ABSTRACT
This chapter highlights key issues in the assessment of capacity for highly complex, risky and life-shortening decisions. Professionals who may be well placed to assess capacity in these decision areas, and who have experience in these types of assessment, may include clinical neuropsychologists, clinical psychologists, consultant psychiatrists, speech and language therapists and social workers. The Mental Health Act may need to be referred to in situations where a person’s mental health is a key factor in the risk to self or others. There is a balance between being professionally cautious and being over-cautious and completely risk-averse. Positive risk-taking, whilst trying to manage the risks, is sometimes the best compromise for the person and professionals. It is useful to reflect on these issues in the professional supervision sessions. It is important to remember that someone’s capacity to make a high-risk decision that is used to make regularly may change after an impairment in, or disturbance of, the mind or brain.
