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ARC takes calls every day on its national helpline from parents who are reeling from the shock of being told of something wrong with their unborn baby at the mid-pregnancy scan, struggling to take in the news and to know how to proceed.
What is essential is that there must be the flexibility for women and parents to have the option to make their own reproductive choices. I therefore hope that this amendment will not be carried.
The Lord Bishop of Winchester: I do not intend to enter into the debate, but the appearance of the amendment tabled by the noble Baroness, Lady Masham, at this time underlines for me what was already my conviction: that the whole question of abortion ought not to be included in this Bill, either in this House or in another place. I valued the letter of the noble Lords, Lord Alton and Lord Steel, making the point that there was a separate look to be taken at this issue. I believe that that is the case and that this debate makes that point.
The only thing I will say is that it is strange for me to be debating this amendment now because my first engagement this morning was as patron in a major regional voluntary organisation that serves the needs of acutely disabled children and young people. I spent about one-third of the hour and a half that I was
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Baroness Finlay of Llandaff: I completely concur with the remarks that have just been made. The complexity of the ethics and the decision-making, and the agony of people in making these decisions, should not be included in the Bill. They are important issues, and I concur with the calls for an ad hoc Select Committee of this House to be set up to look at the issues around abortion as we have had an Act in place now for 40 years. However, whichever way amendments are put down, whether in the same form as that of the noble Baroness, Lady Masham, or in some other way, this Bill is not the place for us to make decisions and votes in the House on something that is deeply complex and needs in-depth analysis.
Baroness Wilkins: My name is down to this amendment and I strongly support it on the grounds of equal human rights. As Jenny Morris points out in her book, Pride Against Prejudice:
“A foetus of more than 24 weeks’ gestation is treated as having rights as a human being but loses those rights once it is diagnosed as being disabled”.
The abortion of a foetus because of serious impairment is a complex issue, but that statement is the heart of the matter. It is the reason why the disability organisation RADAR has stated that:
“If the Government is serious in its aim to ensure equality for disabled people then the Abortion Act of 1967 must be amended to remove its discriminatory content”.
It is the reason that disabled people, especially those with Down’s syndrome, feel that their lives are devalued by the Abortion Act, and it is why I support the amendment.
As a disabled woman and a feminist, Jenny Morris devotes a chapter of her book to arguing through the complexities of this issue. She suggests that the current law rests on three main strands of argument: that the baby’s quality of life would be intolerable, that the disabled child would entail high personal cost to the parents, especially to the mother, and that the disabled child would be a drain on the country’s resources. I shall take those in turn.
With regard to judgment about the baby’s quality of life being intolerable, none of us can judge whether another human being’s life is worth living. We can only make that judgment about our own lives. As many severely disabled people will tell you, it is impossible for us to judge the quality of life of another person, truly to put yourself into their shoes, and it is not for the medical profession to do so either. “Quality of life” arguments are often a smokescreen for other motivations.
The second justification for the abortion of disabled foetuses after 24 weeks rests on the personal cost to the parents of bringing up the disabled child, as we
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- “we believe there is a culture of prejudice among some health practitioners when a screening or test indicates that the unborn baby is likely to have a disability. Information presented to the woman about having a child with a disability is often negative and it is assumed she will have a termination”.
It says there is growing evidence that doctors pressurise pregnant women to agree to the abortion of babies thought likely to have a disability.
We live in a society that does not provide adequate resources to support disabled people in having equal opportunities. What is more, the parents are subject to the same preconceptions and prejudice about disability as most other non-disabled people. They would no doubt be horrified at the thought of becoming disabled themselves.
Is this situation so very different from the situation of potential mothers in societies such as India or China where it is common for daughters to be completely devalued, with all the social and economic results that that entails? Yet we are appalled by, and rightly reject, any notion that a foetus should be aborted purely on the grounds that it is a girl.
