The Mental Capacity Act

The Mental Capacity Act 2005 (MCA 2005) introduced a statutory framework for advance decision making in England and Wales building upon the common law recognition of advance decisions. Academics considered that a bias may operate against upholding advance decisions refusing life-sustaining treatment 1. It’s commonly felt that judges usually give decisions favouring preservation of life and making advance decisions invalid on various grounds. Recent case-law indicates that a high level of specificity is required for advance refusals of life-sustaining treatment and, in some capacity must be demonstrated at the time of making the decision. This essay will argue the legal back ground of the advance decisions and relevant case law. There are suggestions that advance care planning (ACP) instead of advance decisions (ADRT) may be more helpful when it comes to the practice of law on ground 2.

To adhere with the Nursing and Midwifery Council, Code of Conduct (NMC, 2008) all patient details have been changed, to protect their identity from being revealed.

Consent is defined by NHS Choices (2010) as: "the principle that a person must give

According to the Oxford Dictionary consent is defined as ‘giving permission for something to happen or agreeing to do something’. They define confidentiality as ‘entrusted with private information and if something is intended to be kept secret or in confidence’ (Soanes and Hawker, 2005). As a healthcare professional consent and confidentiality are in place as protective vices, by gaining consent and keeping a patients confidentiality it protects both the patient and the healthcare professional. There are three types of consent: Verbal consent, consent in writing and implied consent. Depending on the situation each type of consent may not be acceptable. For example if a procedure is putting a patient at risk, is complex or invasive for example an operation, written consent is

The need for older people to have their autonomy to make a decision and be an active partner in the decision making process must be recognised and is an essential component in person centred care. ‘’The older person and family have the right to make informed decisions about all aspects of their care and the nurse respects the level of participation desired’’ (An Bord Altranais, 2009). Nurses most realise the importance of patients participation in their care and strive to uphold it as a principle of person centred care, ‘’Lack of time and/or restrictions on patients choice and involvement, was listed as the number 1 factor to hinder quality nursing care’’ (An Bord Altranais, 2009). As nurses it is our responsibility to take the time to overcome communication barriers, for example, a hearing or speech deficit. The nurse can opt to use non-verbal communication to facilitate the decision making process for the patient. Patients are entitled to information about every aspect of their care and should be frequently updated. Information about management and prevention of conditions, procedures, assessments and investigations ,diagnosis, treatment, follow on care, referrals and services available to patients( i.e. health, social) should all be disclosed to patient (Department of Health,2001). If they

In their article, “The Concept of Informed Consent,” Faden and Beauchamp give two varying definitions of informed consent, namely sense one and sense two. Sense one is defined as autonomous authorization, meaning that the patient or subject agrees and then gives authority to move forward with a proposal (Vaughn 191). The authors give four conditions that have to be met for informed consent to be recognized: the patient has to understand the information presented to her, there should be no manipulation or coercion, and she has to intentionally give her authorization (Vaughn 191). Faden and Beauchamp also note that the fourth condition, where the patient gives her authorization, is pivotal in this sense since it differentiates autonomous authorization

My chosen reflection piece is on ageism, see appendix one. I will provide evidence reflecting the links between diabetes and depression, which will form my chosen seminar topic, see appendix two. I will then critically analyze the mental capacity Act (2005) and relate it to my specific scenario, see appendix three. I will explore how nurses the Act within nursing practice, decision- making, and how we access a person’s capacity to make specific decisions. I will explore any ethical issues that may arise following the principles of Mental Capacity Act (2005).

THE FIVE STATUTORY PRINCIPLESThe five principles are outlined in the Section 1 of the Act. These are designed to protect people who lack capacity to make particular decisions, but also to maximise their ability to make decisions, or to participate in decision-making, as far as they are able to do so.

For the purpose of this assignment the patient will be given the pseudonym Susan to protect her privacy and confidentiality in line with the guidelines set out by the Nursing and Midwifery Council (NMC) (2015).

The Mental Health Services Act is a monumental proposition that has helped many people for more than a decade. In California alone, close to 1.2 million adults and around 422,000 children live with a serious mental illness (State 2010). Without the proper treatment, suicide is the leading cause of death for a person battling an untreated mental illness (State 2010). With over thirteen billion dollars raised so far, MHSA has been the root of funding for mental health in California (Williams 2015). MHSA is still a work in progress. The act is nowhere near perfect, as a recent audit has shown, but it is certainly a step in the right direction.

When working with an individual it is important to uphold their rights to be fully involved in their own care, whilst adhering to legal requirements. It is also the individuals right to refuse any care, support or treatment they do not want. It is also essential that people not only give you their consent but also that they understand what they are consenting to and the implications of this. Gaining consent protects not just the career but the individual receiving the care and support as-well. If no consent is given then you cannot proceed with the care. It is illegal to pressure anyone into

In Order to Maintain Confidentiality the client has been provided a pseudonym (Nursing and Midwifery Council 2008). Permission was also granted from this client to use

As a legal and professional obligation the Nursing and Midwifery Council (NMC) (2015) stipulate that all service users must have their confidentiality protected, therefore, the service user in this case study will be given the pseudonym of John.

Permission was consented from the patient to use their condition for this essay; the information was accumulated from their admission, assessment and plan of care. The patient authorized usage of information relating to their period of hospitalisation in agreement that any personal information would not be used. This essay will address this matter in accordance with the Nursing and Midwifery Council (NMC) confidentiality guidelines set out in the Code of Professional Conduct (NMC, 2004). The pseudonym “David” will be used for this reason throughout this essay.

Consent can be quite tricky, a legal minefield for healthcare teams, this is due to the patients who will give or refuse to give private information about themselves who is legally competent but