Application of the Mental Capacity Act (2005) and Consenting for Treatment under Concious Sedation

The Mental Capacity Act 2005 (MCA) is one piece of legislation with which all clinicians should be familiar. As treating clinicians, a capacity assessment is carried out each time a patient is seen, in order to obtain informed consent. When clinicians question the capacity of their patients, they should ensure steps are taken to provide relevant adjuncts to aid understanding, from visual aids to alternative time and environment. If a patient is deemed to lack capacity, it should be determined if this is temporary, fluctuating or permanent, as well as the severity. For those who lack capacity a best interest assessment should be undertaken with all relevant parties involved, with the overall decision being made in the patient’s best interest and in the least restrictive manner. Considerations of sedation technique, clinical holding, or any other procedures should be included in the consent form, with periodic review of the best interest decision as a patient’s circumstances may change over time.