting case from 2005. At in December of last yeara reasonable

1:07:56 > 1:08:03accommodation was reached on the margin of appreciation. And I

1:08:03 > 1:08:10applaud the Minister, David Lidington, for this. Is there not a

1:08:10 > 1:08:15margin of appreciation, is there not a reasonable accommodation in these

1:08:15 > 1:08:21cases where the reasonable person can say this is the current law, it

1:08:21 > 1:08:30has been construed too narrowly. We need to jewel these lines. Perhaps

1:08:30 > 1:08:33by amendment is one can see a way through this, but I understand we

1:08:33 > 1:08:37need a debate on this highly sensitive issue and therefore, for

1:08:37 > 1:08:43the moment, I support the bill and the very excellent way it was put

1:08:43 > 1:08:49forward by Baroness O'Loan. My Lords, in my contribution to the

1:08:49 > 1:08:53debate about this important bill, which I welcome and thank the noble

1:08:53 > 1:08:59lady Baroness O'Loan is introducing, I wish to discuss the concept of

1:08:59 > 1:09:05conscience and how necessary I think it is to have effective provision to

1:09:05 > 1:09:08protect it in medicine. When we talk about conscience, it

1:09:08 > 1:09:13seems to me that we mean the part about the that constitutes moral

1:09:13 > 1:09:19integrity, the deeply held and important moral judgments of our

1:09:19 > 1:09:23conscience constitute the central personal call. They define who we

1:09:23 > 1:09:28are, at least morally speaking, and what we stand for.

1:09:28 > 1:09:34The central moral core of our character. In order for any

1:09:34 > 1:09:38individual to maintain their integrity, they cannot violate their

1:09:38 > 1:09:42fundamental moral commitments. If they achieve this, this gives

1:09:42 > 1:09:46others clear reason to respect them, not because those commitments must

1:09:46 > 1:09:52be true or justified in the eyes of everyone else or even just the

1:09:52 > 1:09:57majority, but because the maintaining of moral integrity is a

1:09:57 > 1:10:02crucial action central to our personal coherence and well-being.

1:10:02 > 1:10:07Conscience involves the moral wholeness of the person, there are

1:10:07 > 1:10:11emotional, intellectual and moral life. When someone betrays their

1:10:11 > 1:10:17conscience they do nothing less than disregards a deep, core aspect of

1:10:17 > 1:10:22their personal identity. Given this reality, my Lords, it is

1:10:22 > 1:10:26utterly impossible to detach conscience from the professional

1:10:26 > 1:10:31life of anyone, let alone a medical professional who deals with often

1:10:31 > 1:10:38grave moral situations every day. A conscientious doctor or nurse or

1:10:38 > 1:10:42midwife is conscientious because of their internal moral life, not

1:10:42 > 1:10:47merely because they are proficient at mechanical is to clean following

1:10:47 > 1:10:52official rules and guidelines. Following this, I think to

1:10:52 > 1:10:56illustrate how important legal conscience protections are, it would

1:10:56 > 1:10:59be helpful to note one crucial difference between the obviously

1:10:59 > 1:11:06pertinent parallel major ready by the noble lady Baroness O'Loan,

1:11:06 > 1:11:13between conscientious objection in military service to what someone

1:11:13 > 1:11:17believes is unjust killing and to the same in medicine. That

1:11:17 > 1:11:23difference is the nature of the role of the coalition. Medical

1:11:23 > 1:11:27professionals are vocational actors, not mere conscripts in a logistical

1:11:27 > 1:11:31machine. Medical professionals are not functional lists with the

1:11:31 > 1:11:42medical system, they are not people providing a shopping service. They

1:11:42 > 1:11:47are not merely employees of the NHS who must do whatever the system

1:11:47 > 1:11:52tells them. We would not want a doctor to do something about when

1:11:52 > 1:11:56Stig -- that went against their professional judgment, no matter

1:11:56 > 1:12:01what a patient might want. I am reminded that according to the

1:12:01 > 1:12:06mental capacity act, one may refuse consent to treatment but one may not

1:12:06 > 1:12:11demand that something is done to you. The integrity of the individual

1:12:11 > 1:12:18clinician is part and parcel of the integrity of medicine itself. Would

1:12:18 > 1:12:22we really trust a doctor who did whatever we wanted and put aside his

1:12:22 > 1:12:28judgment for the sake of fulfilling our wishes? Of course not. We would

1:12:28 > 1:12:33want them to, frankly, give us their best and most conscientious

1:12:33 > 1:12:39judgment, for them to you, as some people think they should,

1:12:39 > 1:12:41compartmentalised their most fundamental moral beliefs from their

1:12:41 > 1:12:46professional behaviour would be to seriously compromise their

1:12:46 > 1:12:52integrity. This would be in no one's best interest. It is crucial, then,

1:12:52 > 1:12:55to the right practice of medicine for both medical professionals and

1:12:55 > 1:13:01patients, as in public life itself, to protect freedom of conscience.

1:13:01 > 1:13:08This bill, it seems to me, would allow for areas of medicine that are

1:13:08 > 1:13:12particularly controversial to remain open to those people with very high

1:13:12 > 1:13:16conscience standards and who would therefore be welcome individuals to

1:13:16 > 1:13:22enter these sorts of roles. It would require a minority of medical

1:13:22 > 1:13:26professionals to be reasonable, -- reasonably accommodated, a concept

1:13:26 > 1:13:30which I believe is highly important in this debate, and thereby

1:13:30 > 1:13:33including a manner consistent with our treatment of minorities more

1:13:33 > 1:13:39generally. Insofar as this is the case, it would allow for a society

1:13:39 > 1:13:44more truly liberal and open, as well as qualitative and its medical care,

1:13:44 > 1:13:49due to the fully integral character of those allowed to act within it in

1:13:49 > 1:13:55all sectors of medicine. This can only be for the common good. If we

1:13:55 > 1:14:01care about conscience in society, particularly in medicine, we should

1:14:01 > 1:14:07maintain a framing of our laws which allows for as much liberality as is

1:14:07 > 1:14:10sensibly feasible in conscientious objection when it comes to the

1:14:10 > 1:14:18perceived ending of human life.

1:14:18 > 1:14:21them in for that reason I am delighted it has been introduced and

1:14:21 > 1:14:32I am passionate to supported. The NHS relies on the commitment of

1:14:32 > 1:14:36thousands of people willing to use their skills and the training in

1:14:36 > 1:14:40order to promote well-being of patients and to provide particular

1:14:40 > 1:14:46care with the compassion. Every patient deserves to be treated by

1:14:46 > 1:14:51those whose primary tasks is to seek the welfare and respect their

1:14:51 > 1:14:57wishes. Many, many of those people who work in the health service do so

1:14:57 > 1:15:04out of religious conviction, but the fees has led them to believe that

1:15:04 > 1:15:09this is a way through vocation to give particular service to others.

1:15:09 > 1:15:15And this is to be welcomed, they are the stimulates what they do and

1:15:15 > 1:15:18sustains them through difficult thing is that they are required to

1:15:18 > 1:15:26do. A minority of those find the faith or belief system is not

1:15:26 > 1:15:32compatible with what they are being asked to do on locations. They are

1:15:32 > 1:15:40firmly held convictions are established as a right in law to be

1:15:40 > 1:15:46respected and protected already. This bill has an expressed intention

1:15:46 > 1:15:57to clarify what those with a conscientious objection bored or

1:15:57 > 1:16:01ought not to be invited to participate in. Its intention is to

1:16:01 > 1:16:06clarify that participation, but, in fact, the bill goes much further

1:16:06 > 1:16:13than that. It expands the level of participation that could be

1:16:13 > 1:16:20protected. We have already heard so many times, not just a hands-on

1:16:20 > 1:16:27active participation, but extends it to supervision, delegation, planning

1:16:27 > 1:16:35and support for staff. It feels to determine where responsibility lies

1:16:35 > 1:16:41for the exercise of care for those patients to whom conscientious

1:16:41 > 1:16:49objector finds it difficult to care. -- fails. The current practice is

1:16:49 > 1:16:54that they must inform colleagues and patients and that care must be

1:16:54 > 1:17:02passed onto another. But what is defined as the participation in this

1:17:02 > 1:17:09bill, seems to deny that right to remove that responsibility, but it

1:17:09 > 1:17:16does not define it as to where it should go. My Lords, I am well aware

1:17:16 > 1:17:21that anecdotes do not always make good evidence, but personal

1:17:21 > 1:17:29experience informs opinions. My husband, at the age of 42, was

1:17:29 > 1:17:34diagnosed with a brain tumour. For the next ten years we managed that

1:17:34 > 1:17:39condition at home, repeated operations and procedures,

1:17:39 > 1:17:45increasing disability and family trauma. And then his consultant

1:17:45 > 1:17:52decided that he would attempt aggressive surgery. That surgery was

1:17:52 > 1:17:57carried out and at the end of the operation the consultant said to me,

1:17:57 > 1:18:03the tumour had been removed, but in doing so, he had done extensive

1:18:03 > 1:18:10damage to the left frontal lobe. My husband had had a stroke during the

1:18:10 > 1:18:19procedure, he was unlikely to have any good life, he was unlikely to

1:18:19 > 1:18:25live through the night and it was not in his best interest to do so.

