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How does someone decide what’s in my best interests?

Principle Four of the Mental Capacity Act (MCA) says that any decision made on behalf of a person who lacks capacity must be made in their best interests. How someone decides what’s in your best interests will depend on you and the situation you’re in.

How are best interests decisions made?

The Mental Capacity Act (MCA) provides a list of things that must be considered when someone is deciding what’s in your best interests. This list is non-exhaustive, which means that there might be other things that also need to be considered as part of the decision.

The decision-maker must take the following into account: 

All the relevant information

If the decision is about medical treatment, relevant information could include:

  • your medical needs
  • the potential benefits or risks of the treatment
  • any long term consequences of giving or withholding the treatment such as impact on quality of life or life expectancy

Your past and present wishes and feelings

This means taking into account any wishes you have previously expressed, or what you say you want now. You might have written your wishes in an Advance Statement or an Advance Care Plan. You might also have previously spoken to those close to you about what you would want in a particular situation.

Any values and beliefs you have that would be relevant to the decision

This includes any cultural values, religious beliefs or political views that you have. You can record these in an Advance Statement if you wish.

The views of your family members, carers and other relevant people

This includes anyone you previously named as someone you want to be involved in decisions about your care. It also includes people you haven’t specifically named, such as your family members, as well as others involved in your care such as a carer or social worker.

The decision-maker should speak to these people to find out your values or wishes, and to see what they think is in your best interests. If there are people that you have expressly said you don’t want to be involved in your care then the decision-maker will also take this into account.