Co-decision-making in the assisted decision-making (Capacity) Act 2015: challenges and complexities

Area of Science:

• Legal and Medical Capacity Assessment
• Healthcare Law and Ethics
• Supported Decision-Making Frameworks

Background:

• The Assisted Decision-Making (Capacity) Act 2015 introduced new tiers of support for individuals with diminished capacity.
• Co-decision-making represents a novel approach where decision-making authority is jointly held.
• Healthcare professionals face challenges in assessing capacity for this shared model.

Purpose of the Study:

• To explore the concept and practical application of co-decision-making under the 2015 Act.
• To analyze the complexities of the capacity test for co-decision-makers.
• To propose frameworks for understanding and implementing co-decision-making effectively.

Main Methods:

• Conceptual analysis of co-decision-making principles.
• Examination of the capacity assessment framework within the Act.
• Exploration of 'partial capacity' as a relevant concept for assessment.

Main Results:

• Co-decision-making is positioned as a central support mechanism within the new legal framework.
• The capacity test for co-decision-making is identified as complex for assessors.
• The concept of 'partial capacity' offers a useful lens for situating co-decision-making on a spectrum.

Conclusions:

• Co-decision-making is a vital but challenging component of the Assisted Decision-Making (Capacity) Act 2015.
• Further conceptual clarity, particularly regarding 'partial capacity,' is needed for effective implementation.
• There is a collective responsibility to ensure co-decision-making functions as a viable support option.