Terminally Ill Adults (End of Life) Bill

Siobhain McDonagh Excerpts

Report stage
Friday 20th June 2025 Commons Chamber

[Kim Leadbeater]

I am not going to take any more interventions, because lots of people want to speak.

Then there are the criminal offences that the Bill introduces—none of which exist now—including life imprisonment for anyone who induces another person to take the approved substance, and 14 years in prison for coercion, dishonesty or pressure. It is a robust process that goes further than any other piece of legislation in the world, and it is far safer and significantly more compassionate than what we have now.

If we look internationally, there are clear, well-established, safe and compassionate assisted dying laws in existence. On Tuesday I joined doctors from Australia who used three key words repeatedly: choice, control and relief. Dr Greg Mewett has 20 years of experience as a GP and 22 years as a palliative care physician, and he spoke about the thorough approach that he has taken to ensure safety and efficacy of the assisted dying process. Perhaps the most stand-out quote from that session came from Dr Jacky Davis, chair of Healthcare Professionals for Assisted Dying, who said that by introducing assisted dying,

“no more people will die but far fewer people will suffer”.

This is not a choice between living and dying. It is a choice for terminally ill people about how they die. I fully appreciate that some colleagues would never vote for any version of this Bill, and I am respectful of that despite disagreeing with them. However, I say to colleagues who are supportive of a change in the law but are hesitant about whether now is the time, that if we do not vote for a change in the law today, we will have many more years of heartbreaking stories from terminally ill people and their families, of pain and trauma—

[Dame Siobhain McDonagh (Mitcham and Morden) (Lab)]

Will my hon. Friend give way?

[Kim Leadbeater]

I am going to finish.

There will be stories of suicide attempts, post-traumatic stress disorder, lonely trips to Switzerland, police investigations, and everything else we have all heard of in recent months. As the Commission on Assisted Dying said in 2011, 14 years ago:

“The current legal status of assisted dying [in the UK] is inadequate and incoherent. It outsources a healthcare issue abroad, especially to Dignitas, instead of the Government and Parliament assuming responsibility.”

That was 14 years ago, and we are in exactly the same position today. Things have got to change.

As the Government’s impact assessment states, the Bill will improve equity of choice, ensuring that terminally ill adults from all socioeconomic backgrounds can access end-of-life options within a regulated and safe framework.

I will draw my comments to a close. There are essentially two ways in which we can look at the situation we are in. We can look at it through a legal lens. As legislators, we have a duty to change the law where it is failing, and when the last four Directors of Public Prosecutions tell us that the law needs to change, surely we have a duty to listen. We need scrutiny before people die, not after. Most importantly, there is the human lens, which is how I approach most things. Giving dying people choice about how they die is about compassion, control, dignity and bodily autonomy. Surely we should all have the right—

[Dame Siobhain McDonagh]

Will my hon. Friend give way?

[Kim Leadbeater]

I am going to finish shortly.

Surely we should all have the right to decide what happens to our bodies and decide when enough is enough. Of course, giving people the right to choose does not take away the right not to choose.

Today, we can vote with either our hearts or with our heads, but either way, we should end up in the same Lobby. On a compassionate, human level, and as responsible lawmakers, we should support this desperately needed reform, which is rigorous, practical and safe, and which is rooted in the principles that should underpin any legislation: compassion, justice and human dignity.

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[Sir James Cleverly]

I will refer to the hon. Gentleman’s point later in my speech. I will try not to take too many interventions, because many people have not had the chance to speak in the debate and I want to give them the chance to do so.

On Second Reading I made the point that we need to think about the detail of the Bill and not just vote in accordance with the broad principles. I made the point that, because it is a private Member’s Bill, the opportunity to change it fundamentally is limited, and so we have an enhanced duty to get it right first time. We were told on Second Reading that a lot of the concerns, worries and detailed questions would be resolved in Committee. We were promised the gold standard: a judicially underpinned set of protections and safeguards. Those protections did not make it through Committee. I have also heard people say, where there are still problems, issues and concerns, that the Lords will do that work. But none of us should think that it is right to subcontract our job to the other place.

