Consent to treatment and mental capacity Introduction118

2014 ◽  
pp. 140-161
Keyword(s):  
Mental Capacity ◽  
Consent To Treatment

4. Consent to Treatment

2018 ◽  
Author(s):  
Jonathan Herring
Keyword(s):  
Mental Capacity ◽  
Best Interests ◽  
Living Wills ◽  
Ethical Aspects ◽  
Capacity To Consent ◽  
Delicate Balance ◽  
Mental Capacity Act 2005 ◽  
Consent To Treatment ◽  
Advance Decisions ◽  
Mental Capacity Act

This chapter examines the legal and ethical aspects of treating a patient without consent. It considers the meaning of ‘consent’ and the position of patients who lack the capacity to consent. For children who lack capacity, consent involves a delicate balance between the rights of the children and those of their parents. For adults lacking capacity, the Mental Capacity Act 2005 has emphasized the ‘best interests’ test, but has largely left open the question of how a person’s best interests are to be ascertained. The chapter also considers what weight should be attached to advance decisions (sometimes called living wills).

scholarly journals The Mental Capacity Act 2005: review of mental capacity assessment in people with proximal femoral fracture

2010 ◽  
Vol 34 (7) ◽  
pp. 284-286 ◽  
Author(s):  
P. Guyver ◽  
P. Hindle ◽  
J. Harrison ◽  
N. Jain ◽  
M. Brinsden
Keyword(s):  
Staff Training ◽  
Femoral Fractures ◽  
Proximal Femoral Fracture ◽  
Mental Capacity ◽  
Clinical Implications ◽  
Proximal Femoral Fractures ◽  
Mental Capacity Act 2005 ◽  
Consent To Treatment ◽  
Mental Capacity Act ◽  
The Impact

Aims and methodTo ascertain whether patients with proximal femoral fractures were being correctly assessed in line with the Mental Capacity Act 2005. Fifty people admitted with proximal femoral fractures were audited to assess whether they had given consent to treatment in accordance with the Act. A Mental Capacity Act 2005 guidance and assessment form was then introduced accompanied by staff training. A re-audit was undertaken to assess the impact.ResultsThe initial audit showed that only one person (2%) had been properly assessed. The re-audit demonstrated that the use of the Mental Capacity Act 2005 assessment form ensured correct assessment.Clinical implicationsOur findings suggest the form is a useful tool in the documentation and assessment of an individual's capacity under the Mental Capacity Act.

scholarly journals Mental capacity to consent to treatment and the association with outcome: A longitudinal study in patients with anorexia nervosa

BJPsych Open ◽  
2017 ◽  
Vol 3 (3) ◽  
pp. 147-153 ◽  
Author(s):  
Isis F.F.M. Elzakkers ◽  
Unna N. Danner ◽  
Lot C. Sternheim ◽  
Daniel McNeish ◽  
Hans W. Hoek ◽  
...  
Keyword(s):  
Decision Making ◽  
Anorexia Nervosa ◽  
Longitudinal Study ◽  
Adult Female ◽  
Favourable Outcome ◽  
Mental Capacity ◽  
Admission Rates ◽  
Prognostic Relevance ◽  
Consent To Treatment ◽  
Neuropsychological Assessments

BackgroundRelevance of diminished mental capacity in anorexia nervosa (AN) to course of disorder is unknown.AimsTo examine prognostic relevance of diminished mental capacity in AN.MethodA longitudinal study was conducted in 70 adult female patients with severe AN. At baseline, mental capacity was assessed by psychiatrists, and clinical and neuropsychological data (decision-making) were collected. After 1 and 2 years, clinical and neuropsychological assessments were repeated, and remission and admission rates were calculated.ResultsPeople with AN with diminished mental capacity had a less favourable outcome with regard to remission and were admitted more frequently. Their appreciation of illness remained hampered. Decision-making did not improve, in contrast to people with full mental capacity.ConclusionsPeople with AN with diminished mental capacity seem to do less well in treatment and display decision-making deficiencies that do not ameliorate with weight improvement.

