The Mental Capacity Act remains obscure to many in primary care, even though it is relevant to much of our day-to-day work.
Clinical scenarios, such as a daughter requesting a blood result for her mother who has dementia, or a carer asking for help with a patient refusing medication, are covered by the Act, but uncertainty remains.
Most doctors know more about the Mental Health Act than the Mental Capacity Act. This is surprising because the former deals with relatively rare severe psychiatric illness, whereas the latter covers the much more prevalent problems of dementia and learning disability.
The support of common law - acting in the patient's best interests to enforce medical treatment - has mainly disappeared, to be replaced by the Mental Capacity Act.
Simplify the practice
This handbook, written by four psychiatrists, aims to simplify the practice of law in England and Wales to explain how it affects care and some of the reasoning behind it.
The chapter headings, highlighted subheadings and different sections allow the reader to revise and learn relevant information. The well laid out index enhances rapid reference to aid care in particular scenarios.
The longest chapter covers deprivation of liberty, one of the least defined parts of the Act.
The application of deprivation of liberty depends more on expanding case law than on the initial wording of the Act and any published summary, as in this book, will be quickly superseded by more recent cases.
Perhaps some of the background is rather too extensive, as occurs with the coverage of the Human Rights Act, but the easy accessibility of this book, in terms of layout and writing, far outweighs this minor criticism. The emphasis is always on the clinical application of the Act, rather than the legal framework.
I would recommend all GPs to have access to this book for a quick personal update when questions involving capacity arise. When I receive those messages to phone a patient or their relative, I for one cannot always fully remember the specific details of mental capacity, such as advance decisions to refuse treatment or lasting power of attorney.
Brindle N, Branton T, Stansfield A et al. A clinician's brief guide to the Mental Capacity Act. London, RCPsych Publications, 2013
- Dr Phipps is a GP in Lincolnshire.