1:18:25 > 1:18:29He was therefore not put into intensive care but onto an open

1:18:29 > 1:18:34hospital ward so that the family could see their goodbyes. In the

1:18:34 > 1:18:44evening, he was obviously failing and be on duty registrar was called.

1:18:44 > 1:18:49He insisted, despite all my pleas, that my husband should be put on

1:18:49 > 1:18:55life support in intensive care. It was his duty, he said, to do so, to

1:18:55 > 1:19:05preserve his life. He survived. We suffered 8.5 months of attempted

1:19:05 > 1:19:12rehabilitation in hospital and we had 14 years of residential care,

1:19:12 > 1:19:19before he died at the age of 69. My Lords, my family paid a very high

1:19:19 > 1:19:28price for that Doctor to have a clear conscience. Of course,

1:19:28 > 1:19:34honestly held conscientious objections must be respected and

1:19:34 > 1:19:42protected, but it must not be in order to jeopardise the duty of care

1:19:42 > 1:19:45and respect for the best interest of the patient and the wishes of the

1:19:45 > 1:19:52family. I was a little concerned at reading the excellent library

1:19:52 > 1:19:56briefing, at the end of that it gives some figures from a survey

1:19:56 > 1:20:07that was held in 2012 as to the views of medical students. Of 733

1:20:07 > 1:20:11people who were asked for their views, almost half of them believed

1:20:11 > 1:20:16in the right for doctors to hold conscientious objections and to be

1:20:16 > 1:20:23protected. As medical science grows and develops, and more interventions

1:20:23 > 1:20:30are likely to raise moral and ethical dilemmas, perhaps it will be

1:20:30 > 1:20:36necessary to clarify aspects of the law as it relates to conscientious

1:20:36 > 1:20:48objections. But, my Lords, this bill is not the way to do it.

1:20:48 > 1:20:53My Lords, I find many reasons to support this bill on moral,

1:20:53 > 1:20:56philosophical, legal and practical grounds, but I wish to be brief and

1:20:56 > 1:21:01I will try to keep the format, five points. Firstly, there is inadequate

1:21:01 > 1:21:06protection in law at the moment I believe. Yes, there are lines of

1:21:06 > 1:21:11professional guidance issued by the General Medical Council and the

1:21:11 > 1:21:14general pharmaceutical Council, but the guidance is not underpinned by

1:21:14 > 1:21:18statute or provision and it is easily changed by a small number of

1:21:18 > 1:21:22people or by pressure groups and the presumption of conscientious

1:21:22 > 1:21:28objection can be quickly eroded. Secondly, I disagree with the

1:21:28 > 1:21:31arguments of some previous speakers that the bill will in fact restrict

1:21:31 > 1:21:37access to any service that the NHS is obliged to provide. What it does

1:21:37 > 1:21:41is to clarify the right conscientious objection in so far as

1:21:41 > 1:21:44caselaw has indeed narrowed the interpretation of what participation

1:21:44 > 1:21:51actually means any operations under consideration. Furthermore, since

1:21:51 > 1:21:56the passing of the Abortion Act in 1967, medicine has developed to the

1:21:56 > 1:22:00extent that the role of the doctor or surgeon is now less common than

1:22:00 > 1:22:05it was then, Norse and Francis prescribers exist now and it is

1:22:05 > 1:22:09doubtful under the current law state whether it protects those

1:22:09 > 1:22:16petitioners if they wish to invoke a protection under being involved.

1:22:16 > 1:22:19Firstly, on practical grounds alone, it is clear that the current state

1:22:19 > 1:22:25of the law is deterring some nurses and new-look qualified doctors from

1:22:25 > 1:22:29entering on a career in obstetrics and gynaecology. There is not only

1:22:29 > 1:22:32fear of discussing this issue but people have been put off from

1:22:32 > 1:22:37applying for such posts as the moral convictions may result in the

1:22:37 > 1:22:42failure to advance in these careers. And this is not a question of

1:22:42 > 1:22:45adherence to a specifically Christian professional morality, I

1:22:45 > 1:22:49know of one case in which a distinguished registrar, a highly

1:22:49 > 1:22:52skilled and eminent gynaecologist who is a Muslim, was undoubtedly

1:22:52 > 1:22:56sidelined in his career because of his objections to conduct any kind

1:22:56 > 1:23:06of operations at rest in this bill. He did not find that the protection

1:23:06 > 1:23:08offered by clause 1.3 before you today was available to him. But as

1:23:08 > 1:23:12Baroness O'Loan has said, it is not even a question of professional

1:23:12 > 1:23:18adherence to any religious belief, it is fundamental to our law and

1:23:18 > 1:23:24that is fundamental to European laws. My Lords, if I may include, I

1:23:24 > 1:23:28have lived much of my working life in countries and under regions whose

1:23:28 > 1:23:32citizens have had no presumption to conscientious objection or to the

1:23:32 > 1:23:37protection of freedom of conscience. And where conscience is not a

1:23:37 > 1:23:41protected within the society, it is discernible in the case that

1:23:41 > 1:23:44individuals may develop as diminished human beings as the

1:23:44 > 1:23:49person may have no alternative to act in violation of principles on

1:23:49 > 1:23:55which he or she recognises as defining his or her own humanity. To

1:23:55 > 1:23:58withhold or deny this protection can have a profoundly damaging effect on

1:23:58 > 1:24:03personality and ultimately can lead to my realisation of impoverished

1:24:03 > 1:24:10beings and that is, I must disagree with the broad thrust of the

1:24:10 > 1:24:14argument made by the Honourable Lord Mackay. For these reasons I believe

1:24:14 > 1:24:20that the passage of this bill may be, in an amended version, will

1:24:20 > 1:24:23present the world with a defined example of British medical ethics,

1:24:23 > 1:24:31destined to be the admiration of many.My Lords, I must apologise, I

1:24:31 > 1:24:38have just had some injections for nervous, it has affected my

1:24:38 > 1:24:44pronunciation. So, on this occasion I may have to speak slightly more

1:24:44 > 1:24:50slowly than usual to make myself understood and I will try not to

1:24:50 > 1:24:54speak to slowly. My Lords, I congratulate the noble baroness,

1:24:54 > 1:25:01Baroness O'Loan, on introducing her bill, which I support. And they do

1:25:01 > 1:25:07so not only as someone who has severe disability would have made me

1:25:07 > 1:25:11a prime candidate for abortion, but also from the perspective of the

1:25:11 > 1:25:22patients, which Baroness Young of old stone said were so important. --

1:25:22 > 1:25:28old squad. Today is quite a big day for me, 22 years ago to this very

1:25:28 > 1:25:35day, I almost died. -- Baroness Young of Old Scone. 22 years on, I

1:25:35 > 1:25:41remember that my neurosurgeon could not give me all its own survival.

1:25:41 > 1:25:47But I am still here and I am acutely aware that it could have so easily

1:25:47 > 1:25:54have been very different. The treatment I received quite literally

1:25:54 > 1:26:04sustained my life. Equally, its withdrawal or denial was undoubtedly

1:26:04 > 1:26:12would have been the end of it. So, in terms of relevance to me

1:26:12 > 1:26:22personally, I can detect the box for 11 eight, 11 B and 11 C. At the

1:26:22 > 1:26:28patient who has pleased my life in the hands of medical professionals,

1:26:28 > 1:26:35and may well need to do so again, I believe, as I am sure all noble

1:26:35 > 1:26:42lords do, that trust in both the clinical contents and personal

1:26:42 > 1:26:48effort is an essential element of the patient practitioner

1:26:48 > 1:26:57partnership. I therefore totally agree that no medical practitioner

1:26:57 > 1:27:03with the conscientious objection to participating in certain activities

1:27:03 > 1:27:08covered by the registration mentioned because it goes against

1:27:08 > 1:27:15their personal beliefs, should be under any duty to participate. And I

1:27:15 > 1:27:24also agree that there is it need to clarify the law in light of the way

1:27:24 > 1:27:30in which it has been put forward by both president and practice as we

1:27:30 > 1:27:36have already heard. As the noble baroness, Baroness O'Loan has

1:27:36 > 1:27:43already said, conscience is not the preserve of religion. Indeed, I am

1:27:43 > 1:27:49certainly not assuming that a medical practitioner's personal

1:27:49 > 1:27:58beliefs will necessarily be informed by a religious faith. For example,

1:27:58 > 1:28:06they might know a person who is diagnosed with a disability before

1:28:06 > 1:28:15birth and who has turned the preconception of a disabled person's

1:28:15 > 1:28:17quality-of-life is that they can contribute to society and the

1:28:17 > 1:28:25ability to love and be loved as an equal buyout human being, all those

1:28:25 > 1:28:33things may have turned a medical practitioner's preconception of

1:28:33 > 1:28:38disability on its head.

