“They have capacity” 🧵
Is not a line in a mental state examination 🛑 “They clearly have capacity”
Capacity is decision specific issue.
It often fluctuates.
It often fluctuates.
It is assessed in 2 stages
STEP 1 Does the person have an impairment of, or disturbance in the functioning of, the mind or brain (whether permanent or temporary)?
And…..Does the impairment or disturbance mean that the person is unable to make a specific decision?
And…..Does the impairment or disturbance mean that the person is unable to make a specific decision?
That means that first you need to do a thorough assessment to establish whether or not the person has an impairment/disturbance of functioning of mind/brain
STEP 2 involves 4 questions
1) understand
2) retain
3) weigh in the balance
4) communicate their decision
1) understand
2) retain
3) weigh in the balance
4) communicate their decision
So, any statement in clinical mental health notes that “They have capacity” needs to be justified by a further question
How did you come to that conclusion?
How did you come to that conclusion?
Because, if you don’t there is a risk that others will take your view at face value.
Please, please let’s not make “They have capacity” become the 3 most deadliest words in the English language 🛑
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