Mindel Scott

Legal Age to Refuse Medical Treatment in Ireland

“The Mental Health Act was considered progressive legislation when it was drafted, but legislation needs to be implemented, resourced and adapted after evidence-based reviews of how it works in practice. Unfortunately, this has not been the case so far, meaning that many vulnerable children who would otherwise have a say in their medical treatment do not have adequate legal safeguards for their mental health treatment. The Law Society of Ireland has warned that persistent delays in reforming the Mental Health Act 2001 mean that “if a child actively objects to detention for mental health care or treatment, even if he or she has the opportunity to consent and appeal, he or she may be imprisoned with the consent of his or her parents. In this regard, a 17-year-old does have the same rights as a seven-year-old child. Children under the age of 16 may consent to their own treatment if they are considered to have sufficient intelligence, competence and understanding to understand what is associated with their treatment. This is called competent Gillick. It is clear that if you are a mentally competent adult, you have the right to refuse or discontinue medical treatment, even if the inevitable consequence is that you will die. It`s different from taking positive steps to end your life or someone else`s. In general, a physician cannot override the parental consent requirement for a young child. However, the best interests of the child are the fundamental guiding principle and the requirement of parental consent may be waived if the child`s life is in danger. If a person performs medical or surgical interventions without consent, he can be charged with the crime of aggression – the decision on the indictment is made by the director of the prosecutor`s office. Persons aged 16 and over have the right to consent to their own treatment.

It may be waived only in exceptional cases. The HSE Directive states that only in life-threatening emergency situations where treatment is immediately necessary to preserve life or health, and the patient is incapable or consent would delay treatment in an unacceptable manner, can a doctor treat without the patient`s explicit consent. The Medical Association provided guidance on consent in its 2019 Guide to Professional Conduct and Ethics for Registered Physicians. This includes in Appendix C a list of specific information that physicians should provide to patients when seeking consent to medical treatment. Some of these lists include: A living will may be valid and enforceable because you may have withdrawn your consent to a particular medical or surgical treatment. It is not possible to say with absolute certainty that such a directive will be applied, because it depends exactly on what it says and whether it responds to the exact circumstances you are facing. If a parent refuses to consent to a particular treatment, this decision may be overturned by the courts if it is considered that the treatment is in the best interests of the child. Consent is an expression of a patient`s autonomy and right to choose the best treatment for them. It is very important to remember that this is not always the treatment that doctors consider best. If there is reason to believe that a parent`s refusal to consent to the medical treatment of a child endangers the child, the health authority may apply to the District Court for an emergency order. If the care order is issued, the child is temporarily placed in the care of the health authority, which can then accept the child`s medical treatment.6 In an emergency situation where treatment is life-saving and waiting for parental consent would put the child at risk, treatment may continue without consent. As with other medical procedures, a child can consent to an abortion from the age of 16.

However, the physician providing the service must be able to believe that the child fully understands the information in order to give valid consent. A child 16 years of age or older, but under 18 years of age, is generally encouraged to involve his or her parents or another supporting adult. However, if the child is over 16 years of age, they may choose not to include an adult. In the above-mentioned Supreme Court case, the child in question was a toddler and was therefore not in a position to express an opinion for himself. However, the views of children who are able to understand the nature and effects of proposed treatment should carry significant weight in any decision about what is in their best interests, even if they do not have a legal right to consent to treatment (see Box 4). If you are mentally incapable, you will not be able to make a decision about refusing or withdrawing medical treatment. It is not clear from the law who exactly is responsible for this. In general, a doctor may decide that treatment should be stopped for medical reasons. By law, health professionals only need 1 person with parental responsibility to give consent to treatment.

You could also be sued for the tort of bodily harm and/or assault and possibly for violation of constitutional rights. If the person concerned is a medical professional, he or she can also be sued for negligence. The patient can take these steps. If a young person refuses treatment that could result in death or serious and permanent injury, his or her decision may be overturned by the Protection Court. An advance health care directive is a document in which a person sets out their wishes to continue or not to pursue medical treatment in the event of mental incapacity. If it is not possible to reach agreement on a particular treatment or on what is in the best interests of the child, the courts may make a decision. Áine Hynes SC, Chair of the Mental Health Law and Capacity Working Group, said: “Under the current Mental Health Act, changes in a child`s capacity and maturity are not taken into account. Regardless of age, a person under the age of 18 may be considered a volunteer patient if parental consent is obtained. In reality, this means that when it comes to mental health care and treatment, a 17-year-old does have the same rights as a seven-year-old. For example, while a 16-year-old has the right to consent to medical treatment, the Mental Health Act does not contain such provisions and instead places the burden of consent on parents.