The Adults with Incapacity (Scotland) Act--Who knows? Who cares?

The Adults with Incapacity (Scotland) Act 2000 provides new guidelines on obtaining consent for adults who are incapable of providing informed consent. This article surveys current practice of health workers when obtaining consent from such individuals, and the results are compared to the Incapacity Act and local guidelines. The survey results suggest that practice of the guidelines is variable and often legally inadequate.

To quantify awareness and practical application of the Adults with Incapacity (Scotland) Act in surgical wards in a central Glasgow teaching hospital, 2 years after the Act's introduction.

An interviewer led anonymous questionnaire was presented to all degree educated staff encountered on random visits to acute and elective surgical and orthopaedic wards in a split site teaching hospital.

17 out of 50 staff approached (34%) had not heard of the Adults with Incapacity Act. There was a significantly higher level of awareness amongst staff based on acute wards (85%) when compared with those from elective wards (54%) (p < 0.05, chi-square) There was a complete absence offormal training in using the Act and knowledge was sometimes inaccurate or incorrect. Most staff that had heard of the Act could suggest causes of incapacity, but some included physical disability. There was a persistence of the belief that a relative can consentfor an incapable adult patient, and this was expressed by some of the staff despite knowledge of the Act.

This study shows that a significant number of ward staff have no knowledge of the Act; and understanding is variable amongst staff who have heard of it. The Adults with Incapacity (Scotland) Act 2000 is a unique piece of legislation to protect the interests of incapable patients, and doctors treating them; but is of no use if medical and nursing staff are unaware of its existence.