1:28:38 > 1:28:45I should add that as I've stated previously, I do not take a position

1:28:45 > 1:28:57on abortion per se. I do, however, take a position on equality. The

1:28:57 > 1:29:03central point for me, and I hope for all noble Lords participating in

1:29:03 > 1:29:11this debate is that genuine equality doesn't have a cut-off point. A

1:29:11 > 1:29:18beginning or an end. And neither is it relative. Equality is as

1:29:18 > 1:29:25fundamental to who we are as human beings as the other unique hallmarks

1:29:25 > 1:29:34of humanity. Our capacity to anchor our actions within the context of

1:29:34 > 1:29:38conscience. For it is our conscience, surely, which exposes

1:29:38 > 1:29:45the dangerous deceit that it is somehow consistent with the concept

1:29:45 > 1:29:53of equality for a more powerful group of human beings to Act as if

1:29:53 > 1:30:02they were more equal than another, weaker group of human beings. And

1:30:02 > 1:30:09moreover, for them to decide that their superiority and strength means

1:30:09 > 1:30:16that they can pretend that exercising their power is actually a

1:30:16 > 1:30:27human right. My Lords, a group may be more powerful, and which group is

1:30:27 > 1:30:34not more powerful than disabled human beings, but more equal? Never.

1:30:34 > 1:30:44Anyone who cares to read George Orwell's Animal Farm knows he well

1:30:44 > 1:30:48and truly nailed that life. My Lords, this is a Bill which defends

1:30:48 > 1:30:55not just the fundamental human right to freedom of conscience, but also

1:30:55 > 1:31:05the right not to prevaricate and prejudice. The right not to

1:31:05 > 1:31:11equivocate on equality. This Bill defends a human being's right to

1:31:11 > 1:31:18choose, to recognise our common humanity, and thus our intrinsic

1:31:18 > 1:31:24equality regardless of disability, or, for that matter, race, sexuality

1:31:24 > 1:31:33or gender. If we truly believe in genuine equality, how can disabled

1:31:33 > 1:31:43human beings be treated any differently from any other protected

1:31:43 > 1:31:50group covered by the equality act 2010, at any stage of our existence,

1:31:50 > 1:32:02whether before or after death. Surely a medical practitioner is

1:32:02 > 1:32:07entitled in all conscience to ask themselves that simple question. My

1:32:07 > 1:32:16Lords, this is not religion. This is cold, hard, clinical logic. And, if

1:32:16 > 1:32:20having asked themselves that question, they should come to the

1:32:20 > 1:32:28logical conclusion that participating in the activities

1:32:28 > 1:32:32covered in 1.1 of this Bill compromises their conscience, the

1:32:32 > 1:32:41law must protect them in line with 1.3. No medical practitioner should

1:32:41 > 1:32:53themselves suffer discrimination for their conscientious objection. My

1:32:53 > 1:33:00Lords, in conclusion, this Bill attack is no one. It condemns no

1:33:00 > 1:33:09one. And it threatens no one. Instead, it affirms. It upholds, and

1:33:09 > 1:33:19it protects what we all value. Integrity, equality, our common

1:33:19 > 1:33:25humanity, and the greatest human rights of all. The freedom to think,

1:33:25 > 1:33:35to speak, and to act in accordance with our conscience. In backing this

1:33:35 > 1:33:41Bill, we all not only affirm our shared values, as equal human beings

1:33:41 > 1:33:54endowed with a conscience, we affirm ourselves.My Lords, I rise to

1:33:54 > 1:33:57support this important Bill. It's a timely recognition of the importance

1:33:57 > 1:34:04of conscience and ethical belief in looking at the end of life decisions

1:34:04 > 1:34:10and the increasingly complex issues and personal dilemmas that many face

1:34:10 > 1:34:18in their daily lives. Speaking from a Sikh perspective, I fully support

1:34:18 > 1:34:22its sentiments and aims and objectives. Majority opinion can at

1:34:22 > 1:34:29times be unthinking and we need to be wary of being pushed or pushing

1:34:29 > 1:34:32others to support debatable attitudes which at times the front

1:34:32 > 1:34:40ethical and moral principles. This year, as has been mentioned, while

1:34:40 > 1:34:44commemorating the centenary of the end of the carnage of World War I,

1:34:44 > 1:34:49we should pause and reflect that it was also a war in which

1:34:49 > 1:34:54conscientious objectors were brutally treated or even shot for

1:34:54 > 1:35:01their belief that it is wrong to kill. Something of the same dilemma

1:35:01 > 1:35:06was faced by Sikh soldiers when the Indian army attacked the Golden

1:35:06 > 1:35:12Temple in Amritsar in 1984. This attack on the holiest of Sikh

1:35:12 > 1:35:18shrines on one of the holiest days in the Sikh Callender was clearly

1:35:18 > 1:35:22political. Soldiers were ordered to shoot innocent pilgrims. Some Sikh

1:35:22 > 1:35:30soldiers refused and were accused of mutiny. Some were shot, somewhere to

1:35:30 > 1:35:33spend years in prison. They were accused of treason and disloyalty to

1:35:33 > 1:35:42their oath of allegiance. Yet in refusing to shoot noncombatants they

1:35:42 > 1:35:46were being true to the ethical teachings of their religion. This

1:35:46 > 1:35:52requirement to be true to our conscience is embedded in Sikhs

1:35:52 > 1:35:58Scriptures. The fourth guru of the Sikhs wrote "All human powers men

1:35:58 > 1:36:05make pacts with subject to death and decay"

1:36:05 > 1:36:08make pacts with subject to death and decay". In the Nuremberg trials many

1:36:08 > 1:36:12Germans accused of war crimes against the dues and others pleaded

1:36:12 > 1:36:17that they would duty bound to follow orders, however questionable -- of

1:36:17 > 1:36:24war crimes against the Jews. The requirements of any state were

1:36:24 > 1:36:29secondary to the overriding norms of civilised behaviour. My Lords, rapid

1:36:29 > 1:36:33advances in the fields of medicine and today's increasing tendency to

1:36:33 > 1:36:37over focus on the right of an individual can easily lead us to

1:36:37 > 1:36:44ignore the rights of wider society and the ethical dilemmas that

1:36:44 > 1:36:48sometimes questionable procedures pose for those immediately involved.

1:36:48 > 1:36:54The downside of what we do is not always immediately apparent. The

1:36:54 > 1:37:01initial, clearly limited humane objectives of the abortion act 1967

1:37:01 > 1:37:08have over time been largely ignored. Abortion has become contrary to the

1:37:08 > 1:37:12original intentions of the Act and the ethical teachings of most

1:37:12 > 1:37:19religions and beliefs, has simply become another method of birth

1:37:19 > 1:37:24control. We must have the right to object and not take part in what we

1:37:24 > 1:37:31considered to be the unnecessary taking of human life. The human

1:37:31 > 1:37:36fertilisation and embryology act 1990 which legalised embryo

1:37:36 > 1:37:40destructive forms of research, and the rapid expansion in molecular

1:37:40 > 1:37:49biology, a new genetic modification techniques, can impinge on deeply

1:37:49 > 1:37:52held ethical beliefs. People should not be compelled to do anything they

1:37:52 > 1:37:58believe is contrary to the respectful life. While conscience

1:37:58 > 1:38:03clauses were included in initial legislation, these have been

1:38:03 > 1:38:08continually eroded by social pressures to conform. Those involved

1:38:08 > 1:38:13in procedures that impact on sincerely held ethical beliefs must

1:38:13 > 1:38:22be given the right to opt out. This need to respect conscience goes

1:38:22 > 1:38:29beyond the field of medicine. Yesterday I was invited to give a

1:38:29 > 1:38:35Sikh perspective on relationship teaching in schools. As a Sikh I am

