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26 September 2011

– New legislation must allow young people to consent to medical treatment if their health is likely to suffer

Ambiguous laws regarding young people and contraception are putting young people at risk of STIs and unplanned pregnancies, according to the Irish Family Planning Association (IFPA) which today (26.09.11) released the findings of a survey of young people attending its services.

The legal status of prescribing contraception to young people under the age of 16 in Ireland is very unclear. This lack of clarity is a serious deterrent to young people in need of sexual health services. It also poses a major dilemma for doctors who are ethically required to provide a confidential service which is in the best interest of their client. The situation is further complicated by the fact that the age of sexual consent in Ireland is 17.

It is the IFPA’s experience that young people would rather run the risk of unplanned pregnancies and STIs, than face the possibility of their parents finding out about their sexual activities. Young people are also concerned that doctors could refuse treatment or report a consensual relationship between people aged under 17. Meanwhile, doctors who provide sexual health services do so in a legal vacuum.

The IFPA welcomes proposed legislative reforms from the Law Reform Commission that would allow for the views of mature teenagers to be taken into account in the context of consenting to medical treatment. However, some of the proposed terminology is unclear and undermines the effectiveness of the proposals. The IFPA proposes that any new legislation must allow for young people to consent to medical treatment if their mental or physical health is likely to suffer if medical treatment is refused.

A survey of 251 consultations with young people at the IFPA’s city centre clinic over the last five years, released in tandem with the publication of the IFPA’s annual report, gives a clear indication of the sexual health needs of young people:

  • Almost half (48%) of young people who attended IFPA’s Cathal Brugha Street Clinic sought ongoing contraception services. A further 32% attended for emergency contraception services and 9% for pregnancy services. 3% attended for menstrual issues. 3% attended for STI services. 5% attended for other services (infections, bloods, HPV vaccine, breast problems and general consultation)
  • Young people who attended with a guardian or older family member were most likely to be accompanied by their mother (80% of accompanied clients). 7% of clients who were accompanied attended with a social or care worker and 6% of clients who attended with someone were accompanied by their father. 3% were accompanied by their sister. 3% were accompanied by their aunt. And 1% were accompanied by other guardians or family members.
  • A total of 65% of young people who attended our clinic attended on their own. In the under 16 age group 54% of clients were unaccompanied. In these cases the doctor had to decide whether to provide services based on the young person’s maturity.
  • Young people represent a small but significant proportion of our clients. It is the IFPA’s experience that sexually active young people are engaging in consensual sex and with similar aged partners and are unlikely to stop sexual activity in the absence of accessible sexual health service. It is also the IFPA’s experience that young people have an evolving capacity to understand the nature and consequences of the medical treatment being offered.

IFPA Medical Director Dr Caitriona Henchion said: “Young people should not have to face uncertainty about services and should be entitled to avail of confidential services without fear of betrayal and without threat of refusal of care. In addition, medical professionals deserve the protection of the law when they supply services which, after careful assessment, they decide are in young people’s best interests.

“Barriers to sexual health services are dangerous to the health and welfare of young people because they increase their risk of unplanned pregnancies and STIs. Giving young people the ability to consent to their own medical care would be a major step towards keeping young people safe and healthy.”

About the Law Reform Commission's proposed legislation:

In July 2011, the Law Reform Commission recommended legislative reforms that would allow for the views of mature teenagers to be taken into account in the context of consenting to medical treatment, including surgery and contraception, over-the-counter medicine and mental health services.

The commission’s proposed legislative changes would allow 16- and 17-year-olds to consent to and refuse medical treatment and also proposed that young people aged under 16 may be able to give their consent or refusal to medical treatment in exceptional circumstances, based on an assessment of their maturity.

About the IFPA

The IFPA is Ireland’s leading sexual health charity. The organisation promotes the right of all people to sexual and reproductive health information and dedicated, confidential and affordable healthcare service.

Since its foundation in 1969 the IFPA has been to the fore in setting the agenda for sexual and reproductive health and rights both nationally and internationally. Today the IFPA offers a comprehensive range of services which promote sexual health and support reproductive choice on a not-for-profit basis through its medical service, crisis pregnancy counselling, education and training and policy work.

The IFPA provides medical services from its clinics in Dublin city centre and Tallaght as well as crisis pregnancy counselling services at 11 centres nationwide.