(1 day, 8 hours ago)
Lords ChamberIt would be part of the process of investigation. In that context, I sympathise very much with the amendment from the noble Lord, Lord Verdirame, which would provide a further filter. There should be a prosecution only in cases where there has been a clear breach of the law. These are very sensitive matters and need to be conducted sensibly. But we have to stand on principle here.
Lord Winston (Lab)
My Lords, I have the greatest respect for the noble Viscount, but I fear there is a difference between speaking in theory and practical reality. I want to point out that I have certainly killed at least one baby at term myself; possibly two.
There is a condition called ectopic pregnancy. Very occasionally, pregnancies grow outside the womb or motor outside the womb during the course of the pregnancy. They are left outside the uterus, where they leave a huge hole in the abdomen, placing the bleeding mother at grave risk when the placenta is removed. In this situation, without any alternative, I did what I thought was a caesarean section in both cases to find that once I had opened the abdomen, the uterus was not in fact pregnant, but I was faced with a baby outside the uterus with a placenta. One baby was clearly very abnormal, with various limb abnormalities; the other baby looked completely normal. Both babies were delivered and—thank goodness, with the help of my colleagues—we were able to save both mothers’ lives. As the noble Lord, Lord Patel, will agree, the bleeding is a very frightening situation in the operating theatre.
If I may, I will tell the Committee the story of someone who was a patient of mine for about seven or eight years. Laura had a very rare condition—there are many rare genetic conditions—in her case, Lesch-Nyhan syndrome. This is a curious disease which tends to affect only boys but can occasionally affect any foetus. Laura had a series of pregnancies. About four of them ended in miscarriage. She desperately wanted a baby. Eventually, she conceived successfully, although she was often infertile, and finally had a baby. She gave birth to a baby rather prematurely, about four weeks before term, who had Lesch-Nyhan syndrome.
Peter was seriously abnormal. He had all sorts of neurological problems. He was unable to eat properly. He was unable to move properly. As a teenager, he had to be strapped in his wheelchair to prevent him mutilating himself. That did not stop him mutilating himself and eventually he started to bite off his lips and his tongue, so he had to have his teeth extracted, and that was not sufficient. He could not be moved around in his wheelchair, because if he was upstairs he would want to tilt himself downstairs. Peter continued to live a very long time; I do not know exactly when he died, but I think he was about 18.
We could do nothing about this lady, but we realised she had this genetic defect. For a long time, we tried to work out the mechanics of it. We eventually sourced the DNA. It was a particular mutation which occurs in very few families in this country. Mutations such as this occur in different ways in different pregnancies, not infrequently; in this case, her mutation was very difficult to deal with. After eight years of trying, she attempted to have more pregnancies because she desperately wanted to have a baby who was free of disease. The risk to her, of course, would be having another baby who might be handicapped and that, of course, would be an immense hardship for that family. That is often one of the big problems for people who try to terminate or deal with these sorts of conditions. Anyway, she had about a dozen pregnancies and eventually we put back into her uterus an embryo which we thought was normal—there was a great deal of resistance in Parliament at the time to this kind of procedure—but she had a live baby, who fortunately was well and was a boy.
That is another example, but it is also fair to say that there are many situations where you have obstetric abnormalities; for example, a baby born with very severe skeletal abnormalities. That could sometimes be unknown. A woman may not report to have her baby for whatever reason during pregnancy until screening is too late and she has not had ultrasound or any other care. That happens in poor families generally. It is inevitable in any society, however good your medical practice might be.
Sometimes, when close to term, a woman is suddenly found to have an abnormal pregnancy in her uterus, which would prevent labour being successful. A caesarean section would probably result in a dead baby but, alternatively, sometimes these babies have been what we call morcellated: you actually try to disintegrate them because it is the only way you can save the mother’s life, if she is critically ill at that stage.
This is a very serious issue and unless one fully understands that these things are possible, one has to recognise that you cannot—