England Wales

Last updated:

Flowchart spells out mental capacity law

A new BMA tool offers practical help for doctors who need to assess the decision-making capacity of their patients.

mental healthThe online resource offers a step-by-step guide through procedures set out in the Mental Capacity Act 2005 for England and Wales, which aims to protect adults who may not be able to make care or treatment decisions themselves.

This could be due to a mental health condition, severe learning disability, brain injury, stroke or unconsciousness from an anaesthetic or sudden accident.

BMA medical ethics department deputy Julian Sheather said the BMA had long been concerned over a lack of awareness of the act among doctors. 

He stressed: ‘Without a practical grasp of the main features of the act, doctors risk either exposing vulnerable patients to unnecessary risks or overriding their decision-making liberties.’


Better awareness

Concerns over awareness of the act were reinforced this March by a Lords select committee, which questioned whether the act was working as intended.

Its post-legislative scrutiny report found that, although the act was held in high regard, there was a lack of awareness and understanding. 

‘For many who are expected to comply with the act it appears to be an optional add-on, far from being central to their working lives,’ the report said.

The BMA’s online tool incorporates a decision-making flow chart and is designed to be used alongside the BMA’s mental capacity toolkit, also available online. 

It guides doctors through considerations such as whether a decision can be delayed until a person regains capacity.

A two-stage test for assessing capacity follows, to help determine whether it is in the best interests of the patient for a decision to be made on their behalf.

Use the BMA interactive tool