In Scotland, decision-making in this area is covered by the Adults With Incapacity (Scotland) Act 2000.
The Act introduced a statutory framework for the medical treatment of incapacitated adults (aged 16 or over) in Scotland.
It acts alongside the common law power to provide treatment in emergencies to people who are unable to give consent.
Any intervention in the affairs of an incapacitated adult must:
- benefit the adult
- take account of the adult’s wishes, so far as these can be ascertained
- take account of the views of relevant others, as far as it is reasonable and practical to do so
- restrict the adult’s freedom as little as possible while still achieving the desired benefit
- encourage the adult to exercise residual capacity.
The 2000 Act introduced new forms of proxy decision-making and clarified the legal basis on which doctors make decisions about the medical treatment of incapacitated adults.
The Act also makes provision for safeguarding the welfare of incapacitated adults and managing their property and financial affairs.
You may become involved in assessing a person's capacity to make decisions about these matters.
However, Part 5 of the Act, which regulates medical treatment and research, will have the biggest impact on medical practice. Its provisions took effect in July 2002.
In Northern Ireland, decision-making is governed by the common law. The Northern Ireland Assembly are working towards statutory provisions for treating adults lacking mental capacity but we do not yet know when this will be introduced. In the meantime, you may find pages 134 to 141 (Chapter 3) of Medical Ethics Today useful.