Assessment of Mental Capacity: Guidance for Doctors and Lawyers

Assessment of Mental Capacity: Guidance for doctors and lawyers......Page 5
Contents......Page 7
Acknowledgements......Page 12
List of cases......Page 14
List of statutes......Page 17
List of statutory instruments......Page 18
Part I Introduction......Page 19
1.2 The need to define capacity......Page 21
1.3 Proposals for law reform......Page 22
1.4 How to use this book......Page 24
1.5 Scope of this book......Page 26
1.6 Where to obtain further advice......Page 29
2.1 Capacity to instruct a solicitor......Page 31
2.2 Confidentiality......Page 32
2.3 Creating the right environment for assessing capacity......Page 35
2.4 Refusal to be assessed......Page 37
2.6 Summary of points for doctors......Page 38
2.7 Summary of points for lawyers......Page 40
Part II Legal principles......Page 43
3.1 Capacity and the role of the courts......Page 45
3.2 Capacity and the law of evidence......Page 46
3.3 Practical suggestions for solicitors instructing doctors......Page 50
3.4 Practical suggestions for doctors receiving instructions from solicitors......Page 51
3.5 Witnessing documents......Page 52
Part III Legal tests of capacity......Page 57
4.1 Powers of attorney......Page 59
4.2 Capacity to manage property and affairs......Page 66
4.3 Capacity to claim and receive social security benefits......Page 74
4.4 Protection from financial abuse......Page 76
5.1 Introduction......Page 79
5.2 Testamentary capacity......Page 80
5.3 Supervening incapacity......Page 81
5.5 Checklist......Page 83
5.6 Capacity to revoke a will......Page 85
5.7 Statutory wills......Page 87
6.2 The test of capacity......Page 89
6.3 Checklist......Page 90
6.5 Gifts made on behalf of Court of Protection patients......Page 92
6.6 Risk of financial abuse......Page 93
7.1 Introduction......Page 94
7.2 The test of capacity......Page 95
7.3 Applying the test......Page 96
7.5 Implications of incapacity......Page 100
8.2 General rules......Page 102
8.3 Voidable contracts......Page 103
8.4 Necessaries......Page 104
8.7 Checklist......Page 105
9.2 Legal incapacity to vote......Page 107
9.3 Eligibility for registration......Page 108
9.4 At the polling station......Page 110
9.6 Conclusion......Page 111
10.1 Right to form relationships......Page 113
10.2 Family relationships......Page 114
10.3 Sexual relationships......Page 117
10.4 Capacity to consent to marriage......Page 119
10.5 Capacity to separate or divorce......Page 122
10.6 Conclusion......Page 123
11.1 Proposed changes to the law......Page 125
11.2 Giving evidence in court......Page 130
11.3 Conclusion......Page 132
12.2 The need for patient consent......Page 134
12.3 Capacity to consent to medical procedures......Page 136
12.4 Treatment of adults lacking capacity to consent......Page 140
12.5 Capacity to make anticipatory decisions......Page 146
12.6 Confidentiality......Page 149
12.7 Access to records......Page 151
13.2 Research governance......Page 154
13.4 Research involving incompetent adults......Page 156
13.5 Innovative treatment......Page 159
13.6 Proposals for law reform......Page 161
Part IV Practical aspects of the assessment of capacity......Page 163
14.1 Introduction......Page 165
14.2 Defining capacity......Page 167
14.3 The doctor’s role......Page 168
14.4 A systematic approach to assessing capacity......Page 171
14.5 The mental state in relation to capacity......Page 173
14.7 The duty to enhance mental capacity......Page 177
14.9 General guidance......Page 180
15.1 Introduction......Page 182
15.2 Who should assess the person?......Page 183
15.3 Psychiatric diagnoses......Page 186
15.4 Medical assessment of mental conditions......Page 188
Appendices......Page 193
Appendix A Case studies......Page 195
Appendix B The Official Solicitor......Page 206
Appendix C Practice Note (Official Solicitor: Declaratory Proceedings: Medical and welfare decisions for adults who Lack Capacity)......Page 209
Appendix D Practice Note (Official Solicitor: Appointment in Family Proceedings)......Page 219
Appendix E Medical certificate for the Official Solicitor with guidance notes......Page 224
Appendix F Medical certificate for the Court of Protection with notes for guidance......Page 229
Appendix G Sample letter: Test of capacity......Page 237
Useful addresses......Page 239
Further reading......Page 244
Index......Page 246