Critical Commentary: Who Decides Now? Protecting and Empowering Vulnerable Adults Who Lose the Capacity to Make Decisions for Themselves

The Mental Capacity Act 2005 and Its Influences on Social Work Practice: Debate and Synthesis

“…Social workers and other professionals may need to devote time to assist service users and their carers to benefit from the Act, and to make sure that they have accessible explanations for people to read and discuss. Whilst savings of professional time may emerge if service users and carers are better informed and more confident, social workers may feel compromised by work pressures and unable to provide the necessary support unless their employers make the necessary allowances (Johns 2007). Furthermore, proactive promotion of the Act on the part of managers and professionals is likely to be required if service users are to maximise their opportunities to plan their care and make their wishes known.…”

Changing practice: adapting to the Mental Capacity Act 2005

“…A requirement was placed on commissioners to fund a service to provide specialist advocacy for people without family or friends where major health and welfare decisions are under consideration (Independent Mental Capacity Advocates (IMCA)) (such a role can be made available when there are concerns about safeguarding). The implications of the MCA for health and social care practitioners when helping service users with care planning and decision making initially were unclear (Dawson and McDonald, 2000) but there was immediate recognition in the Code of Practice (Ministry of Justice, 2007) and other specialist resources that people with dementia were likely to be affected by different provisions of the MCA (Johns, 2007;Bennett, 2010).…”

Problem or safeguard? Research ethics review in social care research and the Mental Capacity Act 2005

“…The debate which followed suggested that inclusion of statutory provision governing research would establish ethical safeguards whilst facilitating research into incapacity and its treatment. However, the focus of ethical scrutiny is taken predominantly from medical ethics as are the standards from which the wider provisions of the Act were drawn (Johns, 2007).…”

“…However, the DH Framework broadly reflects issues in health research. The MCA states that the capacity to make a decision to take part in a research project is central (Johns, 2007). This capacity relates to understanding information relating to the decision, being able to retain that information and to evaluate and communicate the decision (see s.3).…”

“…Consent is decision-specific and so assessment is necessary for subsequent decisions where capacity may be deemed to be impaired or lacking. Johns (2007) believes that the requirements of the MCA concerning intrusive research applies to almost all social research, interpreting s.30 as referring to any research that normally requires informed consent. The Department of Health has subsequently issued a clarification of the meaning of 'intrusive research' under s.30 (2) of the Act as:…”