We are making an incredibly important and fundamental change, as the hon. Member for Strangford (Jim Shannon) highlighted, in the relationship between medical professionals and those they serve. If we make that change, we will introduce a small but permanent question mark in the minds of every patient, particularly a patient who is discussing a serious illness or terminal diagnosis: “What is this medical professional expecting of me? What are they thinking? Where is their head?” Whereas, with the situation we have at the moment, the patient knows that the medical professional is dutybound to do no harm, and to preserve life and dignity wherever possible.

[Dame Siobhain McDonagh]

Next Tuesday will be the second anniversary of my sister’s death. Three weeks prior to her death, we took her to hospital because she had a blood infection. Despite agreeing to allow her into intensive care to sort out that blood infection, the consultant then decided that she should not go, because she had a brain tumour and was going to die. She was going to die, but not at that moment. I am sure, Mr Speaker, that you can understand that a very big row ensued. I won that row: she was made well, she came home, and she died peacefully. What does the right hon. Gentleman think would happen in identical circumstances if this Bill passes?

Marriage between First Cousins

Siobhain McDonagh Excerpts

Wednesday 18th June 2025 Westminster Hall

[Dame Siobhain McDonagh (in the Chair)]

I will call Richard Holden to move the motion. I will then call the Minister to respond. I remind other Members that they may make a speech only with prior permission from the Member in charge of the debate and the Minister. There will not be an opportunity for the Member in charge to wind up, as is the convention in 30-minute debates. I call Richard Holden to move the motion.

[Mr Richard Holden (Basildon and Billericay) (Con)]

I beg to move,

That this House has considered Government policy on marriage between first cousins.

It is a pleasure to serve under your chairmanship, Dame Siobhain. I rise to speak on a topic that many in our country assume is already settled. People assume that the marriage of first cousins is prohibited, as it was for 1,000 years in England. Yet that is not the case today. Despite deep cultural, medical and societal reasons to avoid such unions, our laws have remained unchanged since the era of Henry VIII. To many, that is a source of bewilderment and bafflement—as it was to me, until I dug deeper and realised some of the real dangers that widescale first cousin marriage can bring.

The Church banned first cousin marriage in the fifth century. By the 11th century it had prohibited marriage up to sixth cousins. That ban was reversed by a Tudor monarch with a perhaps chequered marital record and we have remained broadly silent on the issue ever since. However, the rights and freedoms of individual citizens, society and our broader understanding have moved on, and our laws must do the same.

This is not a call for a legislative knee-jerk reaction. Silence, as Matthew Syed has powerfully written in The Times, does not constitute neutrality. Silence is a fundamental choice with serious consequences, both for children born with preventable disorders, and even more so for men and women denied basic freedoms and for communities fragmented from wider society. I urge the House and the Minister to recognise the scale of the issue and—I hope—the moral imperative to act. My argument rests on three key tenets: freedom, social cohesion and health.

During the last Parliament I worked with campaigners to end virginity testing and hymenoplasty. In doing so I stood on the shoulders of giants: brave women from many organisations who support young women trapped in oppressive familial and extended family tribal systems. I pushed for a private Member’s Bill, and then via amendments to the Health and Care Act 2022, with Baroness Sugg in the House of Lords helping as well; the Government accepted the argument by tabling their own amendments. When I picked up that campaign, via a chance encounter with an item on BBC Radio 1’s “Newsbeat”, there was no politician of any party leading the charge in this House. Some of the activists involved might have been a bit miffed that a new, unknown Back-Bench Tory MP was leading their cause—but they got me, and we managed to push through some of the changes that they had been fighting for so bravely and with such strength for such a long time.

What was the reason behind women being forced to undergo procedures that are at best pseudo-scientific, and at worst deeply harmful? It was unscientific concepts of virginity linked to gender-oppressive ideas of purity in an oppressive patriarchal culture. Often those were linked to forced marriages. Some of their stories will never leave me: young women who had had their education and ambitions cut short being sent to marry men they had never met—men chosen not for compatibility or affection, but to preserve family alliances, assets or bastardised notions of honour.

Such arrangements are not just about culture; they are also about control. The system is upheld by pressure and enforced through silence, and people attempt to justify it through tradition. When marriage is confined within families, the cost of refusal rises astronomically: it is not simply turning down a partner, but rejecting grandparents, parents, uncles, aunts and the entire network of family and friends—and that has a price. Choice under those circumstances is no choice at all. That is why I see the legislation that I put forward in my private Member’s Bill, the Marriage (Prohibited Degrees of Relationship) Bill, and the debate we are having today as an extension of the work I did in the last Parliament.

