MEDICAL TERMINATION OF PREGNANCY BILL

§ BARONESS STOCKS

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

§ BARONESS WOOTTON OF ABINGER

I am not very happy with the Bill as it stands at present. It says: … continuance of the pregnancy would involve risk to the life of the pregnant woman …". I suppose that, if we are going to be very literal minded, any pregnancy involves a minute risk to the life of the pregnant woman; and I think it is therefore very desirable to insert the word "serious" before "risk". On that ground I welcome the noble Lord's Amendment. What I should like to do is to effect a marriage between his Amendment and my own, so that the Bill would read: 984 … serious risk to the life of the pregnant woman or of grave and prolonged injury to the physical or mental health …". The reason why I want to put in "prolonged", as well as "grave", is this. It is not an uncommon experience for a woman to suffer a very severe temporary depression at a certain stage in pregnancy—and it is only temporary. It would count as a serious injury to her mental health for the time being, but it might be for a matter of only a few days, and it might be disastrous if an abortion were performed in that time, since when the child is born all this will be a matter of the past and she will be delighted to have it.

§ VISCOUNT DILHORNE

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

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

I cannot think myself there will ever be a prosecution—because I do not think the evidence would be available—of a doctor on the ground that he has not formed his opinion in good faith. But I suppose it is just conceivable that you might be able to establish, if you had these words in, that he had formed the opinion that there was only a trivial risk, and, under the clause as it now stands, he thought he could lawfully perform the 985 operation. I hope that the noble Lord, Lord Silkin, if he is not prepared to accept these Amendments now, will at least say he will give serious consideration to them between now and the Report stage, because in my belief they do no more than say expressly what I always thought was implicit in paragraph (a).

§ LORD AMULREE

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

§ BARONESS GAITSKELL

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

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

§ LORD COHEN

I have very little to say, and in fact I only want to support what the noble Baroness has said. I am induced to do so even more because in Clause 1(1)(b) the word "substantial" is put before the word "risk", which 986 seems to me to make it all the more necessary to put in the adjective which the noble Lord, Lord Segal, desires to see inserted in subsection (1)(a).

§ LORD PARKER OF WADDINGTON

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

§ LORD BYERS

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

§ LORD PARKER OF WADDINGTON

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

§ LORD BYERS

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

§ BARONESS SUMMERSKILL

I hope your Lordships will reject this Amendment because I think it is most harmful. Who can define what is a "trivial injury" 987 to a woman? Are we saying that, after this experience of childbirth, which is not only physically painful but also is a strain on the whole of her mental processes, a woman can sit back for a long time and rest? To-day, within a very short time of having a child, a woman has to do the housework, the washing, and the caring for the other children. In fact, the housewife to-day is exposed to great physical strain, whether she has had a baby or not. It is one of the most arduous tasks in the country, and we are being asked today to expect some doctor to define what will be "trivial". Doctors throughout the country will differ on this, and the only person who will suffer is the poor woman. I ask your Lordships not to confuse this Bill by introducing a word that is utterly ambiguous.

§ LORD CHORLEY

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

§ BARONESS WOOTTON OF ABINGER

I am puzzled by what has been said by both my noble friends Lady Summerskill and Lady Gaitskell. It seemed to be the argument of Lady Gaitskell that it was far more dangerous to have a child than it was to have the pregnancy terminated, which seems to be an argument for terminating all pregnancies, because that would be the lesser risk. According to Lady Summerskill, one of the great risks of having a child is that the woman has to do the housework afterwards (which is indeed true), and that also seems to be an argument for terminating a pregnancy. I know that these are frivolous observations, but I think there is a more substantial argument behind them. That 988 argument is this: that a door which is opened by this Bill—and let me say at once that I want that door to be open—is being gently pushed wider and wider open.

§ VISCOUNT WAVERLEY

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

§ BARONESS GAITSKELL

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

§ VISCOUNT WAVERLEY

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

§ BARONESS GAITSKELL

I thank the noble Viscount.

§ LORD STONHAM

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

§ VISCOUNT DILHORNE

May I intervene for a moment?

§ LORD STONHAM

As soon as I make a statement there is an immediate movement to interrupt. But let me prove my point. The British Medical Association and the Royal College of Obstetricians and Gynæcologists have said the requirements that the risk must be "serious" and the injury to health "grave" are 989 capable of raising considerable difficulties in practice. They may mean that terminations carried out on certain medical indications which are accepted in current medical practice would become questionable in future.

