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Mental capacity as a safeguard in assisted dying: clarity is needed

BMJ 2015; 351 doi: (Published 19 August 2015) Cite this as: BMJ 2015;351:h4461
  1. Annabel Price, consultant psychiatrist and visiting researcher, Department of Psychiatry, University of Cambridge, Cambridge CB2 0SP
  1. ap806{at}

The Marris-Falconer bill includes provisions for assessment of mental capacity in some cases, but Annabel Price calls for more detail on how this would work in practice

The Assisted Dying Bill shortly to be debated in the UK parliament, as with previous bills to legalise physician assisted suicide for terminally ill adults, proposes safeguards to help ensure that vulnerable people do not access it inappropriately.1

A key proposed safeguard is the determination of mental capacity: the bill requires that the person “has the capacity to make the decision to end their own life,” using the framework of the Mental Capacity Act 2005. Compared with some other aspects of the bill this safeguard has received relatively little scrutiny, and the bill as it stands lacks the clarity to guide assessing clinicians on what should be expected of them.

The challenges include knowing where to set the standard to determine capacity (just how much capacity does one need for the decision …

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