We have heard, rightly, about patriarchal systems that rob women of autonomy, but in cousin marriage those systems are particularly resilient. Why? Because the families are not just connected, but fused—inextricably joined. The pressure is not just external, from legal systems; it is intimate and wholly inescapable, especially when it is generation after generation.

Men are trapped too; I have been told of British Pakistani men forced into such arrangements by community and familial obligations, terrified to defy expectations and cut ties with cousins whom they often consider, because of the closeness of their relationship, almost as siblings. There are even cases of gay men and women who have been forced to marry out of familial obligation. That is not hypothetical: since raising this issue, I have been contacted by scores of youth workers, healthcare professionals and ordinary members of the community who have thanked me for raising it and asked me to keep going. They need politicians to speak up, because they feel that they cannot.

Beneath the surface and behind closed doors, there is support and a real hunger for change in these communities. Sadly, what is lacking is the political courage to match that quiet majority—and it is a quiet majority in all parts of our community: polls show that support for reform is not linked to the black, white or other populations, and a YouGov poll just a few weeks ago showed that a majority of British Bangladeshi and Pakistani communities back a ban on first cousin marriage. The vain virtue signallers who said that moves in this direction would be racist must take a look at themselves; they are the ones opposing a majority of the communities that they play-act at representing.

For people in the communities I am speaking up for—most of the British Pakistani community, where this is a big issue, and to a lesser extent the Traveller community—cousin marriage is entangled with status, tradition and expectations, and speaking out can be very dangerous. As with forced marriage and female genital mutilation, silence only enables the system. Only sunlight breaks the cycle, and that means naming the issue, debating it and legislating against it.

Some critics say a ban would infringe upon people’s freedom—but what freedom are we protecting? The reality for so many is a life predetermined by bloodline and birth order. We are not protecting a freedom; we are perpetuating oppression. Whose freedom, if any, are we protecting? Purely the freedom of the oppressor to oppress and keep down—not the freedom of the individual. The state already intervenes where power dynamics distort consent. We rightly outlaw relationships between teachers and pupils or therapists and clients, because of the imbalance. The same must apply here.

Let us not forget that most cousin marriages are not one-offs. In some cases, they are multi-generational. With each generation, the chance to choose diminishes further. The net tightens and lives are lost in the gaps.

I move now beyond individual freedom to the broader issue of social cohesion. Patrick Nash, an Oxford theologian, argues that cousin marriage undermines trust in public institutions; when communities marry inward, loyalty is channelled inward to extended families and clan structures, rather than to the important shared civic values of the nation state and wider society.

At Harvard, Joseph Henrich has documented how the decline of cousin marriage helped to build western liberal democracies. When families are forced to look beyond their kin networks for marriage partners, new alliances form. Societies move beyond tribal loyalty to a broader civic trust. Studies show that, where cousin marriage continues, there is reduced integration, lower social mobility and higher incidence of corruption. Why? Because when job, marriage, dispute resolution and identity all sit within the same extended family structure, wider society fades from relevance.

If we want a society that functions on the basis of fairness, where the rule of law prevails and where people engage beyond their own, we cannot allow closed family systems to continue to flourish unchallenged. So-called community leaders—often unelected and unaccountable—who derive their authority from familial networks become gatekeepers for those people and communities. They decide who speaks, who marries whom and who gets heard. This system is self-perpetuating. These are not British values, and those who perpetuate such systems should be exposed. In many cases, those leaders are the ones resisting reform, not because the arguments for change are weak, but because their own power depends on those structures being preserved. Reform threatens their influence. That is why this issue matters so much.

We must remember that cousin marriage is not a religious obligation, but a cultural tradition, and traditions can and must change. Other nations have already exhibited powerful leadership in this area; we should look towards countries such as Norway, Sweden and Denmark for a steer. Those countries are liberal democracies with incredibly strong human rights records. They are not reactionary or anachronistic, but fundamentally progressive. Why, then, are we allowing Britain to lag behind? We hear concerns about cultural insensitivity—I have been accused of it myself—but is it not far more insensitive to ignore the pleas of those trapped within those structures? Is it not condescending to assume that communities cannot adapt or reform?