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

§ VISCOUNT DILHORNE

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

§ LORD STONHAM

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

§ VISCOUNT DILHORNE

Why?

§ LORD STONHAM

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

§ LORD PARKER OF WADDINGTON

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

§ LORD STONHAM

Irrespective of whether the risks involved in abortion are greater than the risks involved in pregnancy, I would say that of course there are risks involved in pregnancy. My noble friend described them as slight risks. I would not go as far as that: 990 I am not disputing the point. What I would ask the noble and learned Lord, the Lord Chief Justice, and the noble and learned Viscount, Lord Dilhorne, to apply their minds to is the fact that the representatives of the medical profession, whose members would have to carry out these operations, feel that it would be wrong to have these two words in the Bill; and they are going on experience. They also go so far as to say that they would make the position much narrower than it is now in Case Law under the Bourne judgment. That is the opinion of the medical profession. The noble Viscount, Lord Dilhome, said we are giving guidance to the medical profession, and I think it is only right to say what guidance they have given to us. And I hope that my noble friend Lord Segal will bear that in mind, because he is himself a member of one of those organisations.

§ VISCOUNT DILHORNE

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

The noble Lord may want time to consider that point, but I would say to him, whatever may be said about the words "grave" and "serious", that if the clause is open to that interpretation, something is needed to make it clear that, for the operation to be lawful, the risk must be of a substantial character; that the 991 opinion of the doctors must be that there is a risk of a substantial character, and that without the operation an injury of a substantial kind is likely to ensue. I hope we need not spend more time on this matter, but I think there is real substance in Lord Segal's point. I hope that the Government and the noble Lord, Lord Silkin, will say that the Bill is not intended to legalise abortions where two doctors are of opinion that there is just a minimal, slight risk, and then rely on the Act and say that the operation is lawful.

§ LORD SILKIN

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

§ LORD SEGAL

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

Other points have been touched upon. Whatever the actual figures may be which the noble Viscount, Lord Waverley, has mentioned, there is absolutely no doubt whatever that a far greater risk is involved in the traumatic process of doing an abortion than in the ordinary normal process of childbirth. Of that there can be no possible doubt whatever. The risks 992 may be greater to inflict an abortion than to allow the pregnancy to continue.

§ LORD PLATT

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

§ LORD CITRINE

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

§ LORD SEGAL

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

§ LORD BYERS

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

§ LORD SEGAL

I think that would be more correctly addressed to the sponsors of the Bill, not the mover of the Amendment. I am referring to the definition of the word "risk" which appears in the text of the Bill we are asked to approve. If it is the will of the Committee that, without any restriction or qualification except their own judgment, the professional medical abortionist is to be allowed to ride roughshod through the 993 provisions of this Bill, I am quite content to accept that view. But I personally feel that, whatever the view of the representatives of the medical profession, this House ought to insert some qualification into the terms in which he is allowed to operate the provisions of this Bill. I urge that these two Amendments be inserted in the text of the Bill.

§ VISCOUNT DILHORNE

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

§ BARONESS STOCKS

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

§ LORD SEGAL

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

§ BARONESS STOCKS

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

§ LORD SEGAL

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

§ THE LORD ARCHBISHOP OF CANTERBURY

I put down my name in support of this Amendment, and I hope that the Committee will accept it. 996 In a case where pregnancy constitutes a risk to the health of the mother, the mother's anxiety about her care of the other children in the family may, we know, be a real factor in the question of her health. This is a part of the mother's environment of which a doctor will take note when he forms a judgment about the mother's health in connection with a plea for an abortion. But the words now in the Bill introduce quite another principle.

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

§ LORD SOPER

I find it disagreeable—

§ LORD SOMERS

I should like to say—

§ LORD BROCK

My objection to the phrase, "or any existing children of her family", is simply that it departs from the medical considerations of abortion in so far as they affect the physical or mental health of the pregnant woman. Where the family background or circumstances are such as to prejudice the physical or mental health of the pregnant woman, the natural compassion of the doctor fostered by his medical experience will be sufficient to influence him to pay attention to these matters, and indeed to all matters, in advising abortion. But this phrase definitely introduces the 997 problem of social reasons for abortion. It is the natural and worthy fear of many surgeons that they will then be called upon to perform abortions for reasons not connected with the health of the pregnant woman herself. The words as they stand do not even define the existing children of her family. They might well include five or ten step-children, and the husband might well say to her, "We have enough children. You had better get rid of the one you are carrying." It might be the woman's first child, and she might be eager to have it. I cannot imagine that the destruction of the fœtus is the right answer to such a state of affairs, though in some cases it may be because of the effect on the mother's health which is covered by the clause as a whole.

