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"Mental Competency - legislation "
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Mental capacity in relationship : decision-making, dialogue, and autonomy
Recent legal developments challenge how valid the concept of mental capacity is in determining whether individuals with impairments can make decisions about their care and treatment. Kong defends a concept of mental capacity, but argues that such assessments must consider how relationships and dialogue can enable or disable the decision-making abilities of these individuals. This is thoroughly investigated using an interdisciplinary approach that combines philosophy and legal analysis of the law in England and Wales, the European Court of Human Rights, and the United Nations Convention on the Rights of Persons with Disabilities. By exploring key concepts underlying mental capacity, the investigation concludes that both primary relationships, as well as capacity assessments themselves, must display key competencies in order to ensure that autonomy skills are promoted and encouraged. This ultimately provides scope for justifiable interventions into disabling relationships and articulates the dialogical practices that help better situate, interpret, and understand the choices and actions of individuals with impairments.
Book
Research involving adults lacking capacity to consent: a content analysis of participant information sheets for consultees and legal representatives in England and Wales
Background
Research involving adults who lack the capacity to provide informed consent can be challenging. In England and Wales there are legal provisions for consulting with others who know the person with impaired capacity. The role of the ‘proxy’ (or ‘surrogate’) is to advise researchers about the person’s wishes and feelings or to provide consent on the person’s behalf for a clinical trial of a medicine. Information about the study is usually provided to the proxy; however, little information is available to proxies about their role, or the appropriate legal and ethical basis for their decision, to help inform their decision-making. The aim of this study was to analyse the written information that is provided to consultees and legal representatives.
Methods
Studies including adults lacking capacity to consent which utilised consultees or legal representatives were identified using the UK Clinical Trials Gateway database. A representative sample (
n
= 30) were randomly selected. Information sheets and other study documents provided to proxies were obtained, and relevant content was extracted. Content analysis was conducted through four stages: decontextualisation of the unit of analysis, recontextualisation, categorisation, and compilation. The data were summarised narratively according to each theme and category.
Results
Considerable variation was found in the written information sheets provided to proxies. Most directed proxies to consider the wishes and feelings of the person who lacked capacity and to consult with others during the decision-making process. However, a small number of studies extended the scope of the proxy’s role to consider the person’s suitability or eligibility for the study. Particular discrepancies were found in information provided to those acting as consultees or legal representatives in a professional, as opposed to a personal, capacity. Incorrect uses of terminology were frequently found, and a small number of studies inaccurately interpreted the law.
Conclusions
Despite undergoing ethical review, study documents lacked essential information, incorrectly used terminology, and conflated professionals’ clinical and representation roles. Future recommendations include ensuring proxies are provided with adequate and accurate information which complies with the legal frameworks. Further research is needed to explore the information and decision-making needs of those acting as consultees and legal representatives.
Journal Article
Children's Conceptual Knowledge of Lying and its Relation to Their Actual Behaviors
Child witnesses must undergo a competence examination in which they must show appropriate conceptual understanding of lying and truth-telling, and promise to tell the truth. Three experiments (Ns = 123, 103, 177) were conducted to address the assumptions underlying the court competence examination that (1) children who understand lying and its moral implications are less likely to lie and (2) discussing the conceptual issues concerning lying and having children promising to tell the truth promotes truth-telling. Both measures of lying and understanding of truth- and lie-telling were obtained from children between 3 and 7 years of age. Most children demonstrated appropriate conceptual knowledge of lying and truth-telling and the obligation to tell the truth, but many of the same children lied to conceal their own transgression. Promising to tell the truth significantly reduced lying. Implications for legal systems are discussed.
Journal Article
Mental health & mental capacity law for social workers : an introduction
Introduces students to the fundamental principles of mental health law and how they can be applied to everyday practice with clear introductions to key Acts such as the Mental Capacity Act and the Mental Health Act as well as the relevant Codes of Practice.
eBook
Legal aspects of mental capacity : a practical guide for health and social care professionals
LEGAL ASPECTS OF MENTAL CAPACITY
A Practical Guide for Health and Social Care Professionals
SECOND EDITION
Praise for the first edition:
\"Invaluable in negotiating the legal minefield that surrounds the complicated issue of mental capacity.\"
Mental Health Practice
\"In Dimond's Legal Aspects of Mental Capacity, we find a well-crafted reference book that goes beyond mere presentation of the law and relevant regulations.\"
Metapsychology
The Mental Capacity Act (2005) regulates decision-making processes on behalf of adults who are unable to give informed consent due to a loss in mental capacity (be that from birth or due to an illness or injury at some point in their lives). Since the act's implementation, the new Court of Protection has been firmly established, and there have been significant Supreme Court cases, as well as further guidance on the 2005 Act and major developments in the use and assessment for Deprivation of Liberty Safeguards.
