Law Reform Commission of Ireland Report on Children and Medical Treatment
Among the recommendations in the Report are:
- 16 and 17 year olds: the Commission recommends that 16 and 17 year olds should be presumed to have full capacity (based on a functional test that they understand the health care decision and its consequences) to consent to, and refuse, health care and medical treatment. This includes: advice, over-the-counter medicine, surgery, access to contraception and mental health services.
- Those under 16: the Commission recommends that those under 16 should not be presumed competent to consent to, or refuse, medical treatment; but that, in exceptional circumstances they may be able to give their consent or refusal, based on an assessment of their maturity, and a presumption that their parents or guardians will usually be involved.
- The assessment of whether a person under 16 is sufficiently mature to consent to or refuse medical treatment would have to take account of the following factors: (a) whether he or she has sufficient maturity to understand the information relevant to making the specific decision and to appreciate its potential consequences; (b) whether his or her views are stable and reflect his or her values and beliefs; (c) the nature, purpose and utility of the treatment; (d) the risks and benefits involved in the treatment; and (e) 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 any such refusal.
- The Commission recommends that the Mental Health Act 2001 be amended to make specific provision for people under 18: for example, that a Mental Heath Tribunal (with an age appropriate focus) rather than the District Court should review their admission and treatment.