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

In the recent debate on the Second Reading of the Bill it was suggested that I might say something of the mortality associated with therapeutic abortion. This seems to me to be the correct place to do this, as the figures relate to the grounds for the reluctance of surgeons to become involved in operations which have no medical basis or justification. The interest of the House in the recent discussion encourages me to give this information. The information which I now put forward is contained in the report of the Council of the Royal College of Obstetricians and Gynæcologists, and was published in the British Medical Journal on April 2, 1966. The first figure which it is important to note is that the maternal mortality for Britain is approximately 0.19 per thousand births. In Scandinavia the mortality from legalised abortion 998 initially varied from 0.9 to 3.5 per thousand cases. The more recent figures put the mortality for Denmark at 0.7 per thousand, which is nearly three times as high as the present maternal mortality rate, including abortions, for England and Wales. I would remind the Committee that the maternal mortality rate for Britain is 0.19 per thousand, and the present mortality rate for Denmark is 0.7 per thousand. The very low mortality figures of 0.03 to 0.06 per thousand reported from countries in Eastern Europe cannot be reconciled with experiences in Northern Europe and in Britain. The figures of two deaths per 100,000 abortions which was mentioned recently in your Lordships' House would never be accepted by any practical surgeon, because every surgeon knows that you cannot do 100,000 operations with a mortality as low as that. The anæsthetic risk alone is greater.

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

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

§ LORD PLATT

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

§ BARONESS SUMMERSKILL

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

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

There are thousands and thousands of evil, damp habitations without bathrooms, and where one lavatory, sometimes used by many families, is all that the slum possesses, and where the mother 1000 cooks on the landing. These children roam the streets because the pressure of human beings in their homes is such that the conditions there are intolerable. The father may be a drunkard, he may be near unemployable, he may be chronically sick. The mother may be shiftless and may have reached the stage of coplete defeatism. This is the family background where it could rightly be said that an addition to an already large family would involve injury to the physical or mental health of the existing children.

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

§ VISCOUNT MASSEREENE AND FERRARD

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

§ LORD SOPER

I do not find it pleasurable to find myself in opposition to the most reverend Primate; all the more because, although he is not my spiritual superior at the moment, in the course of years he may well be. But I find myself in complete opposition to this Amendment, because it fundamentally breaches two of the quite basic propositions on which I have sought to give my support. I believe in the social clause: I do not fear its intrusion. I am quite satisfied that 80 per cent. of all abortion cases are to be found within the framework of marriage, and among women 1001 who have already three, four or perhaps five children.

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

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

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

§ BARONESS EMMET OF AMBERLEY

I have not spoken before, so perhaps the noble Lord, Lord Conesford, will very kindly give way. I had not intended saying anything on this Amendment, but 1002 I should like to take up the noble Baroness, Lady Summerskill, on what she said about the large family. We know that she speaks from the heart, and we all feel as she does about such families, but I think she is looking to the wrong cure. It is a social cure that a family needs, not a medical cure for the mother. When you come to look at this from a logical point of view, if you are going to try to help such a family by the mother having an abortion when she becomes pregnant, she will probably have to have one every year. When are you going to stop? That is not the way to cure the troubles of the large family. It will eventually affect the woman's health.

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

§ LORD CONESFORD

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

But what we are considering here is something quite different, and let me bring two facts to the attention of the Committee. The first fact is that doctors, and nobody else, are to judge this matter. The second fact that I bring to the attention of the Committee is that the first of the words which we propose to delete is the word "or". The physical or 1003 mental health of the mother need not be affected at all, nor need there be any risk to her life, for an abortion to be lawful under these words. It will be sufficient that there is a risk to the health, mental or physical, of a single child. At an earlier stage the noble Baroness, Lady Wootton of Abinger, called attention, quite rightly, to the part that might be played by psychologists. Psychologists, I think, vary in merit, but so far as I can see, a psychologist might come genuinely to the conclusion that little Tommy would be very jealous if another child were added to the family, and that this would be harmful to his mental health. If a psychologist came to that conclusion an abortion might lawfully be carried out under this clause as it will stand unless we delete these words.

