Professor Richard Huxtable:

I will happily pick up on conscientious objection. I will start with a reflection on the ethics of all this. Conventionally, and this is a word I will reuse in a moment, the position that tends to be adopted, whether regarding embryo research, abortion or assisting dying, has been labelled a "conventional compromise". This is where lawmakers attempt, on the one hand, to provide for, if it is to be a legal right, the rights of the patient to be honoured while at the same time trying to ensure the consciences of the relevant professionals are protected. The compromise consists in the fact that there will nonetheless be a bottom line, such as a duty to refer on the part of the objecting clinician to a colleague who will be willing to vindicate the patient's legal rights.

In this regard, one of the things I would like to introduce, which we have not really picked up on, although it was referred to by Dr. Mills, is the position of not only the senior clinician, the consultant doctor, let us say, but other doctors as well, including junior doctors. I would like to widen our sphere of concern in this regard. If we envisage a model where the patient takes the final fatal step, as I have mentioned a couple of times, such as self-administration of some medication, presumably this medication needs to be prescribed and provided by a pharmacist. Presumably as well, there will be situations where the patient is in contact with the relevant doctor via the involvement of administrative staff. One of the tasks this committee will have to reflect on, therefore, is how far a right of conscientious objection should extend.

I apologise for not recalling the case name, but I do recall there was at least one legal case in England and Wales regarding the rights or otherwise of a secretary to type a referral letter concerning the termination of pregnancy. In that case, the court had to engage with the question of what counted as an act for the purposes of the relevant Act of Parliament in that instance. In that context, I think we should be thinking about a whole suite of people and, ethically, it is right we should do so. As mentioned, these are positions or ethical debates on which reasonable people can and will disagree. There will also be a sense that people will have their own conscientious objections, whether they are clinicians, pharmacists, administrators, etc. These are a few reflections I hope can go some way to answering the question.