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MCA2 best interests vers 2.1

MCA2 best interests vers 2.1

Uploaded by Former Member, 13/08/13 17:57
This is the form that we have devised for recording Best Interests Decisions in Gateshead.
Tags: best interests mental capacity act imca mca court of protection bia cop assessing capacity decision maker mca implementation capabilities
FM
Former Member 7 Years Ago
Oh Dear. Very thorough so far as it goes, and a useful tool, but the trouble with creating forms like this is that you trying to rewrite an Act of Parliament, and if it differs by a fraction - a missing or added word, altered punctuation - you end up not with the law of the land but something you have invented. This has happened here: many brilliant and skilled people spend a long time drafting legislation to get the exact meaning of an Act, on which Parliament then votes. They do not accidentally include or leave out words, because then the meaning changes. Your form has a checklist of seven factors that the Decision Maker that the Decision Maker must always consider when reaching a best interest decision. This checklist is taken from Section 4 of the MCA 2005. Only it isn't. Qyestion 5, "is the decision about life sustaining treatment?" is followed by the response, "If it is, confirm that your decision is not be motivated [sic] by a desire to bring about the person's death, and demonstrate that you have not made assumptions about the person's quality of life". This is not what the Act says: it does not say that we cannot make assumptions about a person's quality of life. Section 4(1)(b) cautions against determining what is in a person's best interest on the basis of "a condition of his, or an aspect of his behaviour, that might lead people to make unjustified assumptions about his quality of life". The wording is quite clear: there are such things as justified assumptions, and indeed sometimes they are all we have to go on. In the end, best interest is a subjective judgement based on the balance of probabilities. If the probability is that a person's life is intolerable to them, for example, then we have to take it into account. It may not be the deciding factor; we may even discard it, after consideration, as not relevant, but if we pretend we cannot do it we are not doing the client a proper service, we are shirking our responsibility, and, critically, we are not following the law of the land.
FM
Former Member 7 Years Ago
Thanks Andrew, We have held a number of multi agency consultation events to look at how MCA compliance could be improved. What we learnt from the workshops and feedback was that people still lack confidence aound the application of the MCA because they find it too leaglistic, and are unclear about what their responsibilities are. Most respondants acknowledged that as a result, they just avoid it alltogether. In considering what would increase confidence, people indicated a very high demand for standard tools with embedded guidance. Standard tools will never be a perfect fit, but if they encourage staff to begin to engage with their responsibilities, we are making progress. We have made the concious decision to put whatever we develop "out there", so that we can be informed by feedback such as yours. We will collate and consider all of it, so that we can continue to make improvements. Best wishes Cat
FM
Former Member 7 Years Ago
As I always thought, it would have helped if some standard assessment and recording forms had been introduced at the same time as the Code, so that LAs etc did not have to make up their own or commission them from various sources. Every form I have seen has minor errors of wording and/or meaning. Shame really, given the importance of the Act.