Mental Capacity - Component 3

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Questions and Answers

What should be considered when making a best interests decision for a person who lacks capacity?

Only the wishes of the family

Non-discrimination and relevant circumstances (correct)

The medical profession's opinions solely

The individual's financial status

What is the burden of proof concerning mental capacity assessments?

Clear and convincing evidence

Preponderance of the evidence

On the balance of probabilities (correct)

Beyond a reasonable doubt

In the context of fluctuating capacity, which scenario is most accurate?

Assessment of capacity is unnecessary at all times.

Capacity may fluctuate, impacting decision-making ability. (correct)

Capacity is permanently lost and cannot return.

Once capacity is regained, it will never fluctuate again.

Which principle supports a patient who is making an unwise decision in a mental capacity assessment?

Presumption of capacity Signup and view all the answers

What is an example of a situation where fluctuating capacity may occur?

A person undergoing an epileptic fit Signup and view all the answers

Which of the following is required to protect from liability when a person is deemed to lack capacity?

A reasonable assessment of capacity and belief that the act is in their best interest Signup and view all the answers

In decision-making, what must be ensured regarding the least restrictive option?

It minimizes the impact on the person's decision-making Signup and view all the answers

What is NOT a characteristic of Deprivation of Liberty Safeguards?

Applies solely to individuals under 18 years old Signup and view all the answers

What is the role of the police under sections 135 and 136 of the MHA regarding mentally disordered persons?

To remove a person to a place of safety for assessment Signup and view all the answers

At what age can an individual begin to make an advance decision in England and Wales?

16 years Signup and view all the answers

Which factor is not necessary when determining the validity of a Lasting Power of Attorney (LPA)?

Is the donee a family member? Signup and view all the answers

Which of the following is a consideration when assessing the safety and appropriateness of waiting for fluctuating capacity to return?

The potential for harm if immediate action is not taken Signup and view all the answers

In the two-part test for assessing capacity, what does the functional test NOT assess?

Presence of physical disabilities Signup and view all the answers

What role does a Lasting Power of Attorney play in decision-making for individuals who may lack capacity?

It enables the appointed individual to make decisions on behalf of the individual Signup and view all the answers

Which of these aspects is relevant for decision-making when someone is in a fluctuating capacity state?

Evaluating the relevant circumstances and encouraging participation Signup and view all the answers

How is impaired capacity assessed during a mental capacity assessment?

By considering both the diagnostic and functional tests Signup and view all the answers

What is required for a Deprivation of Liberty Safeguard (DoLS) to be considered legal?

Authorization by the Court of Protection Signup and view all the answers

Which of the following conditions could invalidate an Advance Decision?

The decision has been subsequently withdrawn Signup and view all the answers

What should be done if there are concerns about a person's rights being excessively restricted?

Raise a safeguarding concern Signup and view all the answers

Under what circumstances is the deprivation of a person’s liberty most appropriate?

During a medical emergency to save life Signup and view all the answers

What must be true for an Advance Decision related to life-sustaining treatment?

It must be a written document, signed and witnessed Signup and view all the answers

What is the role of Lasting Power of Attorney (LPA) in decision-making for individuals lacking capacity?

LPAs can confer authority for healthcare decisions on behalf of the individual Signup and view all the answers

What protection is offered to professionals who follow an Advance Decision if they believe the criteria are not met?

They must document their rationale for treatment decisions Signup and view all the answers

What is a requirement for a valid Advance Decision to refuse treatment?

It must clearly specify the treatment being refused Signup and view all the answers

Study Notes

Diagnostic Test and Capacity

If both diagnostic and a functional test criteria are met, the patient is considered to lack capacity.
A best interests decision should be initiated immediately when capacity is lacking.

Fluctuating Capacity

Refers to variability in a person's decision-making ability; they may lack capacity at one time but regain it later.
Conditions causing fluctuating capacity include seizures, where capacity may return post-ictally.
It is critical to assess if waiting for capacity to return is safe before making health decisions.

Best Interests Decisions

Must consider non-discrimination, relevant personal circumstances, encouragement of participation, and the wishes, feelings, beliefs, and values of the patient.
Consider the views of family and other stakeholders, using structured frameworks like LA66.

Protection from Liability

A reasonable assessment of capacity must have been made.
Must have a reasonable belief that the individual lacks capacity and any acts taken are in their best interest.

Legal Powers for Police

Sections 135 and 136 of the Mental Health Act (MHA) are the sole legal powers allowing police to remove mentally disordered individuals to safety for assessment.
The Mental Capacity Act (MCA) cannot replace the MHA but allows police to assist with restraint if necessary for the individual’s best interests.

Lasting Power of Attorney (LPA)

Must be valid, registered, and determine if the patient lacks capacity.
LPA should align with the patient's best interests and include agreements from family and carers.

Deprivation of Liberty Safeguards (DoLS)

Implemented to limit individuals' freedoms for their safety, requiring authorization from the Court of Protection.
Emergency situations do not require authorization as immediate care takes precedence.

Raising Concerns

Reports should be made if there are worries about excessive restrictions of a patient's rights, utilizing safeguarding referrals.

Advance Decisions

Available to individuals aged 18 and older with the capacity to refuse specified treatments in advance.
For life-sustaining treatments, conditions for validity include being written, signed, witnessed, and explicitly stating circumstances when life is at risk.

Validity of Advance Decisions

Advance decisions become invalid if withdrawn, if a lasting power of attorney has been assigned, or if prior actions contradict the existence of the advance decision.

Managing Liability

Must respect valid advance decisions if aware and satisfied with their validity.
If uncertain, document decision-making rationale to protect against liability.

Legislation Overview

Framework establishes definitions and guidelines for testing decision-making capacity.
Protects individuals lacking capacity, addressing both everyday and significant decisions collectively.

Code of Practice and Statutory Principles

The legal duty requires adherence to the Code of Practice concerning capacity assessments.
Core principles include presuming capacity, assisting decision-making, and ensuring decisions align with the best interests of the person and are minimally restrictive.

Assessing Capacity

Assessments must be time and decision-specific, recognizing the burden of proof lies on the balance of probabilities.
The assessment includes a two-part test: diagnosing impairment and functional ability concerning understanding, communication, retention, and application of information.

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Description

This quiz covers the concept of mental capacity, focusing specifically on fluctuating capacity. It discusses how a patient's decision-making ability can vary, influencing the conclusions drawn from assessments. Understanding best interests decisions is also a key component.