Ethico-legal and MCA

Question 1

Principalism

4 parts of medical ethics

Answer 1

autonomy
beneficence
non-maleficence
justice

Question 2

Define mental capacity

What is the test for mental capacity?

Answer 2

ability to make a specific decision at a specific time

-Two stage test:
Does the person have impairment/disturbance of the mind or brain affecting how it works?
If yes - does that mean the person is unable to make the decision at the time needs to be made (URDC) or four Rs
-Receive - understand information given to them?
-Retain - can they retain this information long enough to make a decision
-Rationalise - can they wigh up the information? - pros and cons maybe?
-Relate - can they commmunicate back to you?

Question 3

5 main principles of Mental capacity act?

Answer 3

1. A presumption of capacity
2. The right for individuals to be supported to make their own decisions - do everything to aid this
3. Should not be assumed that someone lacks capacity simply because their decisions may seem unwise or eccentric
4. If someone lack capacity, stuff done on behalf must be in best interests
5. If someone lacks capacity, all options must be considered before a decision is made - the lease restrictive option

Question 4

MCA - provisions - who can make decisions for people who lack capacity?

Answer 4

Independent mental capacity advocates (IMCAs)
Lasting power of attorney
Advance decisions to refuse wills (‘living wills’)
Court of protection - specialist court for all issues relating to people who lack capacity to make specific decisions.
DOLs - The Deprivation of Liberty Safeguards - aim to make sure that people in care homes and hospitals are looked after in a way that does not inappropriately restrict their freedom.

Question 5

Driving in dementia

Answer 5

risk, insight, attention, memory, visuospatial, routes

insurance; assessment and re-assessment

Question 6

diagnosis disclosure e.g. dementia

Pros of it

Answer 6

pos: support, Rx preferences, legal provisions (LPA etc.), planing,

Question 7

Four compenents needed for capacity

Answer 7

• Receive - understand information given to them?
  
  • Retain - can they retain this information long enough to make a decision
  • Rationalise - can they wigh up the information? - pros and cons maybe?
  • Relate - can they commmunicate back to you?