Best interests provisions in the UK Mental Capacity Act 2005

2012 ◽  
Vol 36 (12) ◽  
pp. 459-462
Author(s):  
Olufunso B. Aribisala
Keyword(s):  
Decision Making ◽  
Mental Capacity ◽  
Best Interests ◽  
England And Wales ◽  
Reasonable Belief ◽  
Mental Capacity Act 2005 ◽  
Mental Capacity Act ◽  
The Uk

SummaryThe Mental Capacity Act 2005 is a critical statute law for psychiatrists in England and Wales. Its best interests provision is fundamental to substitute decision-making for incapacitated adults. It prescribes a process of and gives structure to substitute decision-making. The participation of the incapacitated adult must be encouraged where practicable. In addition to this, ‘the best interests checklist’ must be applied in every case before a practitioner can arrive at a reasonable belief that the action or decision taken on behalf of an incapacitated adult is in his best interests. Most commentators have shown goodwill towards the workings of the Act and want it to succeed.

Mental capacity and decision-making

2020 ◽  
pp. 823-840
Author(s):  
Charlotte Emmett ◽  
Julian C Hughes
Keyword(s):  
Decision Making ◽  
Mental Capacity ◽  
Best Interests ◽  
Disability Rights ◽  
Persons With Disabilities ◽  
Disability Rights Movement ◽  
Mental Capacity Act 2005 ◽  
Mental Capacity Act ◽  
The Uk ◽  
Legal Consequences

This chapter takes the reader through the elements that make up mental capacity and underpin, therefore, decision-making. The provisions of the Mental Capacity Act 2005 (MCA) are considered in some detail, but the laws governing other jurisdictions in the UK are mentioned. It discusses the legal consequences of incapacity, both for the older person concerned and others, are considered and broader principles (e.g. to do with best interests) governing the use of restraint, deprivation of liberty, and support for decision making. Finally, we turn our attention to how international human rights legislation, and the international disability rights movement generally, increasingly shape the legal approach to capacity and decision making in the UK. The chapter ends, therefore, by considering the UN Convention on the Rights of Persons with Disabilities and the compatibility of the MCA with its provisions.

scholarly journals The Mental Capacity Act and mental healthcare in prison: opportunities and challenges

2012 ◽  
Vol 36 (7) ◽  
pp. 241-243 ◽  
Author(s):  
Sharon Davies ◽  
Claire Dimond
Keyword(s):  
Mental Health ◽  
Mental Illness ◽  
Mental Healthcare ◽  
Legal Framework ◽  
Mental Capacity ◽  
Best Interests ◽  
People With Mental Illness ◽  
Mental Capacity Act 2005 ◽  
Mental Capacity Act ◽  
The Uk

SummaryThe UK Mental Health Act 1983 does not apply in prison. The legal framework for the care and treatment of people with mental illness in prison is provided by the Mental Capacity Act 2005. We raise dilemmas about its use. We highlight how assessing best interests and defining harm involves making challenging judgements. How best interests and harm are interpreted has a potentially significant impact on clinical practice within a prison context.

scholarly journals Mental Capacity Act 2005: The Statutory Principles and Best Interests Test

2014 ◽  
Vol 1 (13) ◽  
pp. 150
Author(s):  
Penny Letts
Keyword(s):  
Decision Making ◽  
Mental Capacity ◽  
Best Interests ◽  
Decision Making Process ◽  
Mental Capacity Act 2005 ◽  
Mental Capacity Act

<p align="LEFT">The Mental Capacity Act 2005, due for implementation in 2007, will create a new statutory framework intended to improve and clarify the decision-making process for people aged 16 and over who are unable to make decisions for themselves. Section 1 of the Act sets out five statutory principles intended to underline the provisions of the Act and guide its implementation and operation. The first part of this paper will look at the origins of each of the statutory principles. The second part will consider one of the principles – acting in the best interests of a person lacking capacity – in greater detail by looking at the requirements set out in the Act for determining a person’s best interests.</p>

The early experience of Old Age Psychiatrists in the application of the Mental Capacity Act 2005: a pilot study

2009 ◽  
Vol 22 (1) ◽  
pp. 147-157 ◽  
Author(s):  
Ajit Shah ◽  
Natalie Banner ◽  
Chris Heginbotham ◽  
Bill Fulford
Keyword(s):  
Decision Making ◽  
Old Age ◽  
Social Care ◽  
Mental Capacity ◽  
Best Interests ◽  
Decision Making Capacity ◽  
Mental Capacity Act 2005 ◽  
Old Age Psychiatry ◽  
Mental Capacity Act

ABSTRACTBackground: The Mental Capacity Act 2005 (MCA) was fully implemented in October 2007 in England and Wales.Methods: A pilot questionnaire study examined the experience of consultants in Old Age Psychiatry in the early implementation of the MCA pertaining to local policy and training in the application of the MCA, the assessment of decision-making capacity, the determination of best interests, and the use of the least restrictive option and restraint.Results: Fifty-two (27%) of the 196 consultants in Old Age Psychiatry returned useable questionnaires. Seventy-five percent of them reported that local training on the application of the MCA was available, but less than 50% reported that training was mandatory. The vast majority of assessments of decision-making capacity were conducted by consultants in Old Age Psychiatry. Almost all of them reported using the four-fold specific test of decision-making capacity (DMC) described in the MCA. Restraint was reported to be rarely used.Conclusions: Consultants in Old Age Psychiatry generally reported using the criteria for the assessment of DMC, the determination of best interests and restraint described in the MCA. The findings highlight concern about the workload of clinicians in implementing the MCA and this requires careful monitoring. Consideration should be given to statutory provision of training in the application of the MCA by all healthcare and social care providers for all their healthcare and social care staff.

