Ethics

Question 1

Mental capacity

Answer 1

ability to make decisions and can involve consent about personal welfare, healthcare and financial decisions

Question 2

Situations where treatment can take place without consent

Answer 2

1. Treatment under mental capacity act
2. Treatment under MHA
3. Treatment authorised by the court

Question 3

When to suspect lack of capacity

Answer 3

CARD
Cognitive impairment
Abnormal behaviour
Refusing treatment
Delirium

Question 4

5 principle of MCA

Answer 4

I HELP
best Interest
Help to make decisions
Eccentric or unwise decisions are allowed
Least restricitive option
Presumption of capacity

Question 5

Types of lasting power of attorney

Answer 5

1. Property and affairs
2. Personal welfare

Question 6

Advance care planning

Answer 6

Advance statement or advance decision to refuse treatment or appointing lasting power of attorney
Legal document with a specific refusal of treatment.
Can refuse things but not demand it - cannot refuse basic needs - food / drink etc

Question 7

Advance statement vs Advance decision

Answer 7

Advance statement is not legally binding unlike decisions

Question 8

DoLS

Answer 8

Deprivation of liberty safeguard
Make sure people in care homes, hospitals and supported living who lack capacity does not affect their freedom

Question 9

IMCA

Answer 9

Independent mental capacity act
Someone appointed to support a person who lacks capacity but has nobody to speak on their behalf.

Question 10

Mental disorder definition

Answer 10

Any disorder or disability of the mind.
It includes, mental illness, personality disorder, LD and disorders of sexual preference, BUT NOT alcohol or drug dependence.

Question 11

When to use MHA

Answer 11

Revise Our Mental Health Act

Refusal of voluntary treatment

Other options have been considered

Mental disorder -MCA

Harm - risk of

Appropriate treatment - available

Question 12

Section 2

Answer 12

Admission for assessment
Nonrenewable
Assessment
An AMHP or rarely NR makes application on recommendation of 2 doctors
One of the doctors should be approved under section 12 of MHA
Duration is 28 days

Question 13

Section 3

Answer 13

Admission for treatment which is renewable
Treatment
6 months
An AMHP or rarely NR makes application on recommendation of 2 doctors
One of the doctors should be approved under section 12 of MHA

Question 14

Section 4

Answer 14

Used as emergency when section 2 would involve an unacceptable delay.
Emergency
GP, AMHP or NR
72 hours

Question 15

Section 5(2)

Answer 15

A patient who is a voluntary patient in hospital can be legally detained by a doctor
holding
doctor - responsible clinician
72 hours

Question 16

5 (4)

Answer 16

Similar to 5 2 but by nursing staff
6 hours

Question 17

Section 135

Answer 17

A court order can be obtained to allow the police to break into a property to remove a person to a place of safety
Police
Magistrate / police officer
72 hours

Question 18

Section 136

Answer 18

Someone found in a public place who appears to have a mental disorder can be taken by the police to a place of safety
Police
Police officer
72 hours

Question 19

Psychiatric inpatient settings

Answer 19

Open ward
Low secure
Medium secure
High secure

Question 20

Low secure facilities

Answer 20

Less physical security, but more standard than open secure. Often transferred here if other mental health services cannot treat due to challenging behaviour or risk to others

Question 21

Medium secure facilities

Answer 21

Not as secure as high.
Air locked entrances, unbreakable windows, high nurse to pt ratios with restraint training for staff

Question 22

High secure facilities

Answer 22

For those who present with an immediate and grave danger to general public because they are violent, unstable or dangerous.

Question 23

Where does 5 2 not allow

Answer 23

A+E
Admit to ward and then detain.
Or
Use MCA

Question 24

Requirements for capacity

Answer 24

*understand the information that is relevant to the decision they want to
make
*retain the information long enough to be able to make the decision
*weigh up the information available to make the decision
*communicate their decision by any possible means, including talking, using
sign language, or through simple muscle movements such as blinking an
eye or squeezing a hand.

Question 25

Reasons to question capacity

Answer 25

If disorder of the mind or the brain.