1:38:35 > 1:38:41appalled that the undue emphasis on sexual relationships and sexual

1:38:41 > 1:38:48identity currently being taught in schools. Young children are led to

1:38:48 > 1:38:50questioning their gender and unhelpful helpfully offered support

1:38:50 > 1:39:01to make permanent their potential differences, passing phases of

1:39:01 > 1:39:05growing up. Parents and teachers should have a right to question or

1:39:05 > 1:39:11opt out of such teachings. Today we need to heed the words of the great

1:39:11 > 1:39:15philosopher James Russell Lao all who wrote "We owe allegiance to the

1:39:15 > 1:39:20state but deeper, truer still, to the sympathies that God has set

1:39:20 > 1:39:25within our spirits"

1:39:25 > 1:39:27the sympathies that God has set within our spirits". The Bill is

1:39:27 > 1:39:30timely, well considered and necessary, I give it my full

1:39:30 > 1:39:38support.I first had the pleasure of meeting the noble lady Baroness in

1:39:38 > 1:39:43Northern Ireland many years ago. I was very impressed with the work she

1:39:43 > 1:39:46did there, the excellent way she contributed to the peace process and

1:39:46 > 1:39:51life in Northern Ireland. It is therefore with some regret that I'm

1:39:51 > 1:39:55afraid I have to differ with her on this occasion. I feel bad about that

1:39:55 > 1:40:00but I feel I must do that because she was such an important figure in

1:40:00 > 1:40:05those years in Northern Ireland. My Lords, of course we all agree about

1:40:05 > 1:40:07the right to conscientious objection. It seems to me we are

1:40:07 > 1:40:13simply debating where to draw the line. There is no real point of

1:40:13 > 1:40:18principle here. I think the current provision for conscientious

1:40:18 > 1:40:21objection in medical practice has just about got the balance right.

1:40:21 > 1:40:30Between health care professionals' moral beliefs and patients' freedom.

1:40:30 > 1:40:32I fear this Bill will tip the balance in the wrong direction away

1:40:32 > 1:40:37from the rights of patients. That is the basis of my objection. I don't

1:40:37 > 1:40:42think the case has been made out for the Bill, at least not to my

1:40:42 > 1:40:46satisfaction. There is one particularly important point. There

1:40:46 > 1:40:51is nothing in this Bill which would oblige the objecting health care

1:40:51 > 1:40:58professional to refer a patient's case to another professional who

1:40:58 > 1:41:02didn't have an objection. In other words, if a doctor or whoever it is

1:41:02 > 1:41:06is unhappy about being asked to carry out a procedure or treatment,

1:41:06 > 1:41:11surely they should be able to do what has been traditionally done. I

1:41:11 > 1:41:15can't do this, but I'll refer you to somebody else it can. To me that is

1:41:15 > 1:41:19an enormous gap in the Bill. I don't think I'd miss read it but it isn't

1:41:19 > 1:41:27there and I think that is unfortunate. My Lords, I think the

1:41:27 > 1:41:30Bill would significantly widen the scope of conscientious objection. It

1:41:30 > 1:41:34would increase the number of medical procedures to which conscientious

1:41:34 > 1:41:38objection would apply under the law. If you broaden the razor

1:41:38 > 1:41:44professionals to whom it would apply, for example in clause 1.2 it

1:41:44 > 1:41:51says that participation includes "Any supervision, delegation,

1:41:51 > 1:41:56planning or supporting of staff in respect of that activity". That may

1:41:56 > 1:42:01be so peripheral to the activity itself that it seems to me it's

1:42:01 > 1:42:04extending the principle of conscientious objection to far. I

1:42:04 > 1:42:09prefer the Baroness's comment about it having to be hands-on. Even if we

1:42:09 > 1:42:14don't like her being too narrow in this, I think the Bill itself goes

1:42:14 > 1:42:21far too far in the phrase I've read out.

1:42:21 > 1:42:27What we are talking about is in fact supervision, delegation, planning.

1:42:27 > 1:42:34Let me spell this out slightly. For example, you might have a palliative

1:42:34 > 1:42:38care clinical nurse specialist supervising be specific care needs

1:42:38 > 1:42:42for an oncology ward patient including those who may have refused

1:42:42 > 1:42:47life-sustaining treatment such as chemotherapy. It seems to me that it

1:42:47 > 1:42:50is the right of many patients who suffer from cancer to refuse

1:42:50 > 1:42:55chemotherapy. I know some people myself. Surely, that ought not to be

1:42:55 > 1:43:03with in the ambit of the Bill and I could give many other examples of

1:43:03 > 1:43:09this. It seems to me that the rights of patients should not be forgotten

1:43:09 > 1:43:14in this way. My Lords, the bill also seeks to expand the activities to

1:43:14 > 1:43:24which a health care professional good object and I think it is

1:43:24 > 1:43:27crucial not to distinguish between people starting treatment as people

1:43:27 > 1:43:31stopping treatment at a time of their choosing. We heard a very

1:43:31 > 1:43:36emotional speech from the noble lady opposite about her own personal

1:43:36 > 1:43:40family circumstances and it seems to me that the right to not have

1:43:40 > 1:43:44treatment or the right to stop treatment is absolutely fundamental

1:43:44 > 1:43:52and my fear is that this bill will make that freedom less effective.

1:43:52 > 1:44:01Lastly, there is a case that people who want to refused life-sustaining

1:44:01 > 1:44:06treatment in advance because of the possibility of deterioration in

1:44:06 > 1:44:09their mental health condition and, again, I fear that the bill is

1:44:09 > 1:44:19silent on an issue of whether health care professionals can object to

1:44:19 > 1:44:23adults refusing life-sustaining treatment in advance that others may

1:44:23 > 1:44:27decide is necessary. I regret having to object to this bill, but I'm

1:44:27 > 1:44:30afraid I do object. I think it will be to the detriment of patients and

1:44:30 > 1:44:37I do not think it takes the argument of conscientious objection any

1:44:37 > 1:44:41further in a sensible way.I congratulate my noble friend for

1:44:41 > 1:44:45introducing this bill. The point I wish to make have already been made

1:44:45 > 1:44:49in far more eloquent contributions than my would-be but I wish to give

1:44:49 > 1:44:52a very briefly my reasons for strongly supporting this bill. I

1:44:52 > 1:45:00should acknowledge my position as honorary reader of the Royal College

1:45:00 > 1:45:06of nurses. It seems that all the health care who would be positively

1:45:06 > 1:45:10affected by the successful passage of this bill, none would be more so

1:45:10 > 1:45:14than nurses and midwives. It is nurses who are likely to be asked to

1:45:14 > 1:45:21assist in the withdrawal of treatment and midwives with

1:45:21 > 1:45:25performing abortion. My Lords, it is not a matter of imposing values or

1:45:25 > 1:45:29beliefs on patients but to ask for the right of conscientious objection

1:45:29 > 1:45:32where a human life is being taken by asking the National Health Service

1:45:32 > 1:45:41to accommodate at professionals who have religious authors -- religious

1:45:41 > 1:45:44or philosophical convictions. Such beliefs are given protection under

1:45:44 > 1:45:50from discrimination in conscience clauses recognised and originally

1:45:50 > 1:45:55called for by professional bodies. I refer, for example, to the clause in

1:45:55 > 1:45:59the abortion act. The Royal College of nurses, the general nursing

1:45:59 > 1:46:03Council and to date the nursing midwifery Council and the Royal

1:46:03 > 1:46:06College of midwives all called for a provision to help protect the

1:46:06 > 1:46:10professionals they represented and, indeed, rightly so. It was this

1:46:10 > 1:46:13representation that informs the framing of that act and which should

1:46:13 > 1:46:18inform our interpretation of it today. As a Royal College of Nursing

1:46:18 > 1:46:23position statement on abortion states, I quote, the equally

1:46:23 > 1:46:26acknowledge and respect those nurses, midwives and health care

1:46:26 > 1:46:29assistants who have a conscientious objection within current

1:46:29 > 1:46:33legislation. My Lords, this acknowledgement is important because

1:46:33 > 1:46:38it reflects the understanding that conscientious belief is not just a

1:46:38 > 1:46:42personal idiosyncrasy, but a central element of what it is to be a human

1:46:42 > 1:46:47being. Most importantly in this context, a human being providing

1:46:47 > 1:46:51health care and medical treatment. Such belief is protected and

1:46:51 > 1:46:54equality legislation and we have taken pains in previous law to

1:46:54 > 1:46:58accommodate the consciousness of medical and other health care

1:46:58 > 1:47:01professionals. However, unfortunately, as has been mentioned

1:47:01 > 1:47:07that highlighted by others, these legal judgments have demonstrated a

