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Mental Capicity

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1 Mental Capicity on Mon Jul 18, 2016 6:57 pm

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Case Law has clearly laid out the right of a mentally competent adult to refuse and treatment, including live saving interventions, regardless of the reason, or for no reason at all.
This has now been incorporated into several statutory frameworks. In England and Wales this framework is the Mental Capacity act 2005 (MCA), and in Scotland, the adults with incapacity (Scotland) act 2000.

Central to all of these is the concept of personal autonomy, that is, the right of an individual to 'govern themselves' according to their own set of personal values, preferences, commitments and character traits (Freyenhagen 2009).

This can come into conflict with an ambulance crews tendency towards beneficence (i.e serving the best interests of the patient (Moye 2007) ) and wanting to safeguard their job.

Mental capacity is the ability to make a decision, and covers everything from when to get up to how much alcohol to drink and whether to go to hospital as advised by the ambulance crew.

A lack of capacity is defined as an inability of your patient to make a specific decision at the time they are required to make it, due to an impairment of, or disturbance in the functioning of, the mind or brain. It does not matter if this impairment or disturbance is temporary or permanent.

Examples of impairment

Temporary

Post-ictal following a seizure
A diabetic suffering a hypoglycaemic event
Ingestion of alcohol or drugs

Permanent

Dementia
Significant learning disabilities
Long-term effects of brain damage

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