The Mental Capacity Act advises “People have the right to make decisions that others might regard as unwise or eccentric.” We have all done our share of ‘unwise’ and ‘eccentric’ things. It is part of being a mature human being. So for us the Act is a triumph for common sense and for the voice of the individual. Whether you are living with dementia, a mental health condition or substance misuse, the Act is there to hear your voice.
The five key principles of the Act are:
- A presumption of capacity. Every adult has the right to make his or her own decisions and must be assumed to have capacity to do so unless it is proved otherwise.
- Individuals supported to make their own decisions. A person must be given all practicable help before anyone treats them as not being able to make their own decisions.
- Unwise decisions. People have the right to make decisions that others might regard as unwise or eccentric.
- Best interests. Anything done for or on behalf of a person who lacks mental capacity must be done in their best interests.
- Less restrictive option. Someone making a decision or acting on behalf of a person who lacks capacity must consider whether it is possible to decide or act in a way that would interfere less with the person’s rights and freedoms of action, or whether there is a need to decide or act at all.
A straightforward example. Does a 76- year- old woman with dementia have the right to decide whether she is given a flu jab? The full case study can be found here, but it is worth emphasising that the nurse must start from a position that the woman has capacity (unless there is evidence to the contrary).
About two million people in England and Wales are thought to lack capacity to make decisions for themselves. They are cared for by around six million people, including a broad range of health and social care staff, plus unpaid carers.
We are sure all those working in health and social care will join us in saluting this critical piece of legislation. Whether you are a doctor, nurse, dentist, psychologist, occupational therapist, social worker, residential and care home manager, domiciliary care worker or support worker or an unpaid carer (to name a few), you are all helping some of the most vulnerable in our society to have a voice and to be heard.
Helen Wakeling and Karyn Yee-King
Principal Social Workers