3 The concept of mental capacity Introduction The Five Statutory Principles Assessment of capacity Individuals lacking capacity Understanding the information Communicating the decision The “causative nexus” Key Learning Points References and further reading Reflective Exercise Quiz Reflective Exercise Topic: Weighing and using information Anna is a young transgender woman who has recently gained her A levels and has a place to study History at University. Anna has Autistic Spectrum Disorder (ASD) which can affect her ability to process information. She has had her first appointment with the Adult Gender Identity Clinic prior to going to University, to discuss starting hormone replacement therapy- something which she is very excited about. As part of her assessment process she has been given support to explore all the potential issues which might arise as a result of the HRT. This has included discussions about fertility and gamete storage, a subject she has not previously thought about and one which involves many complex and possibly conflicting strands of information. This is a big life decision and her parents are concerned that she may not consider all the implications as she doesn’t find planning for the far future easy. At the moment Anna says she has no desire to have children, but her parents fear that her decision against storage is because it removes any delay to the start of the HRT rather than as an informed choice. What do you need to know more about with regards to this situation? What specific elements of the MCA might apply? How might your preconceptions/assumptions about this person influence you? How would you ensure your approach is ethical and unbiased? How do you ensure you are communicating in a way to involve the individual in the decisions made about them? Email me a copy of my answers Next:Quiz 0 Introduction 1 Reflecting on values and bias within mental capacity decision-making 2 The history and current context of mental capacity legislation and policy 3 The concept of mental capacity 4 Best interests 5 Supported decision making 6 Deprivation of liberty: human rights 7 MCA in clinical decisions for care and treatment 8 MCA and the Office of the Public Guardian (OPG) role 9 Conclusion