The current law that allows for a termination right up to the full term of a pregnancy if there is a risk of serious handicap clearly demonstrates that the potential life of a disabled child is valued less highly than that of a non-disabled child. As Mencap points out, it means that any questions about when a foetus becomes a person or can feel pain are effectively disregarded in cases of disability. I agree with Jenny Morris’s conclusion that once a foetus, disabled or non-disabled, has a viable life outside its mother’s body, its rights as a human being are greater than its mother’s right to refuse to give it birth. There can be no distinction between disabled and non-disabled foetuses. On the grounds of the equality of human life, I fully support the noble Baroness’s amendment.
Baroness Campbell of Surbiton: I did not know that the first time I spoke in this Chamber after my maiden speech it would be on something so ethically complex. I am moved to support this amendment. Its aim is to repeal those sections of the Abortion Act 1967 that permit termination of a pregnancy if,
- “there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped”.
When contemplating this incredibly complicated ethical issue, I have been guided by two principles: first, the equal value of disabled and non-disabled people and, secondly, the rights of individuals to make informed and autonomous choices. I support a woman’s right to end an unwanted pregnancy within the lawful period, currently 24 weeks. The option of a legal termination is central to women achieving social, economic, political and personal equality in today’s society. However, I do not support the law that singles out impaired foetuses for abortion after 24 weeks. I believe that Section 1(1)(d) is inconsistent with disabled people’s right to be viewed and valued equally.
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The present time limit has been set because the consensus view is that after 24 weeks the foetus is viable—that is, it would be likely to survive if born. We consider termination of a pregnancy after that time to be morally or ethically wrong—unless, that is, prenatal diagnosis indicates disability. Then it is felt that abortion until term is both lawful and somehow acceptable. For me, that exemption confirms the outdated view that the potential life of a disabled child is of less value than that of a non-disabled child.
Personally, I do not have strong views about when a foetus becomes a living entity in all its complexity. However, I do have very strong views about equality for disabled people. My view and that of the Royal Association for Disability and Rehabilitation, as press-released last week, is that whatever the time limit set, it should be equal, irrespective of whether the woman gives birth to a disabled child.
8.30 pm
People often say to me, “You wouldn’t want to bring a child with your disability into this world, would you? It is a serious disability that requires assistance for the rest of your life”. What they are saying in that one sentence is that my life somehow has less quality than theirs. This is not only hurtful, but it undermines my very humanity. Difference, my difference, disabled people’s difference, is part of society’s richness. To continue to single out potentially disabled people perpetuates the view that society would be better off without us. Surely, society should say that every child matters. Once a woman has decided to have a child, she and the world should and can celebrate that life, whatever it turns out to be.
Earl Howe: I have a completely open mind about the repeal of the subsections. However, with great respect to the noble Baroness, Lady Masham, and her motives, I do not think that this is the way to approach the issue.
The problem is the evidence basis—or really, I should say, the lack of one. A report by the House of Commons Science and Technology Committee makes instructive reading. Its key point is that, as policy makers, we are operating in something of a vacuum. In the first place, we need better data than we have at the moment about abortions that are carried out for foetal abnormality beyond 24 weeks. We need more information about the reasons for those abortions. The committee was told that there were inconsistencies around the country in the way in which the law is being interpreted and applied, which cannot be satisfactory, and that the position would be helped greatly by having greater guidance available for clinicians.
One might feel that this is all the more necessary bearing in mind that neither the term “physical and mental abnormalities” nor the term “handicapped” is defined in the Act. Everything is left to subjective decision making by the doctor and the mother. At the very least, it ought to be possible to improve on existing BMA and royal college guidelines by specifying exactly what clinical information should be available to all clinicians and mothers before final decisions are taken. It also ought to be possible for Parliament to
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I find the arguments put forward by the noble Baroness, Lady Masham, and the other two noble Baronesses whose names are attached to the amendment very powerful. However, I genuinely believe that the Select Committee route is the better way to go because it will enable the House to take a more informed view of the matter than it is able to at the moment.