The Mental Capacity Act 2005: Relevance for the Surgeon

2009 ◽  
Vol 91 (5) ◽  
pp. 176-179
Author(s):  
SS Jameson ◽  
UK Amarasuriya ◽  
H Vint ◽  
MR Reed
Keyword(s):  
Surgical Treatment ◽  
Emergency Surgery ◽  
Common Law ◽  
Mental Capacity ◽  
Best Interests ◽  
Surgical Team ◽  
England And Wales ◽  
The Past ◽  
Mental Capacity Act 2005 ◽  
Mental Capacity Act

Patients who lack the capacity to make decisions regarding surgical treatment are complex to manage. In the past, under common law in England and Wales, these patients underwent emergency surgery if in the patient's 'best interests,' as decided by the surgical team. Surgeons in England and Wales now need to understand the changes introduced in October 2007 by the Mental Capacity Act 2005 (MCA).

scholarly journals Capacity issues at the front door

2019 ◽  
Vol 80 (9) ◽  
pp. 513-516
Author(s):  
Peter Lepping
Keyword(s):  
Decision Making ◽  
Cognitive Impairment ◽  
Decision Maker ◽  
Acute Infection ◽  
Mental Capacity ◽  
Best Interests ◽  
Decision Making Capacity ◽  
Mental Capacity Act 2005 ◽  
Mental Capacity Act ◽  
Psychiatric Problems

Decision-making capacity is often overestimated by clinicians. An average of one third of patients lack capacity to make complex decisions and clinicians should be alert to such a possibility. Cognitive impairment, acute infection, intoxication and other common medical and psychiatric problems can impair patients' capacity. The Mental Capacity Act 2005 has to be applied when treating patients who lack capacity. The main decision maker for a proposed treatment or investigation is responsible for assessing capacity. However, all clinicians have to consider and assess capacity, and act in a patient's best interests if he/she lacks capacity.

scholarly journals FROM BEST INTERESTS TO BETTER INTERESTS? VALUES, UNWISDOM AND OBJECTIVITY IN MENTAL CAPACITY LAW

2021 ◽  
pp. 1-29
Author(s):  
John Coggon ◽  
Camillia Kong
Keyword(s):  
Decision Making ◽  
Mental Capacity ◽  
Best Interests ◽  
Philosophical Critique ◽  
Parliamentary Debates ◽  
Capacity Decisions ◽  
Mental Capacity Act 2005 ◽  
Mental Capacity Act ◽  
Personal Decision ◽  
Made In

Abstract The Mental Capacity Act 2005 governs personal decision-making for adults. It incorporates five overarching principles, including that incapacity may not be inferred merely from a person's unwise decisions and that where a person lacks capacity decisions must be made in her best interests. Through analysis of judicial treatment of unwisdom, best interests, subjectivity and objectivity, considered against parliamentary debates on the Mental Capacity Bill and philosophical critique of ideas of (un)wisdom, we argue that these principles are problematically irreconcilable. The Act's radical under-specificity means, paradoxically, that this comes to be resolved through abstracted values, rather than the centricity of the person herself.

scholarly journals Best interests versus resource allocation: could COVID-19 cloud decision-making for the cognitively impaired?

2020 ◽  
Vol 46 (7) ◽  
pp. 447-450 ◽  
Author(s):  
Jordan A Parsons ◽  
Harleen Kaur Johal
Keyword(s):  
Decision Making ◽  
At Risk ◽  
Mental Capacity ◽  
Best Interests ◽  
Health Conditions ◽  
Cognitively Impaired ◽  
Invasive Ventilation ◽  
Mental Capacity Act 2005 ◽  
The Media ◽  
Mental Capacity Act

The COVID-19 pandemic is putting the NHS under unprecedented pressure, requiring clinicians to make uncomfortable decisions they would not ordinarily face. These decisions revolve primarily around intensive care and whether a patient should undergo invasive ventilation. Certain vulnerable populations have featured in the media as falling victim to an increasingly utilitarian response to the pandemic—primarily those of advanced years or with serious existing health conditions. Another vulnerable population potentially at risk is those who lack the capacity to make their own care decisions. Owing to the pandemic, there are increased practical and normative challenges to following the requirements of the Mental Capacity Act 2005. Both capacity assessments and best interests decisions may prove more difficult in the current situation. This may create a more paternalistic situation in decisions about the care of the cognitively impaired which is at risk of taking on a utilitarian focus. We look to these issues and consider whether there is a risk of patients who lack capacity to make their own care decisions being short-changed.

scholarly journals Mental capacity legislation in the UK: systematic review of the experiences of adults lacking capacity and their carers

2017 ◽  
Vol 41 (5) ◽  
pp. 260-266 ◽  
Author(s):  
Sam Wilson
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Mental Capacity ◽  
Quality Data ◽  
Relevant Research ◽  
Negative Experiences ◽  
Mental Capacity Act 2005 ◽  
Potential Benefits ◽  
Mental Capacity Act ◽  
The Uk

Aims and methodCapacity legislation in the UK allows substitute decision-making for adults lacking capacity. Research has explored the experiences of such adults and their carers in relation to the Adults with Incapacity (Scotland) Act 2000, and the Mental Capacity Act 2005 in England and Wales. A systematic review of the relevant research was performed using a framework method.ResultsThe legislation provided mechanisms for substitute decision-making which were seen as useful, but there were negative experiences. Decision-making did not always seem to follow the legislative principles. Awareness of the legislation was limited. Most research was qualitative and some was of low methodological quality. Data were too heterogeneous to allow comparisons between English and Scottish law.Clinical implicationsCapacity legislation was generally viewed positively. However, some experiences were perceived negatively, and the potential benefits of the legislation were not always utilised.

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