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Advance decisions and the Mental Capacity Act
1Liverpool Law School, University of Liverpool.
British Journal of Nursing (Mark Allen Publishing)
|June 16, 2009
Summary
Advance decisions under the Mental Capacity Act 2005 allow competent adults to refuse future treatment. However, meeting specificity requirements and avoiding implicit revocation can be challenging for healthcare professionals.
Area of Science:
- Medical Law and Ethics
- Patient Autonomy
- Healthcare Decision-Making
Background:
- The Mental Capacity Act 2005 governs advance decisions in the UK.
- Competent adults can refuse medical treatment, including life-sustaining care, prospectively.
- Valid advance decisions legally bind healthcare professionals.
Purpose of the Study:
- To analyze the legal requirements for valid advance decisions under the Mental Capacity Act 2005.
- To identify challenges in meeting the specificity requirements for advance decisions.
- To explore factors affecting the continuing validity of advance decisions.
Main Methods:
- Legal analysis of the Mental Capacity Act 2005 provisions.
- Examination of case law and legal commentary on advance decisions.
- Discussion of practical implications for patients and healthcare professionals.
Main Results:
- The Act mandates dual specificity: treatment refusal and specific circumstances.
- Meeting specificity requirements is difficult, particularly for non-progressive conditions.
- Advance decisions can be invalidated by implicit revocation or changed circumstances.
Conclusions:
- Clear and comprehensive communication between patients and healthcare professionals is crucial.
- Thorough discussion of intentions and scope ensures the efficacy of advance decisions.
- Facilitating patient autonomy requires addressing ambiguities in advance decision-making.
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