Mental capacity describes the ability of an individual to make decisions. Having mental capacity requires the ability to understand, retain and use information to make a decision, and to be able to communicate that decision. Understanding should include the nature, purpose and consequences of the proposed intervention, any alternatives, adverse effects or risks, and the consequences of refusal. Capacity is decision- and time-specific. |
Consent is agreement to have an examination, investigation, treatment, care or surgery. To be valid, consent must be:
capacitous (the person must understand what they are doing) informed (the person must have enough information on which to base a decision) uncoerced (freely given) ongoing (consent can be withdrawn at any time).
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In the UK, a treatment may be legally given to a person who lacks mental capacity if it is in their ‘best interests’. This attempts to respect autonomy by involving them in the decision if possible, and trying to identify what they would have wanted if they had capacity. The process is often uncertain. Family members or others concerned for the patient's wellbeing have a right to have their opinion heard. Best interests should take account of current and previously expressed values, preferences or beliefs. The treatment should have overall benefit when weighing the risks and burdens associated with it. |