Lord Alton of Liverpool: I support the comment that has just been made by the noble Earl, Lord Howe, about the way in which we should go about looking at this and some of the other associated issues. I will come back to that in the second part of what I want to say.
First, I pay tribute to the noble Baroness, Lady Masham, for the way in which she moved the amendment this evening and to the noble Baronesses, Lady Wilkins and Lady Campbell, for their remarks, which I strongly support. The noble Baroness, Lady Gould, is someone whom I respect enormously and with whom I work on a range of other issues. I find myself in the uncomfortable position of disagreeing with her, but I do not think that she expected that I would do otherwise. She was right to pay tribute to the sincerity of the noble Baroness, Lady Masham. I pay tribute to her sincerity as well. Those of us who come to the debate, even if we have different views, recognise and respect the fact that we hold those views with sincerity.
I first came into this argument a long time ago. As some noble Lords will know, I introduced a Bill in another place in 1987 to reduce the upper time limit. Indeed, that Bill received its Second Reading with 296 votes, a majority of 45. It was talked out in the end, but it sought to reduce the time limit to 18 weeks. The EU average is about 13 weeks—I say that in passing—and I want to come back to one or two of the other statistical points referred to a moment ago by the noble Earl, Lord Howe, that should inform our debate.
The outcome of the 1987 Bill was that, when the 1990 legislation—relevant to the Bill before the Committee tonight—came before another place, it was agreed that there would be a vote on the upper time limit in the context of that Bill. It was then decided to reduce, from 28 to 24 weeks’ gestation, the upper time limit in most circumstances. An exception was made in the case of disability. In those circumstances, it was decided to increase the upper time limit all the way up to and even during birth, where disability was involved. I opposed that, but it was a decision that was taken in another place.
The noble Baroness, Lady Gould, said that public opinion supported the retention of the law as it stands, but there is diverging evidence. We do not, in the end, make laws on the basis of opinion polls. However, I would just mention that, in May of this
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There are clearly issues here, even if we disagree with one another, that deserve proper consideration. The noble Baroness is right to put these questions before us, as she did at Second Reading. In the previous Human Fertilisation and Embryology Bill, we saw the law changed in the way that I have described. The difficulty is that it is almost impossible for a private Member to change the abortion law because Bills are always talked out by either side. Unless it is done in the context of a government Bill, how else can legislation come forward? That is one of the issues that we cannot go on dodging. I hope that, if a Select Committee is created, it will look at that issue.
When the 1990 provision was incorporated, I warned, on the advice of a renowned professor of law, Professor John Finnis at Oxford University, that the provision could in future be used to terminate pregnancies on grounds such as cleft palate. As my noble friend said, it is not widely known among most people that British law allows the abortion of disabled children right up to and even during birth, yet in 2006, 2,036 abortions were carried out under Section 1(1)(d) of the Abortion Act, which allows abortion up to birth if,
- “there is a substantial risk that if the child were born it would suffer from such physical or mental abnormalities as to be seriously handicapped”.
The noble Earl, Lord Howe, made that point, which, too, is relevant in the context of this Bill, for the obvious reason that, only two days ago, we were discussing what we would do in the case of saviour siblings if “serious” were substituted for “life threatening” as a reason for removing organs from a child’s body.
Abortions carried out on disabled children represent just 1 per cent of the total number of abortions carried out in the United Kingdom, meaning that foetal disability is far from being the most common justification for termination of pregnancy—99 per cent of abortions have nothing whatever to do with disability. If we as a society are truly committed to equality for disabled people, we cannot treat these disabled lives as mere statistics, as the noble Baronesses, Lady Campbell and Lady Wilkins, said. The noble Baroness, Lady Masham, is right to raise this issue. Abortion for disability seems a small proportion of the total number of abortions only because the number of abortions is so very high, now running at 200,000 per year. As the noble Lord, Lord Steel of Aikwood, recently said, that is too many. Six hundred abortions take place per day, 25 every hour. Those 2,000 disabled unborn children are not merely statistics; they are unique human individuals whose only opportunity to live has been denied. One academic has written that,
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- “each life is not an abstraction, it is a personal reality, one that exists only for one particular unborn human who will no longer be if abortion is chosen”.
