ABSTRACT
Making a best interests decision is an important process that needs to be followed once someone is found to lack mental capacity and is a fundamental requirement of The Mental Capacity Act 2005 (MCA) for England and Wales. This chapter is an overview of how the frameworks of the Act can be applied in practice. Broadly, the person who would be carrying out a best interests decision is the person who should act as the decision-maker in instances where joint or multi-disciplinary decisions are not feasible or appropriate. For example, decisions relating to nursing care should be taken by a nurse and those relating to medical treatment should be made by a doctor. It is important that the outcome of the decision should be consistent with the history of the person’s decision-making on related topics when he had capacity, if possible. The best interests process must not be regarded as a procedural ‘after-thought’ to the issue of mental capacity.
