Frances Black (Independent) | Oireachtas source

I am disappointed the Minister will not accept the amendment. The age of medical consent is 16, except in respect of mental health treatment. Sixteen and 17-year-olds cannot refuse consent for hospitalisation, electroconvulsive therapy, or any other form of psychiatric treatment. This is clearly discordant and discriminatory. I really do believe that. I am Chair of the Oireachtas Sub-Committee on Mental Health, and we constantly hear about the need for parity between mental health and other health spheres. It is important we work together.

I do not deny that consent is a difficult issue. It gives people the freedom to make decisions we may find alarming or nonsensical, but the reality is it is their decision to make. A 16-year-old can refuse life-saving vaccines or blood transfusions, but under the proposed legal regime for decision support, 16- or 17-year-olds who, with the support of their family, doctor or other trusted adviser, make an advanced healthcare directive when they are well in preparation for the potential of being unwell and unable to give or refuse consent will have their wishes disregarded. This is totally unacceptable.

When Ireland decriminalised homosexuality in 1993, some Oireachtas Members mooted a differential age of consent for gay people, such as that which existed in Britain. This is an example that was rightly rejected as discriminatory. Have we not learned from that lesson? A young person experiencing a medical need should not be disadvantaged or disregarded just because their illness is mental rather than physical.

Part 8 of the mental health (amendment) Bill is set to provide for 16- and 17-year-olds to give or withdraw consent to treatment in mental health services if they are deemed to have capacity. The heads of that Bill state that the Assisted Decision-Making (Capacity) Act 2015 would apply for the purposes of conducting the necessary capacity assessments. However, the Act does not provide for decision supports for under-18s. The omission of 16- and 17-year-olds from decision-making rights is contrary to our obligations under the UN Convention on the Rights of the Child. Ireland will go before the UN Committee on the Rights of the Child in January 2023 and has committed to addressing these issues prior to that examination.

I hear what the Minister is saying and I expect to be told the issues I have raised today will be resolved, possibly in the new mental health Act. The people directly impacted by these issues cannot be told to continue waiting. We cannot reinscribe inequalities and injustices in new legislation as we wait to fix problems in foundational legislation. To fulfil the Government's promises on a progressive human-rights orientated approach to mental health, we must ensure the mental health and decision support legislation are aligned to include 16- and 17-year-olds. I hope the Minister will reconsider this amendment. I would love to have a discussion with him about this amendment again. I hope he does not close the door on it today. I would like him to reconsider it and be open to having that discussion.