If they can consent, why can’t they refuse?
in Ethical and legal debates in Irish healthcare
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This chapter considers how inconsistencies can be resolved in the context of refusal of medical treatment by young people over sixteen by looking at the roles consent plays in medicine. In some cases the question of whether that refusal should be respected is purely academic – for practical reasons the treatment cannot be given. But where treatment could be provided in the light of such a refusal it is unclear whether it is permissible to do so. This is because it seems inconsistent both to say that a patient can consent to treatment but not refuse it, and to say that we ought to seek consent even where a refusal to provide it may be overridden. The chapter argues that there is a relatively straightforward argument to support the idea that young people can consent to, but not effectively refuse, medical treatment. What will turn out to require further explanation, at least on standard ways of approaching medical ethics, is the idea that it is always morally wrong to give an adult treatment that she refuses.

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