What conditions are being targeted? In 2006, 436 abortions were carried out on children with Down’s syndrome, a chromosomal disorder. Twelve of those 436 abortions were performed after the 24-week time limit for social abortions. What are we saying as a society about the status of Down’s children and adults? A further 129 unborn children were aborted because of “selected cardiovascular anomalies”—that is, heart problems, about which the noble Lord, Lord Darzi, knows more than anybody not just in this Chamber, but probably in the country. One hundred and six unborn children were suffering from spina bifida. Other abortions for disability are carried out because of genetic disorders or bodily deformities. One of the most important points to note is that many of these conditions are not life-threatening. Just a few years ago, a young woman, the Reverend Joanna Jepson, fought a brave court battle to expose a case where an unborn child was aborted simply because he showed signs of having a cleft palate. Due to the vague and poorly defined wording of the 1990 Act, terminations for such minor, and easily treatable, conditions take place as a matter of course. Is it truly just or fair that we operate a kind of crude quality control over human beings, discarding them if they do not measure up to some arbitrary standard of physical perfection?
Back in 1990, when abortion up to birth for disabled people was introduced, I was accused of scaremongering by others when I pointed out that the wording of the 1990 Act would allow for terminations for disabilities such as cleft palate. It was Harriet Harman, then a Back-Bench MP but now the Leader of the House of Commons, who suggested that Professor Finnis, and another eminent lawyer who was advising me at that time about the dangers inherent in the Bill, should be reported to the Law Society or Bar Council. Noble Lords should understand if in relation to so-called “saviour siblings” I express a degree of scepticism that the provisions in the Bill that extend the grounds on which organs and tissue can be taken from “life threatening” to “serious” will not lead to rampant abuse.
The right to life is surely the foundation of all other rights. There is of course another debate to be had about abortion in general, but abortion for disability raises particularly pressing issues to do with equality, diversity and discrimination. As the Disability Rights Commission noted some years ago, Section 1(1)(d) of the Abortion Act,
- “is offensive to many people... it reinforces negative stereotypes of disability; and there is substantial support for the view that to permit terminations at any point during a pregnancy on the ground of risk of disability... is incompatible with valuing disability and non-disability equally”.
The principle that people should not be discriminated against unfairly on grounds of race, gender and orientation is held dear by many in our society and, rightly, by many Members of your Lordships’ House. It has been enshrined in law in various ways during
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Raising disabled children is difficult, exhausting and sometimes demoralising—I worked for several years with children with special needs before I was elected to another place. It can place a strain on relationships and change family dynamics in unsettling ways. Other children can feel neglected, as parents devote large amounts of time to caring for disabled siblings, yet it is still difficult to see abortion as a truly compassionate response in this situation. Is there perhaps a different model for how to care for disabled children, even those who are severely or terminally ill?
I refer the Committee to the charity, Zöe’s Place, which is a daughter charity of the charity, Life. Zöe’s Place, of which I am a patron, is a baby hospice providing respite and palliative care for babies and young children from birth until the age of five. There are two Zöe’s Places now, one in Liverpool and the other in Middlesbrough. Plans are well advanced to open another in the Midlands next year. Surely the answer lies in more hospices like Zöe’s, providing more help and support to parents struggling to raise a disabled child.
The great danger is that if abortion, or post-natal infanticide of a disabled child, is allowed to become a treatment option, we start to decide that it can be in someone’s best interest to be killed. This debate is, to a very large extent, a debate about the kind of culture in which we want to live, and the kind of medical culture in which we want doctors to operate. However compelling the case for ending the life of a badly disabled child, there is a very important principle at stake: we may not intentionally kill. Whatever the law, there will always be difficult cases and situations where individuals end up suffering. No one, of course, would wish to inflict or perpetuate suffering unnecessarily, but we need to accept that we cannot respond to suffering by killing the sufferer.
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