Thoroughly updated to take into account the many updates, developments, and changes in legislation and guidance, the new edition of Dimond's authoritative guide will be warmly welcome by practitioners and students who need to understand and work within the Mental Capacity Act and how it applies to their professional responsibilities.
* A highly practical guide to the Mental Capacity Act and its provisions since its conception in 2005
* Relevant for a wide range of practitioners and students within health and social care
* Highly readable and easily accessible, even for those with no legal background
* Includes a range of learning features, including scenarios, questions and answers, key summary points, and applications for practice.
Legal Aspects of Mental Capacity is an essential resource for all healthcare and social services professionals, students, patient services managers, and carers working with those who lack the capacity to make their own decisions.
eBook
Our future: a Lancet commission on adolescent health and wellbeing
Better childhood health and nutrition, extensions to education, delays in family formation, and new technologies offer the possibility of this being the healthiest generation of adolescents ever. But these are also the ages when new and different health problems related to the onset of sexual activity, emotional control, and behaviour typically emerge. Global trends include those promoting unhealthy lifestyles and commodities, the crisis of youth unemployment, less family stability, environmental degradation, armed conflict, and mass migration, all of which pose major threats to adolescent health and wellbeing.
Journal Article
Coercion and informed consent in research involving prisoners
Prison-based research has been limited due to concern that prisoners may represent a vulnerable population secondary to possible coercion and limited capacity for voluntary informed consent. This study was designed to assess decisional capacity and susceptibility to coercion in prison research subjects. Subjects were 30 mentally ill prisoners and 30 healthy controls. The groups were compared on ability to provide informed consent to a hypothetical drug trial, susceptibility to possible coercion, neuropsychological functioning, and psychiatric symptoms. Results indicated that all controls and all but one of the prisoners demonstrated adequate capacity to consent to the hypothetical drug trial. However, when decisional capacity was measured quantitatively, prisoners performed significantly worse regarding two aspects of this ability. Regarding possible coercion, prisoners’ main reasons for participating in research included avoiding boredom, meeting someone new, appearing cooperative in hopes of being treated better, and helping society. Neuropsychological functioning was strongly positively correlated with decisional capacity and negatively correlated with susceptibility to possible coercion, whereas psychiatric symptoms were only weakly correlated with these variables. In conclusion, a very high percentage of particularly vulnerable, mentally ill prisoners demonstrated adequate capacity to consent to research. Lower scores on a quantitative measure of decisional capacity suggest that extra care should be taken during the consent process when working with these subjects. The reasons prisoners gave for participating in our research indicated that the prison setting may have influenced their decision to participate, but that they were not actually coerced into doing so. Despite serious past incidents, ethicists will need to consider the possibility that prisoners have become an overprotected population.
Journal Article
A Practical Guide to the Mental Capacity Act 2005 : Putting the Principles of the Act into Practice
This book provides a theory-to-practice breakdown of the Mental Capacity Act 2005 and what its implications are for health and social care workers. Informative and accessible, it provides a clear depiction of the ethos behind the Act and offers instruction for its effective, lawful and person-centred application. This practical guide describes how to assess capacity and what a good assessment of capacity should look like, how to deal with conflicts and dilemmas, and the role of legal authority in decision-making. A Practical Guide to the Mental Capacity Act 2005 is an invaluable resource for any health and social care professionals working with individuals who lack decision-making capacity.
eBook
Hidden Behind Bars — The Public Health Implications of Incompetency to Stand Trial
Across the United States, many people are incarcerated without having been convicted of a crime because of concerns about their competency to stand trial.
Journal Article
Human rights violations of people with mental and psychosocial disabilities: an unresolved global crisis
This report reviews the evidence for the types of human rights violations experienced by people with mental and psychosocial disabilities in low-income and middle-income countries as well as strategies to prevent these violations and promote human rights in line with the UN Convention on the Rights of Persons with Disabilities (CRPD). The article draws on the views, expertise, and experience of 51 people with mental and psychosocial disabilities from 18 low-income and middle-income countries as well as a review of English language literature including from UN publications, non-governmental organisation reports, press reports, and the academic literature.
Journal Article