Conscientious Objection (Medical Activities) Bill [HL]

Baroness Eaton Excerpts

2nd reading (Hansard): House of Lords
Friday 26th January 2018 Lords Chamber

[Baroness Eaton (Con)]

My Lords, in my contribution to the debate on this important Bill, which I welcome and thank the noble Baroness, Lady O’Loan, for introducing, I wish to discuss the concept of conscience and how necessary I think it is to have effective provisions to protect it in medicine. When we talk about conscience, it seems to me that we mean the part of ourselves that constitutes moral integrity; the deeply held and important moral judgments of our conscience constitute the central personal core. They define who we are, at least morally speaking, and what we stand for: the central moral core of our character. In order for any individual to maintain their integrity, they cannot violate their fundamental moral commitments. If they achieve this, it gives others clear reason to respect them, not because those commitments must be true or justified in the eyes of everyone else, or even just the majority, but because the maintaining of moral integrity is a crucial action, central to our personal coherence and well-being.

Conscience involves the moral wholeness of the person, their emotional, intellectual and moral life. When someone betrays their conscience, they do nothing less than disregard a deep, core aspect of their personal identity. Given this reality, it is utterly impossible to detach conscience from anyone’s professional life, least of all a medical professional who deals with often grave moral situations every day. A conscientious doctor, nurse or midwife is conscientious because of their internal moral life, not merely because they are proficient at mechanistically following official rules and guidelines. To illustrate how important legal conscience protections are, it would be helpful to note one crucial difference between the obviously pertinent parallel made already by the noble Baroness, Lady O’Loan, between conscientious objection in military service to what someone believes is unjust killing and conscientious objection in medicine. That difference is the nature of the role of the clinician.

Medical professionals are vocational actors, not mere conscripts in a logistical machine or functionaries for the medical system. They are not people who are providing a shopping service. The patient sees a doctor for advice and guidance and the nurse for direct care, but these are not merely employees of the NHS who must do whatever the system tells them to do. We would not want a doctor to do something that went against their professional judgment, no matter what a patient may want. I am reminded that, according to the Mental Capacity Act, one may refuse consent to treatment but one may not demand that something be done to you. The integrity of the individual clinician is part and parcel of the integrity of medicine itself. Would we really trust a doctor who did whatever we wanted and put aside his judgment for the sake of fulfilling our wishes? Of course not. We would want them frankly to give us their best and most conscientious judgment. For them to compartmentalise, as I think some think they should, their most fundamental moral beliefs from their professional behaviour would be to seriously compromise their integrity. This would be in no one’s best interest.

It is crucial, then, to the right practice of medicine for both medical professionals and patients, as in public life itself, to protect freedom of conscience. The Bill, it seems to me, would allow for areas of medicine that are particularly controversial to remain open to those people who have very high conscientious standards, and who would therefore be welcome individuals to enter those sorts of roles. It would require a minority of medical professionals to be reasonably accommodated, a concept which I believe is highly important in this debate, and thereby included in a manner consistent with our treatment of minorities more generally. In so far as this is the case, it would allow for a society that is more truly liberal and open as well as qualitative in its medical care, due to the fully integral character of those allowed to act within it, in all sectors of medicine. That can only be for the common good.

If we care about conscience in society, and particularly in medicine, then we should maintain a framing of our laws that allows for as much liberality as is sensibly feasible in conscientious objection when it comes to the perceived ending of human life. The Bill achieves that very thing. For that reason, I am delighted it has been introduced and passionately support it.