The legal context: capacity and consent
In this chapter I will focus on the issue of capacity to consent to treatment, with brief mention of capacity issues in other contexts. When I ﬁrst meet a client who is able to speak, I always ask them whether they know why they have come to see me. No-one has ever been able to answer this question except in a most cursory manner. This is not necessarily because carers have not tried to explain the visit to them. Either they lack the conﬁdence to say why they think they have come, or else they are unable to understand or remember what they have been told. When I meet someone who is unable to speak, and possibly unable to understand most of what I am saying, then I am particularly aware of the imbalance in power that has resulted in this person sitting in front of me, in a strange and not particularly welcoming environment.