Creating an Advanced Decision to Refuse Medical Treatment Mental Capacity Assessment
An Advanced Decision to Refuse Treatment (sometimes called an Advanced Decision or Living Will) is a document that details any treatment that you don’t wish to have if you are ever in the position where treatment is required and you aren’t able to express your wishes at the time. It records your wishes and is used by health professionals to determine whether to provide specific treatment (often in an emergency situation in hospital).
When adhering to your advanced decision (which could amount to life-saving treatment), medical professionals have to be satisfied that it is valid and that you had the mental capacity to create one at the time it was created. If there is any doubt in their minds, they will provide the necessary treatment. Therefore, in some circumstances, it is important to have a contemporaneous Mental Capacity Assessment that demonstrates you did have the mental capacity to create the advanced decision at the time it was made.
We are instructed by individuals and solicitors who require robust, high quality Mental Capacity Assessments. As consultant Social Workers, we are well placed to complete Mental Capacity Assessments for you concerning a person’s ability to create an Advanced Decision to Refuse Treatment. We have a significant amount of experience as practitioners and have completed hundreds of Mental Capacity Assessments since 2009. In addition, we are qualified Expert Witnesses and instructed to complete Mental Capacity Assessments ahead of legal proceedings.
How is it decided whether a person lacks capacity?
The assessment process itself involves meeting the person (either face-to-face) and consulting their network of support. However, the actual assessment framework for this type of decision is contained within the Mental Capacity Act. This ensures that an objective assessment is completed each time and isn’t subject to personal opinion or assumptions about a particular diagnosis or someone’s age.
When completing a Mental Capacity Assessment for this decision, we adopt best practice principles and adhere to the professional standard of the professional registration and membership bodies we belong to. They are Social Work England, Social Care Wales and the British Association of Social Workers.
How long will the assessment take?
Once instructed, we aim to complete our Mental Capacity Assessments within 14 days with the actual assessment visit usually lasting between 2-3 hours. If, however you require an assessment completed urgently, please let us know and we will do everything we can to meet your specific timescales.
What happens if a person is assessed as lacking capacity?
If the outcome of the assessment is that the person lacks the mental capacity to make the decision, don’t worry. The assessment process is about protecting people’s wishes and autonomy as much as anything else. It’s a process that ensures that people aren’t discriminated against and make decisions for themselves where they’re able to. If a person is assessed as lacking the mental capacity to create an Advanced Decision to Refuse Treatment, they won’t be able to create one.
However, your assessment isn’t wasted because if the outcome is that a person lacks capacity, their views and wishes are documented and can be recorded in their medical records. If the time arises, medical professionals can consider their views and wishes when making best interests decisions about any treatment they provide.
