mental capacity Flashcards
what is the mental capacity act 2005?
it is a statute law that came into force in 2007 for anyone over the age of 16 in england and wales that is unable to make one or all of their decisions themselves - it is assessment and provision for when they are no longer able to
what is best interests?
it is anything done for patient lacking capacity must be done in their best interests - the exception would be if they have made a valid and applicable advance decision to refuse treatment
what should be considered in best interest decisions?
their past and present beliefs, morals and values likely to influence as well as other factors
what should be encouraged in best interest decisions?
encourage participation and avoid discrimination of pre assumptions - can it wait if they will regain consciousness and the consultation with others involved in care
what is a best interest decision?
it is an objective decision - not based on what they would have chosen
what is LPA?
lasting power of attorney - anyone over the age of 18 who can make their decisions if they are not capable or do not want to - can be overruled by court if deemed not in best interest and is not about life sustaining treatment unless explicitly mentioned in document
what are the two LPA types?
heath and welfare - treatment and medical decisions and property and financial management
what is the least restrictive option?
act in a way that that least interfere with the persons rights and freedoms however may be that the best interest is not the least restrictive option
what was the outcome of the 1994 Rec C case?
information must be given in a way that is understood at the time and must be aware of the consequences one way or another - there may be a general lack of capacity but is judged on each individual decision - unwise does not mean lacks capacity
what was the basis of the Rec C case?
a 68 year old man was in hospital for 30 year for paranoid schizophrenia. He had a gangrenous foot and without surgery doctors said would have 15% chance of survival. Did not want amputation as God would chose outcome of trials. Solicitor was granted and no amputation occurred
what are advance decisions?
decisions made to refuse treatment even if will result in death from someone who is capable and at least 18 years old - anything including ANH except if keeps person comfortable - best interests do not apply as holds the same weight as if a competent person were deciding - ignoring can result in prosecution
what is a living will?
it is expressing a wish for a certain treatment if in situation - is considered but does not necessarily have to be followed
what form must an advance decision be in?
not necessary to be in writing but verbally expressed must be in notes. The exception is in life sustaining treatment refusal where must be signed and have a witness and statement stating know risks. They do not need to supply evidence to say they are capable at point of decision making but if known the doctor can assess
what makes a decision valid and applicable?
for advance to be effective it must meet this criteria
if withdrawn prior to losing capacity, LPA refuses, expression made are inconsistent with the decision, regain capacity, circumstances applied are absent, reasonable grounds for believing circumstances were not anticipated then is refused
what must be considered in advance decision?
how long ago, changes to personal life, developments in treatment