We should be empowering individuals, not entrenching power in extended family hierarchies. The state’s job is not to ratify patriarchal bargains, but to protect liberty, health and the chance of every citizen to live a full and independent life. When cousin marriage is prevalent, society and integration suffer, and shared spaces become fewer; school catchments, neighbourhoods and even workplaces can fracture along the lines of extended kin. That is not diversity at its best, but division at its worst. It is not about faith or race. It is about what sort of country we want to live in: one ruled by fear masquerading as family loyalty, or one where each citizen stands equal, with rights and responsibilities to each other deeper than those of family and clan. Those fundamentals are the foundation of a modern nation state and ones I believe this Parliament, this Government and this House should uphold.

Finally, I come to science and the health issue, because the best understood point against cousin marriage, though it is not core to my argument, is health. The Born in Bradford study, one of the UK’s most comprehensive birth cohort analyses, has followed 11,000 children.

Humanist Marriage

Siobhain McDonagh Excerpts

Thursday 12th June 2025 Westminster Hall

[Several hon. Members rose—]

[Dame Siobhain McDonagh (in the Chair)]

I do not think that I need to remind Members that they should bob if they wish to be called in the debate. As everyone can see, a large number of people would like to speak, so rather than impose a rigid timescale, I will be grateful if you could all be kind to one another and speak for approximately four minutes.

--- Later in debate ---

[Cat Eccles (Stourbridge) (Lab)]

It is a pleasure to serve under your chairship, Dame Siobhain. I also declare an interest as a member of the all-party parliamentary humanist group. I rise to speak about the arguments advanced in the past against legal recognition of humanist marriages and why I do not think they hold much weight. However, I will start with my personal situation.

I got married last year. My husband and I would have loved to have had a legally recognised humanist marriage, but because of the previous Government’s endless delays, we were denied that chance. A couple of years ago, I wrote to my MP—not me, but the former Conservative Member for Stourbridge—asking that the matter be resolved following the High Court ruling. The response I got was positive, saying that there was an ambition to remedy the situation, but clearly they were not ambitious enough.

My husband and I chose to marry at the Thomas Robinson building in Stourbridge, which is a beautiful old chapel converted to a register office. We asked about having a humanist celebrant lead the proceedings but were told that would not be possible. We would have needed a separate ceremony, which would have meant not only an additional cost to our budget and organising another event, but that our legally recognised marriage would not have been meaningful to our beliefs.

The registrar offered us a choice of wording for the ceremony from extremely religious to completely neutral. The neutral wording suited us best, but it stripped away all meaning and sentiment along with the religious references. As humanists, we believe in compassion, reason and ethical approaches to human life, giving people the right and responsibility to give meaning to shape their own lives, which makes the denial of humanist marriage even more ironic.

In opening the debate, my hon. Friend the Member for Tamworth (Sarah Edwards) referred to a new briefing from Melanie Field about why the Government should legally recognise humanist marriages. If anyone is an expert on this matter, it is Melanie. She literally led for the civil service on the Marriage Act and our Equality Act 2010. Her time at the EHRC further demonstrates her human rights expertise and no one else has been as intimately involved in both bits of legislation, so when she says that the case for making a humanist marriage order is overwhelming, that should surely carry some authority.

In Melanie’s briefing, she considers the 2020 High Court judgment. As we have heard, the judge ruled that

“there is a continuing discriminatory impact upon those who seek to manifest their humanist beliefs through marriage”,

but that it could be justified, “at this time”, by the then ongoing Law Commission review. Melanie says that this may now be different. Five years have passed since that judgment and three since the review concluded, and no action has since occurred. Obviously, that is first and foremost the fault of the previous Government, but the upshot, Melanie thinks, is that it is possible that the Court would now reach a different conclusion should a further case be brought, and that the case for removing the discrimination against humanists by making an order under the power in the marriage Act, even if done as an interim measure pending wider reform, therefore seems overwhelming.

Melanie considers various concerns raised against that course of action, mainly in a 2014 consultation run by the Conservatives. I will run through them briefly. First, a concern was expressed that the change would lead to inconsistencies with outdoor marriages. Those inconsistencies already exist, as we have heard, with some religious groups already able to hold outdoor marriages. Civil marriages also started happening outdoors in 2021. Secondly, she considers the concern that it would be unfair to allow humanist marriages on approved premises when religious groups cannot have them. She thinks it would be lawful because humanists may have intrinsic belief-based reasons to want their marriages on approved premises.

