Mental Capacity Act Flashcards
When did the MCA come into force?
2007
Who does the MCA apply to?
People aged over 16 in England and Wales who are unable to make decisions for themselves
Purpose of the MCA
Deal with assessment of a person’s capacity, sets out provisions to plan ahead and a safeguard
Stage one of the capacity test
Is there an impairment or disturbance in the functioning of the person’s brain/mind? If so does it undermine capacity
Stage two of the capacity test
Functional test- can they understand, retain and weigh up any information given. Also can they communicate a decision.
All answers must be yes to have capacity.
Who decides for those lacking capacity?
Legally, their Legal Power of Attorney or if they do not have one it is their doctor, who should follow the patients best interests.
Considering best interests with MCA
Consider past wishes, particularly written statements
Beliefs and values must be considered
Avoid discrimination
Assess whether the person will regain capacity
Types of lasting power of Attorney
Property and financial affairs
Health and welfare
Lasting power of attorney
MCA allows people over 18 to choose a person they trust to make decisions on their behalf if in the future they lose capacity or do not wish to make a decision themselves (MCA applies to over 16 but LPA is over 18)
Health and welfare lasting power of attorney
LPA can make decisions about medical treatment but not life sustaining treatment unless this is explicitly stated in the document conferring the LPA
Decisions can be challenged in court by doctors if deemed not in the patients best interests
Least restrictive option
Always try to do as little as possible to take over the patients decisions but this can be overruled if a more drastic decision is in the patients best interests
Form of advance decision
Verbally expressed advance refusals must be recorded in notes
Refusal of life sustaining treatment must be written and signed by the person and a witness and include a statement that the decision is applied even if the patients life is at risk
Does a patients capacity have to be assessed with an advanced written decision
No as capacity is presumed unless it is life sustaining treatment
A doctor may assess if decisions are expressed to them if they wish
When is an advanced decision not valid?
If withdrawn prior to losing capacity- not needed in writing
Appointed someone with LPA to give/refuse consent to that specific treatment after writing the advanced decision
Has made inconsistent expressions with the advance decision
What to do when there is doubts over an advanced decision
Applications must be made to the court for a ruling
Whilst the ruling is awaited, doctors can treat to maintain life or prevent deterioration
Courts usually favour preserving life if there is doubt
