Decision‐making framework in gynaecology for patients who lack mental capacity

Abstract

Key content Caring for and making decisions on behalf of incompetent adults can be a complicated process. The Mental Capacity Act (MCA) 2005 provides a legal framework that protects mentally incapacitated individuals and guides decision makers during the decision-making process. A gynaecologist can easily undertake the determination of mental capacity using the two-stage test of capacity. The best interests meeting is an appropriate way of facilitating the decision-making process by bringing together the relevant people involved in the care of the individual who has lost decisionmaking ability. Learning objectives. To understand mental capacity in relation to the MCA 2005. To understand the test of mental capacity. To understand the different decision-making models, as applied to mental capacity. To be able to apply the MCA statutory checklist in the determination of best interests. Ethical issues There may be conflicts of interest between the medical team and surrogate decision maker in the best interest meeting. A dispute among the members of the best interest team could delay the treatment of the mentally incapacitated individual, and such delay may not be in the best interest of the patient.