Mental Capacity Act 2005 Flashcards
What 3 things must consent be in order for a medical decision to be validly consented?
Informed, voluntary, competent
Recall the 4 criteria for confirmation of competence
Able to: Understand Retain Weigh-up Communicate information that is task-specific
What is the principle of equal consideration?
Determination of competence must not be based upon any arbitrary factor such as age, race or gender
Recall the 3 steps to follow if an individual lacks capacity
- Do everything that is practical to enable them to become competent (eg give hearing aid!)
- If possible and likely, wait for individual to regain competence
- Make decision based on their best interests
What is the Bolam principle?
The principle that states a decision is in a patient’s best interests if numerous doctors agree it is so
What is the key flaw with the Bolam principle?
A person’s medical and best interests are non necessarily the same
Give an example of a case in which the Bolam principle was used to make a decision
Re F 1990 Mental Health Involuntary Sterilisation
Recall 3 key considerations when determining best interests
- Will the individual regain capacity?
- What are their past/present beliefs?
- What are the thoughts and wishes of their family and carers?
What is the “least restrictive alternative” principle?
The decision that is in the best interests of the patient achieves the best outcome via the least restrictive intervention on their life
Recall 2 legal requirements for life-saving treatment to be ceased
- No longer in patient’s best interests
2. No motivation to bring about death
What is not required for withdrawal of life-saving treatment?
Court order
Recall the 2 types of lasting power of attorney
Welfare
Property and affairs
Under what body are LPAs registered?
Court of protection
What authority does the Court of Protection have?
Part of high court; able to make declarations as to best interests
What is the role of a court-appointed deputy?
Make decisions on medical treatments to stop it being brought before the court
What elements of the deputy’s role are defined by the court of protection?
Scope and duration of authority
What specific thing are court-appointed deputies not able to do?
Refuse life-sustaining treatment
Recall 4 medical interventions that must come before the Court of Protection if an individual lacks capacity
- Refusal or withdrawal of nutrition
- Some terminations of pregnancy
- Organ donation
- Non-therapeutic sterilisation
Who is appointed to support those who lack capacity?
Independent Medical Capacity Advocate (IMCA)
Recall 3 situations in which an IMCA may be required
There is no one else to make decisions and:
- There is a serious medical treatment decision to make
- There are proposals to move someone’s place of care for >8 weeks
- There are proposals to change where someone is living (>28 weeks)
Recall 4 elements of the role of an IMCA
- Seek to know patient’s wishes and beliefs
- Gather and evaluate all relevant information
- Find out alternative courses of action
At what point does the remit of an IMCA end?
They cannot make decisions, only advocate for someone if they believe decision-makers are not acting in their best interests
When is an advanced decision valid?
In ALL situations, over the LPA and CofP, with the only exception of the mental health act
What can advanced decisions be regarding?
Treatment REFUSALS only
