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The Mental Capacity Act

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The Mental Capacity Act 2005 (MCA) was created to protect people who can’t make decisions for themselves. It sets out in law how decisions should be made on behalf of a person who lacks capacity.

The Act is based on five key principles, which should underpin healthcare professionals’ approach to decision-making:

  1. Every adult has the right to make decisions for themselves. People must be assumed to have capacity until it is proven otherwise.
  2. People should be given all possible help and support to make their own decisions before anyone concludes that they lack capacity. This includes supporting people to communicate in different ways, such as making noises, or blinking, if they cannot speak properly.
  3. It is every adult’s right to make a decision that seems unwise or strange to someone else. If a person makes such a decision it does not necessarily mean that they lack mental capacity.
  4. Any decision that is made on behalf of a person that lacks capacity must be made in that person’s ‘best interests’.
  5. People who lack capacity should not have their basic rights and freedoms restricted unnecessarily. This means that whenever a decision is made on someone else’s behalf the person making the decision must consider if a different decision or action would interfere less with the person’s right and freedoms.