1:47:07 > 1:47:10degradation in these protections in law. Correcting the situation as

1:47:10 > 1:47:14this bill would do and thereby allowing freedom of conscience by

1:47:14 > 1:47:18health care workers, ensuring their freedom from unjust discrimination

1:47:18 > 1:47:23and respecting diversity of belief would be a very significant and

1:47:23 > 1:47:27much-needed achievement. For the sake of those serving, the medical,

1:47:27 > 1:47:32nursing and midwifery professions and the patients they serve and for

1:47:32 > 1:47:36the sake of the integrity of health care professions, I believe ensuring

1:47:36 > 1:47:41that conscientious objection is given proper protection in law would

1:47:41 > 1:47:45be a truly important reform which this bill seeks to ensure and why I

1:47:45 > 1:47:52give this bill my strongest support. I rise to support this bill brought

1:47:52 > 1:48:00forward by my noble friend. I wish to bring us back for one moment, as

1:48:00 > 1:48:07has just been referred to by the noble lady, to the title of the bill

1:48:07 > 1:48:13we are debating, conscientious objection. And I agree in the

1:48:13 > 1:48:17context of the term conscience. I support and agree with the

1:48:17 > 1:48:25mainstream academic view which has been briefly referred to earlier as

1:48:25 > 1:48:30articulated by Professor Dan Brock of the Harvard medical school in

1:48:30 > 1:48:382008. I quote, deeply held and important moral judgments of

1:48:38 > 1:48:43conscience constitutes the central basis of individuals' moral

1:48:43 > 1:48:51integrity. They define who, at least morally speaking, the individual is,

1:48:51 > 1:48:57what she stands for, what is the central moral core of her character.

1:48:57 > 1:49:03The truth that there is a sense which I think Brock draws out rather

1:49:03 > 1:49:08well in which the role of conscience highlights an important part of what

1:49:08 > 1:49:18makes us human. My Lords, there is something sinister, oppressive and

1:49:18 > 1:49:23inhuman about societysocieties that do not make space for conscience

1:49:23 > 1:49:29which make people suffer for remaining true to their moral

1:49:29 > 1:49:36judgments of conscience whether through secular or religious values.

1:49:36 > 1:49:41As an academic and experts in this field, Doctor Mary Newell of the

1:49:41 > 1:49:44University of Strathclyde 's legal department puts it, I quote,

1:49:44 > 1:49:51conscience clauses exist primarily to protect people from moral

1:49:51 > 1:49:58responsibility for what they regard as wrongdoing. This seems a vital

1:49:58 > 1:50:06part of our legal framework and one which, in the areas of medicine we

1:50:06 > 1:50:12are discussing today, is widely respected internationally. Article

1:50:12 > 1:50:17nine of the European Convention on human rights outlines that everyone

1:50:17 > 1:50:24has the right to freedom of thought, of conscience and of religion.

1:50:24 > 1:50:31Further, has has been referred to, resolution 163 of the Parliamentary

1:50:31 > 1:50:35Constitution of Europe calls on the Council of Europe members to

1:50:35 > 1:50:41guarantee the rights to a conscientious objection for medical

1:50:41 > 1:50:49procedures in these various very areas described in the bill. Whilst,

1:50:49 > 1:50:56and importantly, also ensuring patients are able to access

1:50:56 > 1:51:05appropriate treatment. At this point, some might say that whilst

1:51:05 > 1:51:11they have no desire to force people to act against their conscience,

1:51:11 > 1:51:15people with conscientious objections to procedure is caused by clause one

1:51:15 > 1:51:19should not enter the medical profession. No one has to be a

1:51:19 > 1:51:26doctor or a midwife or a nurse. Well, I don't find that position at

1:51:26 > 1:51:35all remotely persuasive. As someone who has spent his life in business,

1:51:35 > 1:51:39commercial, education and the performing arts, I am keenly aware

1:51:39 > 1:51:44that every industry wants hard-working, dedicated people

1:51:44 > 1:51:53operating in their field. We want hard-working, dedicated doctors,

1:51:53 > 1:51:58nurses and midwives working in this country. Individuals who enter these

1:51:58 > 1:52:02professions also do so because of their deep concerns first human

1:52:02 > 1:52:07life. It is therefore no surprise that the medical procedure is

1:52:07 > 1:52:11covered by clause one of this bill would be problematic to some of

1:52:11 > 1:52:18them. In the absence of this bill, two groups, I believe, really get

1:52:18 > 1:52:24into difficulty. First, let's consider those who are already

1:52:24 > 1:52:28trained and have become medical professionals

1:52:28 > 1:52:35conscientious objections to abortion. The 2016 report, freedom

1:52:35 > 1:52:39of conscience in abortion provision, highlights evidence of clear

1:52:39 > 1:52:44conscientious objection based discrimination against those already

1:52:44 > 1:52:51in the medical profession. These were not frivolous claims but

1:52:51 > 1:52:55serious concerns expressed by those who report is that they would not be

1:52:55 > 1:53:01able to progress their careers if they objected to abortions. It is

1:53:01 > 1:53:05for this reason, my Lords, that I strongly recommend the employment

1:53:05 > 1:53:12discrimination protections in clause three. Second, let us consider the

1:53:12 > 1:53:16implications of asserting that only those without a conscientious

1:53:16 > 1:53:20objection should enter a medical profession. This would be clearly a

1:53:20 > 1:53:24huge disappointment to those who aspire to be medical professionals

1:53:24 > 1:53:31and who have otherwise have become talented doctors or nurses. I know

1:53:31 > 1:53:35we are all greatly disturbed of the News of the shortage of medical

1:53:35 > 1:53:40staff in the National Health Service. In this context, therefore,

1:53:40 > 1:53:44putting any barriers in the way of entering the medical profession

1:53:44 > 1:53:47because individuals feel they cannot exercise their freedom of conscience

1:53:47 > 1:53:55is clearly counter-productive. The irony is that some would argue

1:53:55 > 1:54:00against conscience on the basis that it will apparently restrict services

1:54:00 > 1:54:04and this is greatly confounded by the fact that the right to

1:54:04 > 1:54:08conscientious objection proposed to this bill and already in law only

1:54:08 > 1:54:14applies to individual professionals. The National Health Service in both

1:54:14 > 1:54:18England and Wales has a legal obligation to provide abortion

1:54:18 > 1:54:24services and they have the responsibility to ensure sufficient

1:54:24 > 1:54:32provision. My Lords, I do not wish to see medical professions condemned

1:54:32 > 1:54:37to be providers rather than individuals. I do not wish to see

1:54:37 > 1:54:39services delivered, especially health care services, by people who

1:54:39 > 1:54:45have been forced to renounce a key aspect of their humanity. We once

1:54:45 > 1:54:51doctors and nurses who are more, not less, human and that will only

1:54:51 > 1:54:57happen if we honour their humanity. I want to live in a country where we

1:54:57 > 1:55:00have a richer conception of human beings and where we do not wear

1:55:00 > 1:55:09consumer rights such that the consumer can demand a pound of flesh

1:55:09 > 1:55:11from the provider without any concern for the moral difficulty it

1:55:11 > 1:55:20might place him or her in. It seems to me that part of this challenge of

1:55:20 > 1:55:26living in a civilised society is having the grace to exercise one's

1:55:26 > 1:55:32rights in a way that has regard for how doing so impact other people. My

1:55:32 > 1:55:41Lords, I am committed to this bill. I rise to express my great respect

1:55:41 > 1:55:44for my noble friend but also my considerable concern about the

1:55:44 > 1:55:48likely consequences of this bill if it were to reach the statute book

1:55:48 > 1:55:54and I want to pay tribute to the extraordinary moving contribution by

1:55:54 > 1:55:58the baroness which, to me, says it all, frankly. The focus of my

1:55:58 > 1:56:02remarks will be clause 1.2 of the bill and particularly whitening the

1:56:02 > 1:56:07definition in that clause of the term participation in the treatment

1:56:07 > 1:56:12process. I also would like to make remarks on the withdrawal of life

1:56:12 > 1:56:17prolonging treatment at the request of the patient. The right of

1:56:17 > 1:56:20patients to decide when and whether to accept medical treatment is at

1:56:20 > 1:56:24the heart of this. In the past, it was assumed that the doctor knew

1:56:24 > 1:56:28best and that the patient should not have any say in what happened to

1:56:28 > 1:56:33them should they fall into the hands of the medical profession. In recent

1:56:33 > 1:56:37years, a basic tenants of medical treatment the rights of the patients

1:56:37 > 1:56:42to know about the side-effects of treatments, the consequences of

1:56:42 > 1:56:47nontreatment, so so the treatment himself or herself can make an

1:56:47 > 1:56:51informed decision about what they know is in their own best interest.

