ABSTRACT
This chapter describes the key components of the Mental Capacity Act c. 9 (MCA) and explains its relevance to clinical considerations of decision-making. The MCA is predicated on the basis that an adult retains capacity to make decisions about money, health, welfare and relationships without interference from others, unless there is robust evidence of an underlying brain injury or impairment to suggest that his/her decision-making abilities are impaired. The main aim of the MCA is, “to protect people who lack the capacity to make particular decisions, but also aims to maximise their ability to make decisions or to participate in decision-making, as far as they are able to do so”. Experienced clinicians are frequently asked to conduct an objective, and defensible, assessment of the decision-making capacity of an individual towards whom they have a duty of care and the NICE guidance will be helpful in that regard.
