Clinical governance Understanding the Mental Capacity Act 2005: a guide for clinicians

Key content: Patients who have legal capacity have an unconditional right to accept or refuse life-threatening treatment. The Act allows for advance decisions to be made by someone about future treatment. The Act recognises a Lasting Power of Attorney, which allows a person to make decisions about another person's welfare when the donor lacks capacity. Learning objectives: To understand the test for mental capacity. To be able to determine 'best interests'. To be aware of advance decisions and how they are created. To understand the legal role of the family for patients who lack capacity. To be aware of Lasting Powers ofAttorney and their limitations. Ethical issues: A patient's autonomy could lead them to make an unwise decision. There may be disagreements between doctors and someone who has Lasting Power of Attorney. Advance decisions could lead to the potential illegality of passive euthanasia and refusal of life-sustaining treatment.