Seanad debates

Wednesday, 2 December 2009

Mental Health (Involuntary Procedures) (Amendment) Bill 2008: Committee Stage

 

5:00 pm

Photo of Maria CorriganMaria Corrigan (Fianna Fail)

I welcome the opportunity the Bill provides to debate this crucial and, at times, very distressing aspect of care for people. The amendment that a programme of electroconvulsive therapy shall not be administered to a patient unless the patient gives his or her informed consent in writing to the administration is one with which we are all in agreement where the patient has capacity to consent. This demonstrates the need to move with speed on the capacity to consent legislation which we have been expecting. Much progress has been made on it and I hope it will be brought before us. It raises a vital issue for people with mental health difficulties and people with intellectual disability in terms of the basic human right it would restore to them. We need to see that legislation as quickly as possible because without it, we would find it difficult to implement this amendment.

I refer to the group of people who may not have capacity to give consent. That is where the conundrum arises. Senator Quinn referred to past research. Results are mixed but there is a very clear body of thought in the area of mental health which would attest to the effectiveness of ECT for a very limited number of patients. The conundrum for us is what process should be in place where a patient cannot give consent.

We have spoken about the idea of advanced consent. Looking at the issue of advanced consent would be very beneficial where somebody is at the initial stages of illness or has a history of illness and has the capacity to give consent when well. From my personal and professional experience, I know that for a very small number of people advanced consent would not have been an option because of the speed with which they found themselves suffering from mental health issues. The conundrum for us is what should be in place for those individuals who have not been able to give advanced consent and are not in a position to give consent at the time of proposed treatment.

The amendment proposes that we would withhold the right for ECT to be administered. I am not too sure that this is best way forward. We must have regard for the medical advice given to us. However, perhaps we should look at the provisions, whereby two consultant psychiatrists would sign off on it and at whether a different process should be in place which would see the involvement of a strong advocate for the patient who is not a consultant psychiatrist. I am not casting aspersions on the professional integrity of consultant psychiatrists and accept they act in the best interests of their patients, but I am trying to ensure our legislation provides reassurance that rights will be protected.

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