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www.klice.co.uk Summer2010(Vol.16No.

1)

AbortionandConscientiousObjection
DanielJ.Hill

Abstract
InthisarticleIdonotseektodiscusswhen,ifever,abortionismorallypermissible.RatherIseektoanalysethe
preciselegalstatusoftheexemptionsaffordedunderBritishlawtothosewithaconscientiousobjectiontoabortion.
IthenarguethatthelegalstatusquoinBritainisnotmorallysatisfactory,andthatthelawurgentlyneedstobe
changed.

Introduction
Christiansdisagreeonthesubjectofabortion.SomeChristiansthinkthatallintentionalabortionsare
morallyimpermissible.OtherChristiansthinkthatallintentionalabortionsthatarenotintendedtosave
themotherslifearemorallyimpermissible.OtherChristiansbroadenthistoincludeaspermissible
thoseabortionsthatareintendedtosavethemothershealth,evenifherlifeisnotindanger.Afew
Christiansthinkthatalmostallabortionsuptoacertainperiod(e.g.thecurrentlegallimitoftwenty
fourweeks)arepermissible.Ratherthanenteringdirectlyintothisdebatehere,Iwanttoexaminehow
farthelawaccommodatestheconsciencesofthoseChristians(andothers)thatareopposedtoabortion.
ItseemstomethateventhoseChristiansthatarenotopposedtoabortionoughttosupportlegal
tolerancefortheconscientiousobjectionsoftheirfellowChristiansthataresoopposed.Thisisimportant
notjustforreasonsofsupportingourbrothersandsistersinChrist,butalsobecausethesamedebate
willbeplayedoutinthefutureconcerningeuthanasia,wheremanymoreChristiansmayfindtheir
consciencesbeinginfringedbythelaw.

Thelegalstatusquo
InGreatBritain(butnotNorthernIreland),thelawonabortionissetoutintheAbortionAct1967
(hereinaftertheAct).TheActlegalizedsomeabortions,anditalsoaffordedpermissionfor
conscientiousobjectorstooptout.Thesocalledconscienceclause,Clause4,isasfollows:

4.
Conscientiousobjectiontoparticipationintreatment.
(1)Subjecttosubsection(2)ofthissection,nopersonshallbeunderanyduty,whetherby
contractorbyanystatutoryorotherlegalrequirement,toparticipateinanytreatmentauthorised
bythisActtowhichhehasaconscientiousobjection:
[...]
(2)Nothinginsubsection(1)ofthissectionshallaffectanydutytoparticipateintreatmentwhich
isnecessarytosavethelifeortopreventgravepermanentinjurytothephysicalormentalhealth
ofapregnantwoman.1