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

Of course, there may be room for other reforms which have nothing to do with abortion, but if we are going to revise the criminal law and are going to revise it as a body of Members of two Houses with the Government taking no responsibility, we must, I suggest, insert some principle into the Bill. The health, physical and mental, of the mother, the danger to her life and so forth, are all medical questions, and to deal with them provides a simple principle. But to go outside them to purely social grounds, and say that doctors, of all people, should be allowed to bring about an abortion, not because the health, physical or mental, of the mother will be directly concerned, but 1004 because some child may be inconvenienced—

§ LORD CHORLEY

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

§ LORD CONESFORD

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

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

There is only one other matter to which I should draw attention. I have drawn attention to the fact that it is doctors who are going to judge, and I have drawn attention to the fact that these words are introduced by the word "or". The exclusive interest of a child will be sufficient under this clause as it stands, and doctors are to decide that. The final point that I would bring to the attention of the Committee is one which was put at an earlier stage by the noble Lord, Lord Saltoun. In such a case as was put by the noble Baroness, Lady Summerskill—the case where there are already many 1005 children living in overcrowded conditions—any additional child could be aborted under these words. It may not be one child and one abortion with which we are faced. It may be repeated abortions in that same family. I am not saying that such a case does not pose a problem. Of course it does. But are we quite sure, if we want to legislate for that, that repeated abortions are preferable to sterilisation? I am not at all sure. I support as strongly as I can the Amendment of my noble and learned friend Lord Dilhorne, supported as it has been by the most reverend Primate.

§ BARONESS GAITSKELL

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

As I read this subsection—and I do not think that it is particularly well drafted—I understood that it meant taking into account not just the existing children but injury, mental or physical, to the existing children of her family. It seems to me that it takes into account the consequences to her family when there is a risk of injury to the physical or mental health of a mother in bearing another child—and there really is a risk when she is terribly against having another child. In fact, we are considering the protection of the mother in order to protect the family as a whole, which includes the existing children. I believe that the existing children often need protection when, as my noble friend Lady Summer- 1006 skill pointed out, the social conditions are so terrible—and I myself have seen these conditions in a centre for homeless people in London where in one room there was a woman with eight children. Although she had no home, and, in fact, had no husband, she had eight children and was being looked after by the council.

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

§ LORD PLATT

I am afraid that I cannot support this Amendment. I say "I am afraid" because I regret having to speak in opposite terms from those of my respected and noble friend Lord Brock. Once again I find myself wanting to repeat some of the words of Lord Soper, but without being able to command his eloquence. But perhaps I may say something from the medical point of view. May I first say to the noble Baroness, Lady Emmet of Amberley, that of course I agree with her that poverty and overcrowding are remedied by social methods and not by abortion. I also agree that the proper method of family planning is by contraception and not by abortion. Surely nobody in this House would favour abortion if there were some other way out. If the noble 1007 Baroness could tell us how the housing situation could be put right overnight, or even in a matter of months, then, of course, her words would have more weight.

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

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

§ LORD FERRIER

I am very much opposed to this Amendment, for the reason that I entirely support what was said, in far better words than mine, by the noble Lord, Lord Soper, and the noble Baroness, Lady Summerskill. As I said before, these words bear out the Dugald Baird experimental policy in Aberdeen; namely, accepting that this is a social clause. The problem of the other children in the family has a definite bearing on the doctor's decision as to whether 1008 an abortion should be granted. I use the phrase "doctor's decision" because of the way the noble Lord Lord Cones-ford has spoken; and in the light of what I said on Amendments Nos. 1, 2 and 3. I believe it is important to emphasise that one of the doctors concerned must be related, through the National Health Service, to some sort of social work.

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

§ THE MARQUESS OF SALISBURY

I have not intervened at all in the discussions on this Bill. I did not think it was a subject with which I was very familiar, nor did I think that my views would be of the slightest importance to your Lordships. But it seems to me that the Amendment which we are discussing at the moment is so extremely important that I cannot bear to remain silent. As I listened over the last half-hour to the discussion in which so many of your Lordships have taken part, I felt that the arguments put forward by the noble Baroness, Lady Summerskill, the noble Lord, Lord Soper, the noble Lord, Lord Platt, and others would have been appropriate in a discussion on birth control or family planning. Whether one agrees with those proposals or not, what was said would have been entirely relevant to 1009 a debate on that subject. But this is something quite different. What we are doing, what we are being asked to do, is to kill a living thing, or at any rate, a thing which has in it the seeds of life. I admit that we may be justified in doing that on medical grounds. The health of the mother may be fatally injured unless the fœtus is aborted; though even then I feel that it would be a terrible decision to have to take. But if we depart from the purely medical grounds for abortion and bring in social conditions, it seems to me that we get into very deep waters indeed.