1:56:51 > 1:56:55The centrality of the patient in treatment decisions is assumed

1:56:55 > 1:57:02throughout adult life until the months before death and then the

1:57:02 > 1:57:05General medical Council makes clear that the duties of medical

1:57:05 > 1:57:09practitioners in their guidance on treatment and care towards the end

1:57:09 > 1:57:14of life, good practice in decision-making published in 2010.

1:57:14 > 1:57:19All important for me, the GMC makes clear that a doctor must not refuse

1:57:19 > 1:57:23to withdraw life prolonging treatments because of a

1:57:23 > 1:57:27conscientious objection without first ensuring that arrangements

1:57:27 > 1:57:33have been made for another doctor to take over. In other words, a

1:57:33 > 1:57:37conscientious objector, fair enough, they can have their objection but

1:57:37 > 1:57:41they must not interfere with the ending of life prolonging treatment

1:57:41 > 1:57:46if that is the wish of the patient and, obviously, if it is the wish of

1:57:46 > 1:57:53the patient it is because it is in the best interest of the patient.

1:57:53 > 1:57:57Similar emphasis is placed on the patient's right to decide by the

1:57:57 > 1:58:05mental capacity act code of practice and the nursing and midwifery

1:58:05 > 1:58:10Council.The provisions of this Bill will place an unnecessary additional

1:58:10 > 1:58:15burden on the medical professionals and others in our already

1:58:15 > 1:58:18drastically overstretched NHS. That worries me deeply, because basically

1:58:18 > 1:58:24we want patients to get the treatment they want and deserve. If

1:58:24 > 1:58:29the GMC and other guidance is not fully complied with, then the

1:58:29 > 1:58:36important needs of the patient will not be met. The current law works

1:58:36 > 1:58:43well, as they say if it ain't broke don't fix it. The law allows the

1:58:43 > 1:58:45medical profession to conscientiously object without

1:58:45 > 1:58:50abandoning their patients and without promoting the principles of

1:58:50 > 1:59:00person centred care. Clause 1.2 of the Bill intends to extend the

1:59:00 > 1:59:05definition of participate in the withdrawal of treatment to encompass

1:59:05 > 1:59:08any supervision, delegation, planning or supporting of staff. As

1:59:08 > 1:59:13other noble Lords have said, this is in direct conflict with the Supreme

1:59:13 > 1:59:17Court decision delivered by Lady Hale that it "Participate means

1:59:17 > 1:59:24taking part in a hands-on capacity". It's terribly important I think that

1:59:24 > 1:59:32a medical professional shouldn't be required to do something directly

1:59:32 > 1:59:36contrary to their conscience. I hope your Lordships will want to uphold

1:59:36 > 1:59:40the Supreme Court decision and therefore to reject the Bill. I

1:59:40 > 1:59:45realise my noble friend Lord Browne said how that decision in detail

1:59:45 > 1:59:50which was most helpful. I want to support Lord Dubs's concerned that

1:59:50 > 1:59:54the Bill also says nothing about whether health care staff could

1:59:54 > 1:59:59conscientiously object to helping mentally competent adults with their

1:59:59 > 2:00:02advanced care plan, including clarification of situations, when

2:00:02 > 2:00:08they would want treatment to be withdrawn. If that happened it would

2:00:08 > 2:00:13have a swathe of further detrimental effects for patients. It's important

2:00:13 > 2:00:18for us all to try and put ourselves in the position of a dying person

2:00:18 > 2:00:22who is suffering has become unbearable and whose treatment is

2:00:22 > 2:00:25only prolonging a situation they find intolerable. The patient wants

2:00:25 > 2:00:30to be able to decide how much suffering they are willing and able

2:00:30 > 2:00:35to take. Can anyone really say the patient should be denied that right?

2:00:35 > 2:00:40Particularly vulnerable if this law were passed would be a terminally

2:00:40 > 2:00:46ill patient in a hospice who decided they wanted treatment to cease but a

2:00:46 > 2:00:50charge nurse who had general management responsibility for the

2:00:50 > 2:00:56hospice as a whole and for their care had a conscientious objection

2:00:56 > 2:01:00to that patient's decision. With that charge nurse really be able to

2:01:00 > 2:01:05ensure that someone else took over their management responsibility?

2:01:05 > 2:01:10Would there be such a person? This law is dangerous, my lords. It would

2:01:10 > 2:01:14have a negative impact on palliative and hospice care, terminally ill

2:01:14 > 2:01:19patients could be required to suffer more than they already do, people

2:01:19 > 2:01:24suffer enough, and therefore wrongly in my view. My Lords, this is a

2:01:24 > 2:01:29complex issue but I believe the current law strikes a pretty good

2:01:29 > 2:01:36balance. I therefore cannot support this Bill.My Lords, in the

2:01:36 > 2:01:39beginning perhaps I should try and allay some of the anxieties the

2:01:39 > 2:01:46noble Baroness by referring had to clause one of the Bill which

2:01:46 > 2:01:51restricts its effect to activities under the embryology act 1990 and

2:01:51 > 2:01:57the Abortion Act 1967. That's not going to take us, I think into the

2:01:57 > 2:02:05area of hospices and so one. I will speak very briefly because so much

2:02:05 > 2:02:15has been said so well. If I could say that my noble and Leonard friend

2:02:15 > 2:02:19has set out very clearly most of the reasons for which I support this

2:02:19 > 2:02:28Bill -- noble and learned friend. And my noble friend the Baroness has

2:02:28 > 2:02:32set the margin for philosophic terms. I would rather turn to the

2:02:32 > 2:02:37practicalities, and there is a common concern not limited to those

2:02:37 > 2:02:41who oppose the Bill in principle, about the extent to which the

2:02:41 > 2:02:50exemption of the Bill supplies, the whiteness of that extent. My Lords,

2:02:50 > 2:02:57it seems to me that two things need to be held in mind when we start on

2:02:57 > 2:03:07this. The first is to empty our minds of our own views as to the

2:03:07 > 2:03:11rightness or wrongness of the termination of life. What we are

2:03:11 > 2:03:16looking at is the rightness or wrongness of requiring people to do

2:03:16 > 2:03:21things which are absolutely abhorrent to them. The question is

2:03:21 > 2:03:26how close to the deed that is done do you have to be before you are

2:03:26 > 2:03:31right to think you are in some sense guilty? Therefore it might be

2:03:31 > 2:03:36helpful to look at how we apply this test elsewhere. For instance, if

2:03:36 > 2:03:49there is a burglary and if I make arrangements for the burglar to have

2:03:49 > 2:03:53somebody to keep watch while he burbles, or if I arrange for there

2:03:53 > 2:04:02to be a getaway car and delegate the duty of driving it to somebody else,

2:04:02 > 2:04:07it would be quite clear I would have thought in a court that guilt

2:04:07 > 2:04:11attached to me because I had made it possible for the burglary to take

2:04:11 > 2:04:19place. The question is, in my mind, at what stage in the administrative

2:04:19 > 2:04:24and preparatory procedures can a person who is involved probably say

2:04:24 > 2:04:29that if I had not done this, that would not have happened. If I have

2:04:29 > 2:04:41not provided this particular pharmaceutical product, or if I had

2:04:41 > 2:04:45not myself being present at a particular time in neighbouring some

2:04:45 > 2:04:50function to take place, then it could not have happened. I think the

2:04:50 > 2:04:56definition we must seek in committee is a definition which makes clear

2:04:56 > 2:05:02where the line stops in the administrative and preparatory

2:05:02 > 2:05:13training, where the line below which there is no guilt. Whether you are

2:05:13 > 2:05:17organising the bus service that goes past the House that was burgled and

2:05:17 > 2:05:21not the car that the burglar got away in. It's a simple illustration,

2:05:21 > 2:05:27I hope it's helpful. I warmly and enthusiastically support the Bill

2:05:27 > 2:05:31and its intentions and the noble Baroness and I would like to see

2:05:31 > 2:05:34more about the contributions but I think we need to bring this to an

2:05:34 > 2:05:41end because we are focusing very clearly -- not focusing very clearly

2:05:41 > 2:05:45and what the real issues are.I thank you for bringing this timely

2:05:45 > 2:05:50Bill to her Lordship's house and for her eloquent and persuasive

2:05:50 > 2:05:54introductory remarks. My interests link to various charities which work

2:05:54 > 2:05:59on these issues are declared in the register. I served as a member of

2:05:59 > 2:06:04the all Parliamentary party pro-life group enquiry into freedom of

2:06:04 > 2:06:07conscience in abortion provision which has been referred to during

2:06:07 > 2:06:12the course of this debate, and enquiry admirably chaired by Fiona

2:06:12 > 2:06:18Bruce MP. On Wednesday this week I met Mary Dougan, one of the two

2:06:18 > 2:06:24midwives referred to by my noble friend and others. The call of the

2:06:24 > 2:06:28midwife is an incredibly high calling. It's a call to bring new

2:06:28 > 2:06:33life into the world. And to tell such women that they must facilitate

2:06:33 > 2:06:37the taking of the lives of babies in the womb or lose their jobs is not

2:06:37 > 2:06:44the hallmark of a liberal or a tolerant society. In the 18th

2:06:44 > 2:06:48century, the renowned German philosopher Emanuel Kant understood

2:06:48 > 2:06:58conscience as "An internal quote in man". -- internal court in man. It

2:06:58 > 2:07:01acts as an external constraint on human behaviour. Whether it's

2:07:01 > 2:07:06inspired by religious or secular belief is largely irrelevant.

