There are five key principles which need to be followed when determining whether a person lacks capacity to make a particular decision.
1. A person must be assumed to have capacity unless it is established that they lack capacity
2. A person is not to be treated as unable to make a decision unless all practicable steps to help them do so have been taken without success
3. A person is not to be treated as unable to make a decision merely because they make an unwise decision
4. An act done, or decision made, under this Act for or on behalf of a person who lacks capacity must be done, or made, in their best interests
5. Before the act is done, or the decision made, regard must be had to whether the purpose for which is it needed can be as effectively achieved in a way that is less restrictive of the person's rights and freedom of action
Capacity can vary over time and according to what decisions need to be made. It is also both time and decision specific and an 'unwise decision' made by the person does not in itself indicate a lack of capacity. The following factors need to be considered in determining capacity for a specific decision:-
- Does the person have a general understanding of what decision they need to make and why they need to make it?
- Do they understand the consequences of making, or not making, the decision, or of deciding one way or another?
- Are they able to understand the information relevant to that decision?
- Can they weigh up the relative importance of the information?
- Can they use and retain the information as part of the decision-making process?
- Can they communicate their decision - by any means, including blinking an eye or squeezing a hand?
The Code of Practice should be referred to when dealing with an individual with mental capacity issues whether you are a carer or a professional involved in that persons care.
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