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

§ LORD CHORLEY

I agree very much with the noble Marquess, Lord Salisbury in regarding this as the most important part of the Bill. I agree with what the noble Lord, Lord Ferrier, and the noble Lord, Lord Platt, have said, that this, alas!, will bring very great depression to hundreds of thousands of people in this country, because it means that they will have to continue getting a back-street illegal abortion. The whole object, or the main object, of the Bill is to get rid of back-street illegal abortions. I think it clear from the statistics given to us that a very large number of the illegal abortions are asked for by married women who find that the struggle to bring up a large family is not only wearing them down but making it 1010 impossible for them to bring up a really fine family, which is the ambition of all good parents.

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

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

The noble Lord, Lord Conesford, with whom I have crossed swords, said it is for the doctors to decide. Of course that is not so. It is the woman's task, and not only the woman, but the father as well. He comes into these cases, because it is a family decision. Very often the father sees the back-street abortionist and fixes up the operation. It is a family 1011 decision, even if the father is not mentioned in the Bill, and that is the first and most important step. The doctors come in only at the second stage.

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

§ LORD PARKER OF WADDINGTON

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

That has nothing whatever to do with the words we are considering. The case we are considering is where a mother goes to her doctor and says, "I want an abortion. Look at those children in that room. It does not affect me mentally or physically; I can cope with the situation. I can go out to work and feed them and do the best I can for them, 1012 It will not hurt me at all. But I am asking you to say, as a social question, that it is wrong for them to be living under those conditions which will be made worse if I have this child." That is the problem to which we are addressing our minds.

§ BARONESS WOOTTON OF ABINGER

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

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

§ LORD STONHAM

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

§ BARONESS WOOTTON OF ABINGER

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

I know cases in which, understandably, doctors and social workers who have had much contact with the more distressing social areas of our community have formed strong opinions as to who ought 1013 to have children and who ought not to have them. Those opinions are not, in the strict sense, medical opinions. They are an expression of dislike of people who may live rather disorderly, and even idle, lives and who do not come up to the standards of behaviour and morality which these medical practitioners approve. There is a real risk that, if we allow a social clause, we shall be allowing the medical profession to make judgments on considerations which are not medical but social and on which they are not better qualified than other people. In short, I am anxious that we should be absolutely clear of pseudo-eugenics and regard this Bill entirely from the point of view of the pregnant woman, her welfare and the welfare of the child she may be about to bear.

§ LORD SOPER

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

§ BARONESS WOOTTON OF ABINGER

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

§ LORD MOLSON

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

1014 The Bill raises the question of social considerations and the conscience of the doctor. The noble Lord, Lord Brock, spoke for a large section of the profession when he talked of being influenced purely by medical considerations. The noble Lord, Lord Platt, also spoke for a large section of the medical profession when he expressed a contrary view. I do not believe it is possible to speak about a medical conscience, or a religious conscience, or a social conscience. I think that every man's conscience is built up of many different considerations applying to different aspects of human life; but they are all governed by what he, in his soul, believes to be right.

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

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

It has been argued that these matters of large families should be dealt with by the social services, and especially by family allowances. Certainly let that be done. But it cannot be done in this Bill, and it is no answer to say that some time in the future other measures can and will be taken which will reduce these problems. No social service will actually 1015 abolish the case of the large family with the feckless mother living in bad conditions—though the number of such cases may be greatly reduced. I am sure that the time will never come when there will not be a case of a mother who finds herself pregnant and who sincerely believes—and it is the opinion of those best qualified to judge—that the addition of one more child to her family will be greatly to the disadvantage of all the existing members of that family.

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

§ VISCOUNT DILHORNE

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

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

The noble Baroness, Lady Summerskill, has made, not for the first time, a very moving speech about the social conditions and poverty of some large families; and she was supported in that by the noble Lord, Lord Soper. If I thought for 1016 one moment that this Amendment would prevent an abortion taking place where the health of the pregnant mother would be affected by those conditions, then I should not have moved it. What will be the position? Let us take a particular case. A woman finds herself pregnant after having three, four or five children, to take the example given by the noble Lord, Lord Soper, and it will be her decision to consult her doctor to see whether the pregnancy should be terminated; and she will want it terminated. If the conditions are anything like the noble Baroness described, or those envisaged by the noble Lord, Lord Soper, I should have thought that the vast majority of doctors would be able to form the perfectly honest opinion that she should not add to her burdens in the future by having an additional child without a risk, and a serious risk, of injury to her mental and physical health.

As the Bill stands, it is my belief that the cases to which the noble Baroness so movingly referred, and the cases quoted by