MCA in clinical decisions for care and treatment

Factors when seeking consent

A diagnosis of a disease or condition of the brain may define why someone may lack capacity, BUT it is important to establish the degree of impairment of the brain and its effect on the individual’s ability to be part of the decision-making process and give valid consent (BMA 2018).

Neurological diseases, mental health diagnosis, learning disabilities, brain injury (traumatic or surgical), chronic brain failure such as dementia, effects of medication or anaesthesia can all impact on mental capacity.

  1. The medical condition may affect an individual’s ability to understand, retain information and weigh up the risks and benefits of a proposed treatment.
  2. The proposed treatment may be highly complex, with many potential risks – making it difficult to understand the decision and weigh-up the information to give Informed consent.
  3. The setting in which decisions are made may be unfamiliar and frightening, causing anxiety which may impact on the individual’s decision-making
  4. The pressures on staff, within the care setting, may lead to individuals feeling rushed or intimidated into making a decision
  5. The balance of power, knowledge and position between the individual and the professional may affect the Autonomy of the individual (Bonsall 2015; Sidin 2016).