Assessing capacity

• You must always reflect if you are dealing with:
  • A child or young person with limited capacities to consent
  • A competent adult: an adult is assumed competent unless shown to lack capacity
  • An adult with limited or no capacities to consent
• In order for someone to have capacity to make a decision, they must be able to:
  • Understand information relevant to the decision in question
  • Retain that information
  • Use that information to make their decision
  • Communicate a decision

Principles of the Adults with Incapacity Act

• Intervention must benefit the adult and such benefit cannot reasonably be achieved without the intervention
• Takes account of past and present wishes
• Consult with other relevant persons
• Encourage the adult to use residual capacity

AWI Section 47 Certificate

• Authorises practitioner to provide reasonable interventions related to the treatment authorised
• Does not authorise force unless immediately necessary and only for as long as is necessary
• Does not specifically authorise the transport of the adult to the place of treatment

Aiding decision making in a patient lacking capacity

• Power of attorney: one or more persons given the powers to act as a persons continuing (financial) and/or welfare attorney in case capacity is lost at some future point (granted whilst they have capacity)
• Guardianship: person requires someone to make specific welfare and/or financial decisions on their behalf over the long term
  • Applied for by one or more individuals or local authority, granted by the Sheriff
  • Cannot place the adult in hospital for treatment of mental disorder against their will
  • If the adult does not comply with the wishes of a welfare guardian, there is a mechanism for the sheriff to issue a compliance order