Mental Capacity Act 2005 Case Study

“A decision made by a person (‘P’) after he has reached 18 and when he has capacity to do so, that if – (a) at a later time and in such circumstances as he may specify, a specified treatment is proposed to be carried out or continued by a person providing health care for him, and (b) at that time he lacks capacity to consent to the carrying out or continuation of the treatment, the specified treatment is not to be carried out or

“Everyone has an important role to play in achieving healthcare rights and contributing to safe, high quality care. Genuine partnerships between those families and carers of people receiving care and those providing it lead to the best possible outcomes.” (Western NSW Local Health District 2012).

The process of consent should apply not only to surgical procedures but all clinical procedures and examinations which involve any form of touching. This must not mean more forms: it means more communication. As part of the process of obtaining consent, except when they have indicated otherwise, patients should be given sufficient information about what is to take place, the risks, uncertainties, and possible negative consequences of the proposed treatment, about any alternatives and about the likely outcome, to enable them to make a choice about how to proceed.”5

According to the Oxford Dictionary consent is defined as ‘giving permission for something to happen or agreeing to do something’. They define confidentiality as ‘entrusted with private information and if something is intended to be kept secret or in confidence’ (Soanes and Hawker, 2005). As a healthcare professional consent and confidentiality are in place as protective vices, by gaining consent and keeping a patients confidentiality it protects both the patient and the healthcare professional. There are three types of consent: Verbal consent, consent in writing and implied consent. Depending on the situation each type of consent may not be acceptable. For example if a procedure is putting a patient at risk, is complex or invasive for example an operation, written consent is

My chosen reflection piece is on ageism, see appendix one. I will provide evidence reflecting the links between diabetes and depression, which will form my chosen seminar topic, see appendix two. I will then critically analyze the mental capacity Act (2005) and relate it to my specific scenario, see appendix three. I will explore how nurses the Act within nursing practice, decision- making, and how we access a person’s capacity to make specific decisions. I will explore any ethical issues that may arise following the principles of Mental Capacity Act (2005).

THE FIVE STATUTORY PRINCIPLESThe five principles are outlined in the Section 1 of the Act. These are designed to protect people who lack capacity to make particular decisions, but also to maximise their ability to make decisions, or to participate in decision-making, as far as they are able to do so.

Dimond (2009) and NHS choices (2016) explained consent as the process involving a person giving their approval to accept or refuse a treatment or interventions, after receiving detailed information from a health care professional about the risk or benefits of the procedure. In order for consent to be deemed valid, it needs to be given voluntarily without any influence or pressure from either a family member or clinician. In addition, the capacity of the person is important when giving consent and the ability to process the given information and make a decision. Tingle &Cribb (2014) agree, emphasizing that the autonomy of the person giving

The patient shows the ability to make her own treatment decisions as she has knowledge of the issues, is capable of making such decisions and there is no sign of coercion in reaching her decision. (cbhd.org, 2008). Margie shows the understanding that the deactivation of the pacemaker may end her life. She has made it known that continued treatment with the pacemaker is no longer consistent with her healthcare goals. (Pozgfar, 2012).

It is also clear that while making these decisions, the decisions ought to be made based on informed consent (Werth and Crow 195). Sometime, the patient may be experiencing dementia, clinical depression or delirium for which they may be affecting the patient’s decision making capabilities (Werth and Crow 197, 198). If such a person is allowed to make their right-to-die decision, this may be done without the patient having comprehensive information before consent and thus should not be encouraged (Werth and Crow 198).

Patient refusal could result from misinterpreting what is said during difficult situations of decision making or due to denial of the truly bad situation, poor registration of bad news or even confusion by multiple sources of information. In addition,

I agree with the decision reached. The appeal should be dismissed and Professor Starson should be deemed to have the capacity to make his own medical decisions. This is because of the provision set out in section 4(1) of the Health Care Consent Act which sets out the test for incapacity which is the defining issue of this case. The section states that the individual must be able to; understand the information that is relevant to making a decision about the treatment, and appreciate the reasonably foreseeable consequences of a decision or lack of decision. If one is to determine whether Professor Starson lacks capacity to make is own medical decisions regarding treatment they would first have to apply both of the components of the aforementioned

3. HCPs using the techniques at the circumstances that their patients cannot make right decisions (U, 100%, 50).

Because Hai is adamant to receive medical treatment, could his consent to treatment and refusal be deemed valid?

Insofar as informed consent has been expounded, two main principles of bioethics have emerged as paramount; autonomy and non-maleficence. Although seemingly clear, the boundary of both respecting a person’s autonomy and doing no harm becomes blurred when the patients have disabilities that remove their ability to reason and justify soundly (e.g. total brain injuries or severe stroke patients). Although the participants in the proposed study will be fully-abled as per the exclusion criteria, understanding why cognitively impaired participants cannot give ‘informed’ consent further elaborates on higher-order-thinking required in the informed consent process. Without such a process, patients whom elect to become participants may not understand that this research is a separate entity to their regular treatment regime, and essentially will have become coerced into consenting due to a lack of clarification (Kerridge, Lowe, & Stewart, 2009; Rigg, 2012a; Rigg, 2012b).

MCA (2005) states ensure that the treatment chosen is necessary and it might be necessary to choose an option that is the least restrictive only if it is in the best interest of the patient. At one point the doctor wanted to Sara to be admitted into the hospital. According to Jootun and Pryde (2013) dementia can have a major influence on the individual’s ability to make sense of the environment. The nurse informed the doctor that placing Sara in a completely new environment would only make the situation worst. It was then decided that it would be best to treat Sara at home. The nurse and doctor came to a conclusion that a less restrictive option was for the doctor to prescribe Sara with antibiotics to treat the cellulitis. The Mental Capacity