In General Comment No. 1, the UN Committee on the Rights of Persons with Disabilities calls for ‘the best interpretation of will and preferences’ to replace best interests determinations in decision-making law, but it has given little guidance on the content of this new standard. As a result, ‘best interpretation’ is sometimes treated as synonymous with ‘true interpretation’. On this reading, ‘the best interpretation of will and preferences’ is just whatever interpretation most accurately represents the interpreted person's will and preferences.This article shows that the conflation of the word ‘best’ with the word ‘true’ must be avoided. Interpretative processes contribute to changes in the interpreted person, including changes in their will and preferences. There are both supportive and abusive forms of these contributions, but conflating ‘best interpretation’ with ‘true interpretation’ removes both from view. An alternative reading of ‘best interpretation’ should therefore be preferred: one that requires the process of interpretation to be responsive to both truth and the detailed substantive rights found in the UN Convention on the Rights of Persons with Disabilities.
Judges in England and Wales tell three apparently contradictory stories about the relationship between autonomy and mental capacity. Sometimes, capacity is autonomy's gatekeeper: those with capacity are autonomous, but those without capacity are not. Sometimes, capacity is necessary for autonomy but insufficient; for voluntariness, freedom from undue external influences is also required. Finally, sometimes autonomy survives incapacity, and a person without capacity is nevertheless treated as autonomous. These three accounts coexist, so no story of evolution, in which one account comes to replace another, can be told. Similarly, no story of judicial factions is plausible, for judges switch account to suit the facts of a particular case. This article gives examples of all three accounts, traces their recent history, and shows how each serves one or two characteristic purposes. It then shows how they can be combined into a coherent descriptive account of the relationship between autonomy and mental capacity in domestic law.
McFarlane LJ's leading judgment in PC v City of York Council consistently stresses the 'plain' statutory language of the Mental Capacity Act 2005. In doing so, it reveals how intractably difficult performing an assessment in accord with the Act can sometimes be. In particular, it raises questions about the sources of evidence upon which a finding of incapacity can be based, illustrates that causation under the Act may have been widely neglected, and highlights contestable assumptions that underlie the Act's 'decision-specific' approach to assessment.
Meno’s paradox—which asks ‘how will you know it is the thing you didn’t know?’—appears in Plato’s dialogue of the same name. This article suggests that a similar question arises in some supportive relationships. Attention to this question clarifies one condition necessary to justify making a best interests decisions against someone’s will: the decided-for person must be unable to recognise that they have failed to recognise a need. From this condition, two duties are derived: a duty to ensure that someone cannot recognise that they have failed to recognise a need before making a decision against their will; and a duty to provide consensual support to those who have had decisions made against their will, in order to help them to avoid such second-order failures of recognition in the future. The article assesses the Mental Capacity Act 2005 against each of these duties. For each duty, it finds that the Act allows compliance, but does not robustly require it.
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