Participation heldnottobecoveredbytheconscienceclause.
So,thecurrentlegalstatusinBritainisthat Isthere,though,anydutyontheGPtosignthe
nobodyneedstoparticipateinanytreatmentto form/certificate?TheNationalHealthService
terminateapregnancyifheorshehasa (GeneralMedicalServicesContracts)Regulations
conscientiousobjectionandiftheabortionisnot 2004state:
necessarytosavethemotherslifeortoprevent
gravepermanentinjurytoherphysicalormental 3.
health.Thequestionarisesastowhatismeantby (1)Acontractorwhosecontractincludesthe
participateinthistreatment,and,infact,this provisionofcontraceptiveservicesshall
questionhasbeenconsideredbytheCourts,inthe makeavailabletoallitspatientswho
caseofReginav.SalfordAreaHealthAuthority requestsuchservicestheservicesdescribed
(Respondent)exparteJanaway.2MrsJanawaywasa insubparagraph(2).
RomanCatholic,andworkedasareceptionistfor (2)Theservicesreferredtoinsubparagraph
aGeneralPractice.Shewasaskedtotypealetter (1)are
referringapregnantwomanseekinganabortion []
toaconsultant.MrsJanawayrefusedtodothis, (e)theprovisionofadviceandreferralin
andwasdismissedfromherpost.Hercasewent casesofunplannedorunwantedpregnancy,
allthewaytotheHouseofLords,whereitwas including[...]whereappropriate,wherethe
dismissed,withtheirLordshipsholdingthat contractorhasaconscientiousobjectionto
participateinanytreatmentmeantactually theterminationofpregnancy,prompt
takingpartintreatmentadministeredinahospital referraltoanotherproviderofprimary
orotherapprovedplace. medicalserviceswhodoesnothavesuch
conscientiousobjections;4
Referrals
So,thelawholdsthattypingupalettertoa ItwillbenotedthattheRegulationsheredonot
consultantisnotcoveredbyparticipateinany statethattheGPhastosigntheformsendingthe
treatmentfortheterminationofpregnancy.The womantoaconsultantorclinic,butdosaythatifa
questionarisesofwhetheraGPsreferringa contractor(ageneralpracticeorindividual
patienttotheabortionclinicortoaconsultant generalpractitioner,forourpurposes)has
woulditselfbecoveredbythephraseparticipate decidedtooffercontraceptiveservices,that
inanytreatment.Thegovernmenthasexpressed contractorhastobepreparedtoreferapregnant
theopinionthatparticipateinanytreatment womanseekinganabortionontoanotherGPthat
doesnotcoverthesigningoftheform/certificate doesnothavetheconscientiousobjection.
bytheGP.LordWarner(thenMinisterofStateat
theDepartmentofHealth)saidon20July2005: TheEthicsoftheSituation
Wehaveseenthelegislationandhowthecourts
TheHouseofLordsruledin1988thatthis interpretit.Thequestionarisesastowhetherthey
exemption[theconscienceclauseoftheAct] drawtheboundariesintherightplacemorally.I
doesnotextendtogivingadvice, shallnowarguethattheydonot.Theargument
performingthepreparatorystepstoarrange thatIwishtomakeisputbrieflybyJennifer
anabortionwheretherequestmeetslegal JacksoninherEthicsinMedicine:
requirementsandundertaking
administrationconnectedwithabortion [I]sitnotarbitrarytoallowdoctorsand
procedures.Doctorswithaconscientious nursestorefusetoassistonconscientious
objectiontoabortionshouldmaketheir grounds,butnottoallowdoctors
viewsknowntothepatientandenablethe secretaries,pharmacistsorotherstorefuse?
patienttoseeanotherdoctorwithoutdelay ImagineapersonalsecretaryofJosef
ifthatisthepatientswish.3 Mengelefendingoffcriticismofherrolein
arrangingformoreconcentrationcamp
So,itwouldappearthatthesigningoftheform/ prisonerstobedeliveredforuseinlethal
certificateisnotcoveredorwouldinfuturebe experiments,protesting:Youcantcriticize
me,Imerelytypedtheletters.5 whatwouldbefallthemthere?Orwoulditbe
morallyacceptabletosayIamnotmorally
Letustakeasourstartingpointtheethicalview preparedtosendthesepeopletoAuschwitz,butI
heldbytheconscientiousobjector.Thisisagood ammorallypreparedtosendthemontosomeone
pointtostartbecauseourinquiryinthispaperis lessscrupulous,who,Iknow,willinturnsend
notwhetherthisviewistrueorfalsebuthow themontoAuschwitz?OrtosayIamnot
much,ifanything,shouldbeconcededtoit morallypreparedtotypealetterformysuperior
legally.Ishallrestrictmyattentioninthispaperto sendingthesepeopletoAuschwitz,butIam
abortionsinwhichitisnotthecasethatthe morallypreparedtotypealettersendingthemon
motherslifeorhealthisingravedangerIshall tosomeonelessscrupulous,who,Iknow,willin
callthesenonemergencyabortions.Theviewof turnsendthemontoAuschwitz?Itseemstome
theconscientiousobjectoristhatitismorally clearthat,absentspecialcircumstances,noneof
wrongintentionallytoperformanonemergency thesewouldbemorallypermissible.Nevertheless,
abortion. ifonehadaguntoonesheaditmightbe
permissibletodooneofthesethingstosaveones
Letusthinkaboutthefollowingethicalquestions: life,orthelivesofonesfamily.Anditmightbe
permissibletodooneofthemaspartofdeep
(1)Isitmorallywrong,absentspecial coverinordertobeabletosavemorelivesinthe
circumstances,toreferapregnantwoman longtermbysabotagingtheNazimachinefrom
ontothehospitalorabortionclinicinthe within.
knowledgethatshewillreceiveanon
emergencyabortionthere? Toapplytheanalogy,itseemstomethatthe
conscientiousobjectorislogicallycommittedto
(2)Isitmorallywrong,absentspecial answeringyesto(1)(4)above.Ifitisnot
circumstances,toreferapregnantwoman morallypermissibletoperformanonemergency
ontoaGPintheknowledgethatshewillbe abortion,then,absentspecialcircumstances,itis
referredbythisGPontothehospitalor notmorallypermissibletoreferthemotheron
abortionclinicandthatshewillreceivea directlyorindirectlyforanonemergency
nonemergencyabortionthere? abortion,ortoplayanypartinassistingthis
referralprocess.Ofcourse,ifspecial
(3)Isitmorallywrong,absentspecial circumstancesobtained,itmightbepermissible:
circumstances,totypealetterreferringa forexampleiftheGPortheGPsfamilywere
pregnantwomanontothehospitalor beingthreatenedwithaguntotheirheads.A
abortionclinicintheknowledgethatshe morerealisticexamplemightbeiftheGPwere
willreceiveanonemergencyabortion keentoreducethenumberofabortionsand,
there? indeed,tosavelivesquitegenerally,andthought
thatheorshewouldbestruckoffifheorshe
(4)Isitmorallywrong,absentspecial refusedtoreferontotheabortionclinic.Inthis
circumstances,totypealetterreferringa case,itmightbepermissiblefortheGP,whilenot
pregnantwomanontoaGPinthe intendingthatanyabortiontakeplace,reluctantly
knowledgethatshewillbereferredbythis tosigntheformononeortwooccasionssolelyin
GPontothehospitalorabortionclinicand ordertokeephisorherjobinorderthatmore
thatshewillreceiveanonemergency livesmightbesavedinthelongterm.
abortionthere?
Thepointis,however,thatthesearespecial
ConsideranextensionofJenniferJacksons circumstances,and,inthecontextofthesecond
analogywithJosefMengele.Woulditbemorally example,circumstancesthatthestatehasthe
acceptabletosendpeopleontoAuschwitz, powertoprevent.Thismeansthatitis
knowingwhatwouldbefallthemthere?Orwould unsatisfactorytolegislatethatnobodymaybe
itbemorallyacceptablemerelytotypethe legallyobligedtoparticipateinthetreatment
transferletterforonessuperior,againknowing (understoodasperthecourts)foranon
emergencyterminationofpregnancywhilesimultaneouslyinsistingthatsomemaybelegallyobligedto
referpeopleonforsuchatermination:thelogicallyconsistentpersonthathasaconscientiousobjectionto
participatinginanonemergencyabortionwillalsohaveaconscientiousobjectiontoreferringonfor
suchanabortioniftheenvisagedspecialcircumstancesareabsentastheyusuallyare.

