TEENAGERS AGED 16 and 17 should be allowed to consent to or decline healthcare and treatment, including contraceptive advice and psychiatric treatment, and be entitled to confidentiality on the same basis as those over 18, says the Law Reform Commission.
Its report on Children and the Law: Medical Treatment will be published by Minister for Children Frances Fitzgerald this evening. It follows the publication of a consultation paper in 2009 which was the basis for public consultation. The report, reflecting this consultation, includes a draft Bill.
The proposals are aimed at ensuring mature teenagers have their views fully taken into account when seeking medical treatment, and at providing clarity to healthcare professionals and children.
The report outlines a number of general principles that should underlie the proposed legislation, including a recognition of family as the fundamental unit of society; that the State may intervene to supply the place of parents in exceptional circumstances; and the need to take into account the rights and best interests of the child.
It stresses the evolving nature of maturity, and argues 16- and 17-year-olds should be regarded as “young persons” with the capacity to make judgments about their own health and wellbeing. Children under that age should also have their views taken into account, but should not be regarded as having the capacity to consent to or refuse medical treatment.
However, in exceptional circumstances they may have such maturity, and the report sets out the considerations that should be taken into account in assessing whether this is the case, including the nature, purpose and utility of the treatment and its risks and benefits; the stability of the child’s views and whether they reflect the child’s values and beliefs; and any other specific welfare, protection or public health considerations.
Where any person under 18 refuses life-sustaining treatment an application to the High Court would be required to decide on the validity of the refusal.
The report also recommends 16- and 17-year-olds should be enabled to make advanced care directives, specifying their treatment in the event of future loss of capacity to make decisions due to accident or progressive illness.
It recommends the development and publication of a code of practice by the Minister for Children, in consultation with the Minister for Health, based on the assistance of a broad-based working group, to provide detailed guidelines to supplement the legislation.
The report makes recommendations on the treatment of young people under the 2001 Mental Health Act, which provides for the involuntary detention of people with mental illness. This would involve amending the 2001 Act, and provides for age-appropriate facilities for children and young people suffering from mental illness, that they should receive the least intrusive and restrictive treatment possible and that the protections that apply to adults under the Act should also apply to them.