Conscientious Objection (Medical Activities) Bill [HL]

Baroness Richardson of Calow Excerpts

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

[Baroness Richardson of Calow (CB)]

My Lords, the NHS relies on the conscientious commitment of many thousands of people who are willing to use their skills and training in order to promote the well-being of patients and to provide particular care with compassion. Every patient deserves to be treated by those whose primary task is to seek their welfare and respect their wishes. Very many of those who work in the health service do so out of religious conviction. Their faith has led them to believe that this is a way, through a vocation, to give particular service to others, and this is to be welcomed. Their faith stimulates what they do and sustains them through the very difficult things they are required to do. A minority of these find that their faith, or their belief system, is incompatible with what they are asked to do on occasions. Their firmly held convictions are established as a right in law to be respected and protected already.

The Bill has the express intention of clarifying what those with a conscientious objection ought or ought not to be invited to participate in. Its intention is to clarify that participation, but in fact the Bill goes much further than that: it expands the level of participation that could be protected, not only, as we have already heard so many times, the hands-on, active participation, but extending it to,

“supervision, delegation, planning or supporting”,

the staff. It fails to determine where responsibility lies for the exercise of care for those patients for whom the conscientious objector finds it difficult to care. Current practice is that they must inform colleagues and patients and that care must be passed on to another, but what is defined as participation in the Bill seems to deny that right. It removes that responsibility but does not define where it should go.

I am well aware that anecdotes do not always make good evidence, but personal experience informs opinions. My husband at the age of 42 was diagnosed with a brain tumour. For the next 10 years, we managed that condition at home, with repeated operations and procedures, increasing disability and family trauma. Then his consultant decided that he would attempt aggressive surgery, which was carried out. At the end of the operation, the consultant said to me that the tumour had been removed but, in doing so, he had done extensive damage to the left frontal lobe; my husband had had a stroke during the procedure, and he was unlikely to have any good life, he was unlikely to live through the night, and it was not in his best interests to do so. He was, therefore, not putting him into intensive care but on to an open ward so that the family could say their goodbyes.

In the evening, my husband was obviously failing, and the on-duty registrar was called. He insisted, despite all my pleas, that my husband should be put on life support in intensive care. It was his duty, he said, to do so, to preserve his life. He survived; we suffered 8.5 months of attempted rehabilitation in hospital; and he had 14 years of residential care before he died, aged 69. My family paid a very high price for that doctor to have a clear conscience. Of course, honestly held conscientious objections must be respected and protected, but it must not be in order to jeopardise the duty of care and respect for the best interests of the patient and the wishes of the family.

I was a little concerned, reading the excellent Library briefing, that at the end it gives some figures from a survey held in 2012 of the views of medical students. Of the 733 people who were asked for their views, almost half believed in the right of doctors to hold conscientious objections and to be protected. As medical science grows and develops and more interventions are likely to raise moral and ethical dilemmas, perhaps it will be necessary to clarify aspects of the law as it relates to conscientious objections, but this Bill is not the way to do it.