2:07:06 > 2:07:11Conscience is unfounded and where more personal preference but rather

2:07:11 > 2:07:13it provides meaningful conviction which allows people to structure

2:07:13 > 2:07:19their own ethical identity and to exercise their judgment. It was in

2:07:19 > 2:07:26accordance with cant's dictum that the framers of the 1948 universal

2:07:26 > 2:07:32declaration of human rights, written as the world emerged from the

2:07:32 > 2:07:38horrors of the Second World War, that they understood conscience.

2:07:38 > 2:07:42Conscience features prominently in the document, with the very first

2:07:42 > 2:07:47article recognising that all human beings are born free and equal in

2:07:47 > 2:07:54dignity and rights. They are endowed with reason and conscience. Both the

2:07:54 > 2:07:57Universal Declaration of Human Rights and the European Convention

2:07:57 > 2:08:04on human rights explicitly guarantee a right to freedom of conscience for

2:08:04 > 2:08:08all and it's been recognised in every major human rights treaty

2:08:08 > 2:08:13since then. My Lords, it was also recognised in another place and here

2:08:13 > 2:08:19during the debates in 1967 that formed the Abortion Act. It was

2:08:19 > 2:08:31David Steele who told the House of Commons" the Bill imposes no

2:08:31 > 2:08:36obligation on anyone to participate in an operation. The clause also

2:08:36 > 2:08:45gives nurses and hospital employees a clear right to opt out". My Lords,

2:08:45 > 2:08:50the case of Mary Dougan shows how that assurance which was given in

2:08:50 > 2:08:54sincerity and in the genuine belief that it would be prevented has at

2:08:54 > 2:08:59least been diluted and watered down. While conscientious protection in

2:08:59 > 2:09:02section four was specifically enshrined in the Act, in practice

2:09:02 > 2:09:08the report that we undertook over the last two years found that

2:09:08 > 2:09:11medical professionals are far too dependent on the individual

2:09:11 > 2:09:15attitudes and discretion of their personal line managers or

2:09:15 > 2:09:20colleagues. During the enquiry evidence from the British Medical

2:09:20 > 2:09:25Association confirmed some doctors had complained of being harassed and

2:09:25 > 2:09:29discriminated against specifically because of their conscientious

2:09:29 > 2:09:32objection to abortion. The enquiry also heard evidence on how career

2:09:32 > 2:09:38progression, a point the noble lord with so much experience in this

2:09:38 > 2:09:44field may during his speech earlier today, of how career progression

2:09:44 > 2:09:47opportunities in gynaecology and abstract checks had been limited for

2:09:47 > 2:09:55those who wanted to exercise their conscience -- gynaecology and

2:09:55 > 2:09:59obstetrics. I was struck by this from Professor John Wyatt. He told

2:09:59 > 2:10:03us, over the last century there have been many startling and egregious

2:10:03 > 2:10:07cases in which the core moral commitments of medicine have been

2:10:07 > 2:10:12corrupted and violated because of state coercion being exercised and

2:10:12 > 2:10:17physicians. The vast majority of evidence that was received accorded

2:10:17 > 2:10:22with what John Wyatt said to us, and recognised the importance of

2:10:22 > 2:10:27conscience as a key part of what it means to live in a free unfulfilled

2:10:27 > 2:10:33society, in a diverse and democratic society. My noble friend referred to

2:10:33 > 2:10:37Doctor Mary Neal a senior lecturer in Law at the University of

2:10:37 > 2:10:43Strathclyde. I met with her earlier this week. In her written evidence

2:10:43 > 2:10:46she said, we should not expect someone who believes abortion to be

2:10:46 > 2:10:54seriously morally wrong to be willing to participate in it in any

2:10:54 > 2:10:58capacity and conscience provisions should be drafted and interpreted so

2:10:58 > 2:11:01as to protect health care practitioners against any such

2:11:01 > 2:11:08expectations. My Lords, at its core this Bill is about the minority's

2:11:08 > 2:11:11right to dissent from mainstream opinion and to resist compelled

2:11:11 > 2:11:15action. It prevents abuse of a dominant position and is deeply

2:11:15 > 2:11:18concerned with the right of individual liberty. Most of the

2:11:18 > 2:11:23arguments that have been advanced during today's debate simply do not

2:11:23 > 2:11:28stand up to scrutiny. The arguments against the Bill. The Abortion Act

2:11:28 > 2:11:33already limits scope of conscientious objection, and if it

2:11:33 > 2:11:39was working in such a pernicious way as some have described in preventing

2:11:39 > 2:11:42people participating in abortions it would not enable one abortion to

2:11:42 > 2:11:48take place every three minutes this country, 20 every hour, over 8

2:11:48 > 2:11:52million since the passage of that legislation. I don't believe that

2:11:52 > 2:11:57argument stacks up. The state has a duty to safeguard the conscience of

2:11:57 > 2:12:00individual professionals as well as providing an effective health care

2:12:00 > 2:12:04service. The denial of conscience is an attribute of an illiberal

2:12:04 > 2:12:08society. It is the hallmark of an illiberal society because it is an

2:12:08 > 2:12:16act of coercion. A doctor, nurse or midwife isn't a functionary or

2:12:16 > 2:12:25automata on. I'm acutely conscious of the high calling of the healer.

2:12:25 > 2:12:33Hippocrates, the father of medicine, Gates said it was an extraordinary

2:12:33 > 2:12:39calling for the protection of human life. As has previously been said,

2:12:39 > 2:12:43we do not want to go to extraordinary lengths to keep

2:12:43 > 2:12:47someone alive who has no wish to and her story was heartbreaking, but

2:12:47 > 2:12:52neither should we tell doctors they must give lethal injections to take

2:12:52 > 2:12:56life. The bill is consistent with the tradition of Hippocrates who

2:12:56 > 2:13:01said, in a fundamental move away from more primitive medical

2:13:01 > 2:13:04traditions, there would be prohibitions on abortion and

2:13:04 > 2:13:07euthanasia. He refused to accommodate those who believes that

2:13:07 > 2:13:11care and kill could be used as synonyms and nor does my noble

2:13:11 > 2:13:15friend and that is why I hope that our bill will receive a second

2:13:15 > 2:13:23reading in neurologic's has today.I declare interest as the new chair of

2:13:23 > 2:13:27the Parliamentary group on sexual and reproductive health, a position

2:13:27 > 2:13:31I have taken over from the noble Baroness, Baroness Gould, as I wish

2:13:31 > 2:13:36to place on record my thanks to her for all the work she has done in her

2:13:36 > 2:13:46time in that position. I also, in that capacity, had the great

2:13:46 > 2:13:50privilege of talking to the noble Lord, Lord steel. He could not be

2:13:50 > 2:13:58here today. If you were, he would, like me, seeks to vigorously oppose

2:13:58 > 2:14:06the noble Baroness's bill and he would have picked up the noble Lord,

2:14:06 > 2:14:13Lord Alton, on his partial quotation from 1967 because what the noble

2:14:13 > 2:14:19Lord went on to say was that a conscientious objection was written

2:14:19 > 2:14:22into his bill but with the proviso that no woman would be denied access

2:14:22 > 2:14:26to the services which would then become illegal and the thing that he

2:14:26 > 2:14:31wanted to stay to the noble Lords today, had he been present, is do

2:14:31 > 2:14:36not be fooled by this bill. This is taking us back to the early 1960s

