Trevor Ó Clochartaigh (Sinn Fein) | Oireachtas source

I support amendment No. 203 proposed by Senators van Turnhout and Zappone. I have outlined my reasons previously which are similar in vein to the advance health care directives. There are concerns that the impending legislative provisions on advance health care directives discriminate against anybody who may experience mental ill health. Given that one in four Irish people experience some form of mental health difficulty during their life this issue could apply to any of us. It is felt by a number of experts that the proposed legislation blatantly excludes the use of legally binding advance health care directives for the treatment choices of those subject to involuntary detention under the Mental Health Act 2001. These experts believe it is clearly discriminatory under the EU Convention on the Rights of Persons with Disabilities, which the Government is planning to ratify in the near future.

The use of differential standards reinforces stigma and the notion that the preferences of individuals with mental health conditions are not respected on an equal basis with others. There were 80,457 admissions to Irish psychiatric units and hospitals in 2013, of whom 11% were involuntary. Similar legislation in the United States was litigated as discriminatory under the Americans with Disabilities Act of 1990 in the case of Hargrave v Vermont in 2003. After filing a legal challenge for differential treatment in the United States Court of Appeals, Ms Nancy Hargrave asserted:

It seems fundamentally unfair that I choose or refuse chemotherapy which is saving my life, but I do not have the same right to choose or refuse psychiatric medication.

The findings of a national study published in The Journal of Ethicson medicine and public health suggests an urgent need for legally binding advance health care directives for those who have been involuntarily detained under the mental health legislation in order to provide a sense of control over future treatment, to enhance recovery and to promote trust and respect. There is a compelling argument. The Minister has said she has looked at the issue in great detail. There seems to be quite a body of evidence internationally that supports the call. There are many people in Ireland also making that call and it warrants further debate and thought between here and Report Stage. I support the calls to have it looked at again.