Decision‐making framework in gynaecology for patients who lack mental capacity TOG 2018

Question 1

The mental capacity act 2005 applies to people above what age?

Answer 1

16

Question 2

How to assess capacity using 2 stage test

Answer 2

Step 1: Assess if there is disturbance or impairment in the function of the mind or brain

Step 2 - functional
Understand
Retain
weigh up
communicate

Capacity changes with time and decision

Question 3

5 key principles of mental capacity act

Answer 3

1. Presumption of capacity unless proved otherwise
2. Right for individuals to be supported to make their own decisions
3. Individuals retain the right to make unwise or eccentric decisions
4. All actions taken under MCA are in a patients best interests
5. Action taken on behalf of an incapacitated individual should be the least restrictive of their basic rights and freedom of action

Question 4

What decision making models can be used for incapacitated individuals?

Answer 4

Advanced care planning - Advance statements (not legally binding), advance decision to refuse treatment, Lastinging power of attorney - nominated another individual to make decision on one’s behalf in the even of loss of capacity.

Substituted judgement - another individual appointment by court of protection to made decision on behalf

Best interests - action taken under MCA on behalf of individual in their best interests