Finallyweshouldconsiderthequestionofhowfartheconscientiousobjectionshouldbe
accommodated.Itseemstome,inthelightoftheabove,thatanylogicallyconsistentpersonopposedto
anonemergencyabortionwillalsobeopposedtobeinganaccessoryinanywaytononemergency
abortions.Inotherwords,suchapersonwillopposeanycounselling,procuring,aiding,abetting,
helping,orcooperationwithnonemergencyabortions.Forexample,referringontotheabortionclinic,
referringontoanotherGPthatisknownwillreferoninturntotheabortionclinic,andclerkingin
preparatorytoanabortion,wouldallcountascounsellingorprocuringoraidingorabettingorhelping
orcooperatingwiththeabortion.Ontheotherhand,thegivingofmedicaladviceortreatment
concerningaseparateconditiontoawomanseeking,orhavingjusthad,anabortionshouldnotcome
withintheambitoftheconscienceclause.7Eveniftheabortioninquestionwereclearlyimmoralthat
wouldnotmakeimmoralthegivingofadviceortreatmentforaquiteseparatecondition(unless,of
course,theadviceortreatmentweregivenwiththeintentionofenablingthemothertoreceivethe
abortion).Iconcludethatthelawurgentlyneedstobechangedtoallowforaconsistentconscientious
objectionalongthelinessketchedoutabove.

