Mental Capacity Act 2005: Principles, Assessment, and Safeguards

Comprehensive vocabulary flashcards covering the Mental Capacity Act 2005, its core principles, functional capacity testing, best interests evaluations, Lasting Powers of Attorney, Section 5 protection, and Deprivation of Liberty Safeguards (DOLS).

Law Commission Report 'Mental Incapacity' (1995)

The consultative report that established the foundation for the Mental Capacity Act 2005 by identifying that existing law was unsystematic, full of glaring gaps, and out of touch with modern understanding of mental disability.

Scope of the Mental Capacity Act 2005

Legislation applying to individuals aged 16 and over who have difficulty making decisions, covering both day-to-day actions and major life-changing decisions.

Excluded Decisions under the MCA 2005

Decisions of an intensely personal nature that remain outside the Act's scope, including consenting to marriage or civil partnership, divorce, sexual relations, adoption, and discharging parental responsibility for a child not relating to property.

Presumption of Capacity (Section 1(2))

The statutory principle stating that a person must be assumed to have capacity unless it is proven otherwise on the balance of probabilities.

Supported Decision-Making (Section 1(3))

The statutory requirement that a person cannot be treated as unable to make a decision until all practicable steps to help them have been taken without success.

Unwise Decisions Principle (Section 1(4))

The principle establishing that an individual must not be treated as lacking capacity merely because they make a decision that others consider unwise, irrational, or illogical.

Best Interests Principle (Section 1(5))

The statutory rule mandating that any act performed or decision made on behalf of an individual who lacks capacity must be done in their best interests.

Minimum Intervention Principle (Section 1(6))

The requirement that before an act is done or a decision is made, consideration must be given to whether the objective can be achieved in a way that is less restrictive of the person's rights and freedom.

Kings College Hospital NHS Foundation Trust v C, V [2015]

A Court of Protection ruling confirming that a patient's refusal of life-sustaining dialysis based on fear of aging and losing her 'sparkle' was an unwise decision rather than proof of incapacity.

Two-Stage Test of Capacity (Section 2(1))

The assessment requiring proof that an individual is unable to make a specific decision at the material time because of an impairment of, or disturbance in the functioning of, the mind or brain.

Functional Test of Capacity

An issue-specific approach requiring capacity to be assessed for a specific decision at the precise time it needs to be made, rather than treating capacity as a general, permanent status.

Section 2(3) Stereotyping Prohibition

The statutory rule that lack of capacity cannot be established solely by reference to an individual's age, appearance, condition, or aspects of their behaviour.

Four Inability Criteria (Section 3(1))

The elements of being unable to make a decision: inability to understand relevant information, retain that information, use or weigh it, or communicate the resulting decision.

RT v LT and A Local Authority [2010]

A case demonstrating that failure in just one Section 3 criterion suffices to show inability, where a young woman's dichotomous (black-and-white) thinking prevented her from using and weighing information.

Best Interests Checklist (Section 4)

The statutory factors that must be evaluated when determining best interests, including past and present wishes, beliefs and values, other factors the person would consider, and the views of carers, LPA donees, and deputies.

Aintree University Hospitals NHS Foundation Trust v James [2013]

The first MCA 2005 case heard by the Supreme Court, holding that the assessment of a patient's wishes and feelings under the best interests test is subjective and must consider matters from the patient's point of view.

Balance Sheet Approach

A judicial method utilized in best interests evaluations (such as in An NHS Trust v K [2012]) to compare and weigh the potential benefits and risks or burdens of a proposed intervention.

Section 5 MCA 2005

A provision offering protection from legal liability to individuals performing acts in connection with care or treatment, provided they reasonably believe the person lacks capacity and the act is in their best interests.

Restraint Limitations under Section 5

The rule stating that restraint is only lawful under Section 5 if it is necessary to prevent harm to the individual and represents a proportionate response to the likelihood and seriousness of that harm.

R (Sessay) v South London & Maudsley NHS Foundation Trust [2011]

A ruling that Section 5 cannot be used by police to justify removing a mentally disordered individual from private domestic premises, as the specific powers under Section 135 or 136 of the Mental Health Act 1983 must be used instead.

Lasting Power of Attorney (LPA)

A legal instrument executed under Sections 9-14 by a capable individual aged 18 or older, conferring power on an attorney to make decisions regarding property and affairs, personal welfare, and the refusal of life-sustaining treatment.

Prescribed Person (LPA)

A certifier (most commonly a doctor) who must confirm that a donor understands the effect of the LPA and is executing it free from undue pressure or fraud.

Re DP [2014]

A case where the Court of Protection revoked an LPA after the attorney breached fiduciary duties by failing to keep accounts, paying himself an unauthorized salary, and taking gifts amounting to £38,000.

Deprivation of Liberty Safeguards (DOLS)

The statutory regime allowing hospitals and care homes to lawfully deprive an individual of their liberty for care or treatment if specific authorization criteria are satisfied.

Supervisory Body (DOLS)

The local authority or Primary Care Trust (PCT) responsible for commissioning assessments and granting standard authorisations for deprivations of liberty.

Managing Authority (DOLS)

The NHS body running a hospital or the registered care home manager responsible for applying for standard authorisations or issuing urgent authorisations.

Standard Authorisation vs. Urgent Authorisation

A standard authorisation is granted by a supervisory body for up to 12 months, whereas an urgent authorisation can be issued by a managing authority for a maximum of 7 days pending a standard application.

Six DOLS Qualifying Assessments

The mandatory six-stage assessment process requiring verification of age (over 18), mental health, mental capacity, best interests, eligibility (vis-à-vis the Mental Health Act), and no refusals.

Liberty Protection Safeguards (LPS)

The framework created under the Mental Capacity (Amendment) Act 2019 designed to replace DOLS following widespread recognition of procedural and operational issues.

JE v DE and Surrey County Council [2006]

A case confirming a deprivation of liberty occurred when a 76-year-old man was retained in a care home and refused permission to return home to his wife, despite expressing a clear desire to do so.

A Local Authority v A and B [2010]

A ruling establishing that locking an adult and a child with Smith Magenis syndrome in their bedrooms overnight did not amount to a deprivation of liberty in the context of a supportive family home.

Hillingdon LBC v Neary [2011]

A Court of Protection ruling concerning Steven Neary, an autistic 20-year-old who was unlawfully retained in residential accommodation against his father's wishes under an improper application of the best interests standard.