2:14:36 > 2:14:40when practitioners such as the senior registrar in the West

2:14:40 > 2:14:45Midlands effectively denied women their legal rights. My Lords, I

2:14:45 > 2:14:51often talk to students about the contracting systems of the United

2:14:51 > 2:14:59States and this country when we come to discussing and legislating on

2:14:59 > 2:15:03matters of morality and conscience. I draw the contrast between the

2:15:03 > 2:15:07United States of America where such is the level of religiosity in

2:15:07 > 2:15:12debate that no elected politician can go against the prevailing

2:15:12 > 2:15:16religious orthodoxy and therefore they do not and matters of

2:15:16 > 2:15:20conscience and morality are mitigated in the courts. We in the

2:15:20 > 2:15:25House of Lords do things rather differently. We bring in all shades

2:15:25 > 2:15:29of religious opinion and we debate these matters extensively. I ask

2:15:29 > 2:15:33them to compare and contrast the two. I think it is right that we

2:15:33 > 2:15:38have our system and I think it is right that we engage in debates such

2:15:38 > 2:15:44as these. I therefore agree with the right reverend is that we take these

2:15:44 > 2:15:49matters and look at them in very informed and deliberative ways. I

2:15:49 > 2:15:56agree with him that it is time that we perhaps reviewed the 1967 act. It

2:15:56 > 2:16:03was brought in 50 years ago and times have changed, though unlike

2:16:03 > 2:16:08him I believe it is now too restrictive and I would wish to see

2:16:08 > 2:16:15it liberalised. I want to take, address this issue of conscience and

2:16:15 > 2:16:18I listened very carefully to the speeches of the noble Baroness Seton

2:16:18 > 2:16:24and the noble Lord Elton. I think somebody looking at our debate today

2:16:24 > 2:16:31would believe that only those who object to abortion are holders of

2:16:31 > 2:16:34conscience and morality. I do not believe that that is true for a

2:16:34 > 2:16:38moment. I remember talking to the noble Lord Stanley, a young doctor,

2:16:38 > 2:16:45who held David Steel to...I made it clear at the beginning that the

2:16:45 > 2:16:51question of whether you believe in the right or wrong of the act is

2:16:51 > 2:16:55absolutely immaterial. What matters is the effect on the person so I

2:16:55 > 2:17:03attribute no beliefs to anybody.The point that I wish to make stems

2:17:03 > 2:17:07exactly from that. Noble Lords will remember during the passage of the

2:17:07 > 2:17:15same-sex marriage act, there was a proposal that registrars should dash

2:17:15 > 2:17:18public servants dash should according to their conscience be

2:17:18 > 2:17:23permitted to deny services to people who would be married under that act,

2:17:23 > 2:17:27the effect of that meaning that people like me and my noble friend,

2:17:27 > 2:17:31were we to turn up to a registry office to register at the death of

2:17:31 > 2:17:35our loved one would not be accorded the same treatment and dignity as

2:17:35 > 2:17:44any other person. I feel that, and the noble Baroness Young talks about

2:17:44 > 2:17:50the United States of America. I feel that this bill is just one example

2:17:50 > 2:17:55of a very much larger movement in which people who are opponents of

2:17:55 > 2:18:02certain legislation and matters of what I would consider social

2:18:02 > 2:18:07progress use the issue of conscience as a proxy measure by which to

2:18:07 > 2:18:10undermine laws which are democratically passed. I believe

2:18:10 > 2:18:15that that is a very, very serious and insidious development and one

2:18:15 > 2:18:20that we in this House should strongly, strongly resist. This is

2:18:20 > 2:18:26not about the clarification of conscience, it is about the

2:18:26 > 2:18:30extension of the rights of people to opt out of provision of laws which

2:18:30 > 2:18:38have been very carefully considered and agreed in great detail in our

2:18:38 > 2:18:42democratic institutions. I believe that the impact of this is exactly

2:18:42 > 2:18:49what the noble Baroness sought to deny. She said this is not about

2:18:49 > 2:18:53restricting access to services. It absolutely is, my lords. We already

2:18:53 > 2:18:59have examples of it. We have examples in the NHS of GPs who

2:18:59 > 2:19:03refuse to provide access to contraceptive services. There are

2:19:03 > 2:19:08borrowers in London where there is no provision. What happens in those

2:19:08 > 2:19:13circumstances? Poor woman and women who do not have the freedom or the

2:19:13 > 2:19:19wherewithal to travel elsewhere to get the services suffer. This is a

2:19:19 > 2:19:23deeply, deeply pernicious Bill and I hope that my Lords, when we get the

2:19:23 > 2:19:28opportunity to do so, we will vote against it in such overwhelming

2:19:28 > 2:19:32numbers that we put an end to the arguments that lie behind it which I

2:19:32 > 2:19:43believe are thoroughly disingenuous. The end of a powerful speech. May I

2:19:43 > 2:19:46ask her, is she delivering the line of her party on this bill is he

2:19:46 > 2:19:53speaking personally?I make it absolutely clear, as in all other

2:19:53 > 2:19:57benches, we have a variety of beliefs on the subject and what I

2:19:57 > 2:20:01think I can say in all clear conscience is that I represent the

2:20:01 > 2:20:09majority of my colleagues in this debate.Was able question from me,

2:20:09 > 2:20:16to clarify what I think she said. Am I right in thinking that she said

2:20:16 > 2:20:21that in medical practitioner who has a conscientious objection to helping

2:20:21 > 2:20:28with an abortion would still have to to help with an abortion if that was

2:20:28 > 2:20:34necessary? Because that is what I understood she said.For the

2:20:34 > 2:20:37avoidance of doubt, I am in agreement with the statements that

2:20:37 > 2:20:47were made in the court judgment in 2016 that's no practitioner needs to

2:20:47 > 2:20:51be compelled to take part in the hands on offering of a procedure but

2:20:51 > 2:20:57they cannot indirectly deny women access to treatment to which they

2:20:57 > 2:21:10are legally entitled.My Lords, in many ways, the noble Lords kind of

2:21:10 > 2:21:15gave the game away rather about this particular piece of legislation.

2:21:15 > 2:21:20That it is in fact an opposition to a whole range of legislation,

2:21:20 > 2:21:24abortion rights, human fertilisation and embryology, the equality act,

2:21:24 > 2:21:29several others that have been referred to. In fact, when I read

2:21:29 > 2:21:35this bill, the words wolf in sheep's clothing into my mind. I think I

2:21:35 > 2:21:39need to, from the outset, thatMUSIC Make the Labour Party's position on

2:21:39 > 2:21:45this clear. We will not oppose the bill at

2:21:45 > 2:21:49second reading but only because that is the customs practice of this

2:21:49 > 2:21:54House. However, this proposal flies in the face of our party policy and,

2:21:54 > 2:21:58indeed, much of the legislation it seeks change we put on the statute

2:21:58 > 2:22:03books or supported being put on the statute books. I will read from the

2:22:03 > 2:22:09front bench the opposition to the proposals it contains. I find myself

2:22:09 > 2:22:25in agreement with Baroness Young, Lord Browne and several others. And

2:22:25 > 2:22:29Baroness Richardson, who I commend for moving a very appropriate

2:22:29 > 2:22:42contribution. There is no doubt... I would also like to add to the Bishop

2:22:42 > 2:22:48of Peterborough, right reverend, the word I look for in his contribution

2:22:48 > 2:22:53is the word equalities and the reason I looked for that is because

2:22:53 > 2:22:59this House and many of us struggled with how to reflect conscience and

2:22:59 > 2:23:04help to ensure equalities and I think I would ask the right reverend

2:23:04 > 2:23:10to reflect on that because many of the proposals in this bill will

2:23:10 > 2:23:14affect LGBT rights and the rights of other groups. Because he is wise in

2:23:14 > 2:23:23his ways, I think it is also necessary for him to reflect on the

2:23:23 > 2:23:26fact that this bill will restrict rights to abortion and other

2:23:26 > 2:23:31procedures. It will dramatically extends the scope of conscientious

2:23:31 > 2:23:35objection, increasing the number of medical procedures to which it could

2:23:35 > 2:23:38apply under law, increasing the types of professional to which it

2:23:38 > 2:23:41would apply and expanding the activities which would be applicable

2:23:41 > 2:23:46from abortion to IVF and the withdrawal of end of life care. The

2:23:46 > 2:23:50reason it is significant is that it represents a new front in the

2:23:50 > 2:23:56attempt to undermine our equalities laws to extend the number of areas

2:23:56 > 2:23:59were conscientious objection can be used to refuse to provide state

2:23:59 > 2:24:02services. In this case, the extension proposed in the bill is so