Mental Capacity Act - Capacity and best intrest

What is valid consent?

Consent that must be given before medical treatment/ personal care - ensuring people have a say in there own body

What is the definition of lacking capacity?

when patients are unable to make a specific choice or an action at a specific time

What are the 3 principles to get valid consent?

It must be voluntary consent, an informed choice of what they are consenting too, and they must have capacity to make that choice

What decisions are covered in the MCA 2005?

day-to-day decisions as well as life-changing deceptions

What decisions are not covered by the MCA 2005?

• very personal or intimate decisions

• Decisions around family or relationships

• Voting choices

*unless for safeguarding people without capacity

What are the 5 key principles of the MCA 2005?

• They must be assumed to have capacity unless otherwise proven

• Before deciding if they can make there own decision all practical steps must be taken to help them communicate

• A person should not be treated as if they cannot make a decision just because they make an unwise one

• Decisions that are made for those without capacity must be in there best interest

• When a decision is made the least restrictive action should be taken

What questions need to be asked when assessing mental capacity?

• is the person able to make the decision with support?

• If they cannot make the decision is it due to an impairment of the mind/ brain?

• Is there an inability to make choices due to the impairment of the mind/ brain?

• Are they able to understand relevant information

• Are they able to weigh up the choices

• Is there ability to communicate affected

What is the code of practice in the MCA?

The code helps to guide professions and it is there legal duty to regard the code

However, it is just guidance. But if it is not followed there needs to be sufficient evidence to back this up

When is best-interest not needed?

• If there is an advanced decision to reject/ remove care

• Id there is a valid lasting power if attorney for health and welfare

• If there is a court appointed deputy

What is a best-interest determination?

A decision made in a patients best-interest when wishes have not been expressly laid out - there is not one definition but there are a range of factors to be considered

What factors should be considered when making a best-interest decision?

• will they regain capacity

• Patients encouraged to participate where possible

• The decisions being made are not motivated by death

• Ascertaining

  • past/ present wishes

  • Beliefs and values

• Others must be consulted

  • Named individuals

  • Caring/ welfare workers

  • LPA - in finance

  • IMCA

What is the criminial offence for the MCA?

Ill-treatment and or lawful neglet of someone lacking capacity can cause up to 5 years incarceratoin

What are the safeguards under the MCA

-IMCA

-DOLS

Advance care planning

Court protection

When is an Independent Mental Capacity advocate needed?

• When there are no friend or family

• Serious life-choices are made

• DOLS

• Arranging accommodation for more than 28 days in hospital and more than 8 weeks in a care home

When may you want to consult an Independent Mental Capacity Advocate

• adult protection

  • Due to abuse

• Care review

Do best intrastent treatments need to be for physical health?

No best interest treatments can be to improve the quality of life but it is subjective to the patients wishes and beliefs when acting out best interests