The Mental Capacity Act Flashcards
What is the Mental Capacity Act?
Designed to protect and empower individuals who may lack the mental capacity to make their own decisions about their care and treatment.
Important because of the increasing population who lack capacity- people are surviving longer, we have an ageing population.
Before a patient needs to make a decision or give consent, we need to know they are competent. An individual who lacks mental competence cannot give consent.
Who is required to perform a capacity assessment?
Any adult wishing to take action in connection with or on behalf of an individual thought to be lacking capacity.
Professional responsible for the person’s treatment must ensure capacity has been assessed.
How is capacity maximised?
Right information.
Time to process/weigh up.
Aids (glasses, hearing aid, interpreter, braille, etc.).
What are the statutory principles of the Mental Capacity Act?
Presumption of capacity.
Freedom to make unwise choice.
Capacity must be decision-specific.
Decision making capacity must be maximised.
What is the 2 stage test of capacity?
Does the person have an impairment or a disturbance in the functioning of their mind or brain?
Is the impairment or disturbance sufficient to impair capacity to make a decision?
What should a person be able to do to make decision?
Understand.
Retain.
Weigh up and balance.
Communicate.
What is the meaning of ‘fluctuant’ capacity?
Capacity can be partial, temporary, and change over time.
Is the person likely to regain capacity, and if so can the decision wait until they have capacity?
What are the requirements for a person writing an advance directive?
Must be 18+.
Must have mental capacity.
What are the requirements of a request for an advance directive?
Must be a refusal of care.
Must be competent, informed and voluntary.
Must be treatment-specific.
The request cannot refuse basic nursing care, oral feeding/hydration.
What are the requirements for life sustaining decision advance directives?
Must be written, signed and witnessed, and clearly state that decision applies even if life is at risk.
What questions must be asked to assess whether an advance directive is applicable to a current situation?
Has the prognosis/treatment changed since the AD was made?
Have there been children since the AD was made?
Has there been a significant and lasting change in beliefs since the AD was made?
In which cases are healthcare professionals not liable for following/ignoring an advance directive?
If they stop/withhold treatment due to reasonable belief that a valid AD exists.
If they treat a person and have taken reasonable steps to find out if a valid AD exists.
Cannot refuse treatment under Mental Health Act or basic nursing care.
When can advance directives be withdrawn?
Withdrawal can be at any time provided the individual is still competent.
Withdrawal can be oral or in writing.
Once capacity is lost the AD cannot be withdrawn.
What is lasting power of attorney?
A power of attorney is a legal document that allows another person authority to make a decision on another’s behalf.
Under a power of attorney, the donee can make decisions that are as valid as one made by the donor.
Decisions made be an LPA must be in the person’s best interests.
What are the requirements for a lasting power of attorney?
Donor must be over 18.
Must have capacity.
2 types: welfare, and property and affairs.
If the person has capacity the welfare LPA cannot be used.
Donor can specify limits to attorney decision-making.
Must be written and signed.
Must be registered with Office of Public guardian.
