Mental Capacity Legislation Principles and Practice

"Prior to its introduction, clinicians and carers were in uncertain legal territory when making decisions of a social, health or financial nature for those individuals without capacity. Importantly, however, the statute is more than a solution to a recognized gap in English and Welsh Law; it is also about a culture change. It requires those in a caring and/or professional capacity to engage with a person, who may lack decision-making capacity, in a manner that involves him/her, and others important to them, in the process of decision-making. In doing so they must have regard to past and presents beliefs and values of the person concerned. The MCA, in its approach, is not so much giving power to others to make decisions, rather it is asking those who have to take a decision on behalf of another to do so in a manner that is transparent, justifiable, and respectful of all issues relevant to that person. It is applicable in any situation where someone might lack capacity including, for example, the person transiently incapacitated through excess alcohol or from a head injury requiring treatment, to people with potentially more enduring incapacity due to dementia or learning disabilities. It is therefore as relevant in intensive care as it is in social care. The MCA is both about the 'here and now', when an immediate decision may have to be made on behalf of a person lacking capacity at the present time but also about planning for the future; how individuals, whilst having capacity, can determine who can take decisions on their behalf in the event that they lose capacity through illness or injury, at a later date"--