_____________________________________________

1.AbortionAct1967,1967c.87(27thOctober1967)[cited2009September9].Availablefrom:http://
www.statutelaw.gov.uk/content.aspx?activeTextDocId=1181037.
2.Reginav.SalfordAreaHealthAuthority(Respondent)exparteJanaway[1988]2W.L.R.442;HA[1988]3AllER1079
249.
3.Hansard[HL]vol673colWA20(20Jul2005)[cited2009October2].Availablefromhttp://
www.publications.parliament.uk/pa/ld200506/ldhansrd/vo050720/text/50720w01.htm.
4.TheNationalHealthService(GeneralMedicalServicesContracts)Regulations2004[cited2009September9].Available
from:http://www.opsi.gov.uk/si/si2004/20040291.htm#3a.
5.JenniferJackson,EthicsinMedicine,(Cambridge:Polity,2006),p.48.
6.GeneralMedicalCouncil[Internet].PersonalBeliefsandMedicalPractice[March2008;cited2009September9].
Availablefrom:http://www.gmcuk.org/guidance/ethical_guidance/personal_beliefs/personal_beliefs.asp#F.
7.IdliketothankfortheirhelpJaniceAllister,JamesBogle,ClareCarlisle,JamieDow,CharlesFoster,LucyFrith,Harry
Lesser,SimonLeighton,MichaelMcGhee,SteveMichael,IanSapsford,PeterSaunders,TomSimpson,SteveTaylor,and
DemianWhiting,aswellasofficialsfromtheBMA,GMC,andDepartmentofHealth.MygreatestdebtistoJosephShaw
andHelenWatt,whohavebeenextremelygenerouswiththeirtimeandexpertisetohelpme.Obviously,noneofthe
abovementionedshouldbeheldresponsibleforanydefectsinthisessay.

Forfurtherreading:
CharlesFoster,ChoosingLife,ChoosingDeathTheTyrannyofAutonomyinMedicalLawandEthics,Hart,2009.
JenniferJackson,EthicsinMedicine,Polity,2006.[introduction]
HelenWatt,ed.,Cooperation,Complicity&Conscience:Problemsinhealthcare,science,lawandpublicpolicy,Linacre
Centre,2006.[moreadvanced]

Dr.DanielJ.HillisateachingfellowintheDepartmentofPhilosophyattheUniversityofLiverpool,
andSecretaryoftheTyndaleFellowshipsStudyGroupinthePhilosophyofReligion.Hegainedhis
PhDin2001fromKingsCollege,London,forathesisontheconceptofGod.Hehasalsowrittenanar
ticlearguingthattorturetogaininformationisnevermorallypermissible,evenintickingbombsitua
tions.


TheKirbyLaingInstituteforChristianEthics,
TyndaleHouse36SelwynGardens,Cambridge,CB39BA,UK
T01223566619/566625F01223566608EEthics@Tyndale.cam.ac.ukWwww.klice.co.uk