Basildon EM Handbook 2018

Mental Capacity Act

The Mental Capacity Act aims to protect people who lack capacity, and maximize their ability to make decisions. The Act came into full force in October 2007.

The Act is underpinned by five statutory principles:

1.A person should be assumed to have capacity .

2.Do not declare lack of capacity unless all steps have been taken to enable capacity.

3.A person is allowed to make an unwise decision.

4.If a person lacks capacity then decisions should be made in their best interests.

5.Any decision made should be the least restrictive option.

Assessing capacity

The trust now has a one-page MCA assessment form, please use it.  Capacity is dynamic and a specific function of the decision to be taken. It is possible for a patient to lack capacity to make a decision about one specific issue but not about another.  Patients should always be assumed to have capacity but if there is reason to believe a patient lacks capacity it should be assessed using the two-stage test:

1.Does the person have an impairment of the functioning of mind or brain?

2.Does the impairment = person is unable to make a specific decision ?

The functional test of capacity advised in The Act is that, in order for a person to be able to make a decision, they must be able to:

1.Understand the decision to be made and the information provided about the decision.

2.Retain this information sufficiently long to make the decision.

3.Use the information to make the decision (weigh up the pros and cons).

4.Communicate their decision.

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