Thirdly, Melanie considers concerns that there may be other belief groups who could try to gain legal recognition, but no such other groups exist or have been identified. Fourthly, she refers to the supposed risk of commercialisation. Again, no evidence is offered that that would happen, and, as we have heard, in Scotland and Northern Ireland there are laws prohibiting profit and gain by religious or humanist celebrants. Finally, she considers the desirability—or otherwise—of piecemeal reform, and any added complexity that might arise in the law, but she thinks that this concern is insignificant when set against the context of people being denied their human rights.

Melanie also notes that the supposed solution to this issue, the Law Commission reforms, have been criticised by religious groups and others, including for devaluing marriage in a way that means they do not in fact appear to be a simple solution. She also notes that the previous Government pursued many piecemeal marriage reforms while saying that they were against such measures.

In conclusion, the humanist marriage order is not complex. It is a simple, cost-neutral change. It just recreates for humanists the legal provisions that already exist for Quakers. They are tried and tested, and they should be extended so that other couples are not refused their rights as I was.

[Dame Siobhain McDonagh (in the Chair)]

I am afraid that I will now impose a four-minute limit on speeches. I apologise to people for coughing, and will endeavour not to. Please do not be too distracted by me.

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[Peter Dowd (Bootle) (Lab)]

First of all, it is a pleasure to see you in the Chair this afternoon, Dame Siobhain. Secondly, it is also a pleasure to hear my hon. Friend the Member for Tamworth (Sarah Edwards) set out in this debate the reasons for humanist marriages and why they should be recognised.

On the question of humanist marriages being recognised, I ask myself why they are not. What is the problem? My hon. Friend made what I think amounts to an unimpeachable case as to why marriages of this nature should be facilitated, as other types and classifications of marriage are, and I thank Humanists UK for the briefing that it sent. I thought, “Shall I throw in some facts and figures?” No, I think other people are much better at that than I would be. It still comes back to the question of why we are debating this issue so many years on. I am not quite sure why we should have to reiterate this request time after time after time. But we are where we are, so I decided to participate in the debate with my tuppence-worth.

I wondered what my approach should be. As you know, Dame Siobhain, we think very carefully about these matters. As I said—facts, figures, statistics? I decided not to do that. Rhetoric has its place in debate. Who has not used rhetoric in their day? What about a little bit of polemic? Should I throw a little bit of polemic in? I decided not to. What about an historical examination of the nature of marriage going back thousands of years, because marriage predates, for example, any current religious timeline in relation to the concept? I decided not to do that, either.

Perhaps taking a different perspective might add a different angle to the debate—on the nature of marriage, so to speak. Indeed, who is impartial to a quote here or there from literature in one form or another? I began to think laterally, which I have to admit is a big challenge for me in most circumstances. I looked to my constituency for inspiration—it is a fantastic place to do so. A number of streets that date back to the 19th century that are named after characters in Shakespearean plays. On the surface, they are just street names. But lo and behold, they are named after characters who were married and who faced terrible challenges in getting married.

What has that got to do with what we are talking about today? That is a fair question. It elucidates that the debate must, in part, be about the nature of marriage, the commitment of marriage, and marriage in good faith. It must also be about the wishes of the people concerned to marry as they see fit, without duress and with, of course, appropriate safeguarding mechanisms. It is also about giving those who choose to do so the capacity to marry as they see fit, and for the process to be recognised as other marriages and ceremonies are.

Shakespeare uses marriage as one of the most prominent themes, if not the most prominent, in his repertoire. Does he talk about the service? No. Does he talk about the legalistic nature of it? No. He focuses on the personal nature of marriage: the relationships, the tensions, the feelings, as Beatrice and Benedick realise when they acknowledge, reluctantly, that they are to become partners in marriage. So, let us leave the last words to Shakespeare:

“Marriage is a matter of more worth

Than to be dealt in by attorneyship.”

This debate should not be much ado about nothing.

[Dame Siobhain McDonagh (in the Chair)]

Just to warn the Front Benchers, I am going to reduce your time to nine minutes in order to keep the time limit for Back Benchers at four minutes.