5 Principles of Mental Capacity Act


The Mental Capacity Act (MCA) safeguards and empowers those who might not be able to make their own decisions regarding their care and treatment. Anyone who is 16 years old or older is covered.

It involves everyday choices like what to wear or what to buy at the grocery store, as well as important life-altering choices like whether to enter a nursing home or have major surgery.

What are the five principles of mental capacity act?

The five key principles are:

Principle 1 – A presumption of capacity.

Every adult has the right to make their own judgments, and unless otherwise shown, it is presumed that they are capable of doing so. Simply because a patient has a certain sickness or impairment, either physical or mental, practitioners cannot presume that they are incapable of making their own decisions.

Principle 2 – The right to be supported when making decisions.

Before it is judged that someone cannot make their own decisions, they must be provided every chance for help and information. This means that every effort should be made to support and encourage people to make their own decisions.

Principle 3 – An unwise decision cannot be seen as a wrong decision.

People must be allowed to make decisions that other people may find odd or foolish. As each person has their own ideas and choices that may be completely at odds with those who would otherwise deem them to be lacking in capacity, such a judgement cannot be used to show incapacity.

It is evident that any decision made by an individual, provided that people has the capacity to do so, must be honored no matter how strange it may seem. Principle 3 enables a person’s culture and individual traits to be considered when they are making decisions.

Principle 4 – Best interests must be at the heart of all decision making.

Once it has been conclusively proven that a person lacks capacity, decisions can only be made on their behalf.

Any choice taken on someone else’s behalf must be in that person’s best interests. This implies that the decision should be based on what they would decide if they had the capacity to do so. The maintenance of the person’s wellness in a holistic way, which implies that all of their needs are considered, can be highly difficult and depends on a variety of circumstances.

Principle 5 – Any intervention must be with the least restriction possible.

Any choice made on behalf of someone who lacks mental capacity must be made in a way that restricts their freedom and fundamental rights the least. Taking into account the specific case’s circumstances, any intervention should be evaluated.

This principle states that the decision-maker must consider all options and determine if there are any alternatives that would be less limiting than the one being considered.

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2 stages of mental capacity assessment

The presumption of capacity may be revoked if the patient fails the two-stage mental capacity test set out in Section 2 of the Mental Capacity Act.

Diagnostic test

The diagnostic stage of this test indicates that a person lacks ability “if at the material moment [they are] unable to make a decision for [themselves]” due to “an impairment of, or disturbance in the functioning of, the mind or brain.” This could be momentary or ongoing. Examples of what the MCA Code of Practice refers to as “impairments or disturbances of the mind or brain” include dementia, severe learning problems, and the long-term consequences of brain injury.

DCPs must make sure that all pertinent information is conveyed to patients in a manner they can understand in order to assist them in making decisions.

Functional test

The second aspect of the examination, known as the functional test, examines the patient’s decision-making capacity after the diagnostic test has been completed. Importantly, we are merely attempting to ascertain whether a patient is capable of making a certain decision at the time of inquiry (for instance, regarding their course of treatment).

According to the functional test, a patient cannot decide for themselves if they are unable to comprehend the information pertinent to the choice and to remember that knowledge Utilize or consider that information while making a decision, and Communicate that decision (whether by talking, using sign language or any other means).If a patient fails an aspect of the functional test, then they are deemed to lack capacity. In such cases, we must document specifically which aspect of the test the patient has failed. In addition, it must also be noted what steps have been taken to help the patient make their own decision and how capacity has been assessed by the clinician.

Best online training course for mental capacity act

Nursing Revalidation provides best online training course for Mental Capacity Act and Deprivation of Liberty Safeguards (MCA and DOLS)

This course describes in detail the many facets and procedures of the Mental Capacity Act. This includes who the act affects, when it applies, how to assess capacity and the procedures that can be put in place in the home or workplace to ensure best practices are followed and people are treated fairly at all times.

The bottom line

The Mental Capacity Act (SMCA) governs decision-making on behalf of adults who may not be able to make particular decisions.

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