Most of the points on this checklist, and the example of looking for
an advance decision in the notes, are actually clear-cut requirements of
The Capacity Act. There is no need to delve into the murky, interpretive,
world of ethics. If people carry out an assessment of capacity and then use
the best interests checklist for people who lack it, then most of the
ethical checklist points become redundant. Ignoring a properly worded,
written advance decision about life sustaining treatment (without using
The Mental Health Act to override it) is now illegal, not just unethical.
My experience, which seems to be supported by emerging research, is
that doctors, and other staff, in general hospitals have received poor
levels of training in The Capacity Act. Hence a confusion between ethics
and the law?
Competing interests:
None declared
Competing interests:
No competing interests
11 March 2009
Nick J Woodhead
Mental Health act Coordination manager
Somerset Partnership NHS Foundation Trust, Bridgwater, TA6 4RN
Rapid Response:
Mostly Capacity Act requirements, not ethics
Most of the points on this checklist, and the example of looking for
an advance decision in the notes, are actually clear-cut requirements of
The Capacity Act. There is no need to delve into the murky, interpretive,
world of ethics. If people carry out an assessment of capacity and then use
the best interests checklist for people who lack it, then most of the
ethical checklist points become redundant. Ignoring a properly worded,
written advance decision about life sustaining treatment (without using
The Mental Health Act to override it) is now illegal, not just unethical.
My experience, which seems to be supported by emerging research, is
that doctors, and other staff, in general hospitals have received poor
levels of training in The Capacity Act. Hence a confusion between ethics
and the law?
Competing interests:
None declared
Competing interests: No competing interests