Implementing legislative changes on young people's consent to treatment: a guide for trainers

2011 ◽  
Vol 17 (6) ◽  
pp. 454-460
Author(s):  
Sarah Huline-Dickens
Keyword(s):  
Mental Health ◽  
Young People ◽  
Mental Capacity ◽  
England And Wales ◽  
Mental Capacity Act 2005 ◽  
Consent To Treatment ◽  
Legislative Changes ◽  
Mental Capacity Act ◽  
Structured Approach

SummaryThis article reviews the recent changes in the law in England and Wales relating to consent to treatment for young people, in particular the Mental Capacity Act 2005 and the 2007 amendments to the Mental Health Act 1983. Using a fictitious case study, it offers a structured approach to the application of these new items of legislation that could be useful to trainers and their trainees.

scholarly journals 37 * CONSENT TO TREATMENT MENTAL CAPACITY ACT 2005- MENTAL CAPACITY ACT 2 DOCUMENTATION AUDIT

2015 ◽  
Vol 44 (suppl 1) ◽  
pp. i8-i9
Author(s):  
V. Ralph ◽  
R. Page ◽  
F. Baird ◽  
M. Avari ◽  
M. Brenner
Keyword(s):  
Mental Capacity ◽  
Mental Capacity Act 2005 ◽  
Consent To Treatment ◽  
Mental Capacity Act

scholarly journals Mental capacity in psychiatric patients

2007 ◽  
Vol 191 (4) ◽  
pp. 291-297 ◽  
Author(s):  
David Okai ◽  
Gareth Owen ◽  
Hugh McGuire ◽  
Swaran Singh ◽  
Rachel Churchill ◽  
...  
Keyword(s):  
Interrater Reliability ◽  
Clinical Epidemiology ◽  
Psychiatric Patients ◽  
Demographic Variables ◽  
Mental Capacity ◽  
Assessment Tools ◽  
Capacity Assessment ◽  
Cross Sectional ◽  
Consent To Treatment ◽  
Psychiatric Population

BackgroundMental capacity is central to legal and ethical debates on the use of compulsion in psychiatry.AimsTo describe the clinical epidemiology of mental incapacity in patients with psychiatric disorders, including interrater reliability of assessments, frequency in the psychiatric population and associations of mental incapacity.MethodCross-sectional studies of capacity to consent to treatment for psychiatric patients were systematically reviewed from Medline, EMBASE and PsycInfo databases. Information on the reliability of assessments, frequency and associations of mental incapacity was extracted.ResultsOut of 37 papers reviewed, 29 different capacity assessment tools were identified. Studies were highly heterogeneous in their measurement and definitions of capacity. Interrater reliabilities between tools were high. Studies indicate incapacity is common (median 29%) but the majority of psychiatric in-patients are capable of making treatment decisions. Psychosis, severity of symptoms, involuntary admission and treatment refusal were the strongest risk factors for incapacity.ConclusionsMental capacity can be reliably assessed. The majority of psychiatric in-patients have capacity, and socio-demographic variables do not have a major impact but clinical ones do.

scholarly journals Reliability of mental capacity assessments in psychiatric in-patients

2005 ◽  
Vol 187 (4) ◽  
pp. 372-378 ◽  
Author(s):  
Ruth Cairns ◽  
Clementine Maddock ◽  
Alec Buchanan ◽  
Anthony S. David ◽  
Peter Hayward ◽  
...  
Keyword(s):  
Excellent Agreement ◽  
Interrater Reliability ◽  
Psychiatric Illness ◽  
Assessment Tool ◽  
Mental Capacity ◽  
Clinical Interview ◽  
Competence Assessment ◽  
Consent To Treatment ◽  
High Level ◽  
Level Of Agreement

BackgroundPrevious work on the reliability of mental capacity assessments in patients with psychiatric illness has been limited.AimsTo describe the interrater reliability of two independent assessments of capacity to consent to treatment, as well as assessments made by a panel of clinicians based on the same interview.MethodFifty-five patients were interviewed by two interviewers 1–7 days apart and a binary (yes/no) capacity judgement was made, guided by the MacArthur Competence Assessment Tool for Treatment (MacCAT-T). Four senior clinicians used transcripts of the interviews to judge capacity.ResultsThere was excellent agreement between the two interviewers for capacity judgements made at separate interviews (kappa=0.82). A high level of agreement was seen between senior clinicians for capacity judgements of the same interview (mean kappa=0.84)ConclusionsIn combination with a clinical interview, the MacCAT–T can be used to produce highly reliable judgements of capacity.

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