Compromised Capacity

Question 1

If someone lacks capacity, what do you do?

Answer 1

If someone lacks capacity to make a specific decision, a decision may have to be made in their best interests.

Question 2

What does it mean to make a decision in the best interests of the patient?

Answer 2

This means that a decision will be made on their behalf, having been considered from their point of view. The decision should be one that health and social care professionals believe is the right decision for that individual patient themselves

Question 3

Best Interests Criteria? (x5)

Answer 3

When making a best interests decision on behalf of someone who lacks capacity, five factors must be considered:

1) Equal consideration and non-discrimination
2) All relevant circumstances
3) Regaining Capcity
4) Participation
5) Wishes, Feelings, Beliefs and Values

Question 4

Equal consideration and non-discrimination means..

Answer 4

Assumptions should not be based on age, condition or behaviour

Question 5

All relevant circumstances means…

Answer 5

all things patient would take into account should be identified

Question 6

Regaining Capacity means…

Answer 6

If possibility of regaining capacity but consider delaying decision

Question 7

Participation means…

Answer 7

All steps taken to encourage/enable participation of the patient in the process

Question 8

Wishes, Feelings, Beliefs and Values means to…

Answer 8

Find and take all into consideration. Includes past views, religious or moral opinions

Question 9

Name 2 frameworks to assist in a best interests conversation?

Answer 9

Four Quadrants framework or Seedhouses ethical grade

Question 10

How would you approach a best interests conversation?

Answer 10

o Step 1 – does the patient have capacity
o Step 2 – what are the medical interventions and how effective? Prognosis, cost-effectiveness –> discuss these with the patient
o Ste 3 – consider patient as a whole! Values (aspirations), beliefs etc