Hostname: page-component-cd9895bd7-lnqnp Total loading time: 0 Render date: 2024-12-25T19:18:39.387Z Has data issue: false hasContentIssue false

Mental capacity legislation in the UK: systematic review of the experiences of adults lacking capacity and their carers

Published online by Cambridge University Press:  02 January 2018

Sam Wilson*
Affiliation:
Royal Cornhill Hospital, Aberdeen
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.
Aims and method

Capacity legislation in the UK allows substitute decision-making for adults lacking capacity. Research has explored the experiences of such adults and their carers in relation to the Adults with Incapacity (Scotland) Act 2000, and the Mental Capacity Act 2005 in England and Wales. A systematic review of the relevant research was performed using a framework method.

Results

The legislation provided mechanisms for substitute decision-making which were seen as useful, but there were negative experiences. Decision-making did not always seem to follow the legislative principles. Awareness of the legislation was limited. Most research was qualitative and some was of low methodological quality. Data were too heterogeneous to allow comparisons between English and Scottish law.

Clinical implications

Capacity legislation was generally viewed positively. However, some experiences were perceived negatively, and the potential benefits of the legislation were not always utilised.

Type
Review Article
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an open-access article published by the Royal College of Psychiatrists and distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 2017 The Authors

Footnotes

Declaration of interest

None.

References

1 Buchanan, A. Mental capacity, legal competence and consent to treatment. J R Soc Med 2004; 97: 415–20.Google Scholar
2 Law Commission. Mental Incapacity (Law Com No. 231). HMSO, 1995.Google Scholar
3 Scottish Law Commission. Report on Incapable Adults (Scot Law Com No. 151). HMSO, 1995.Google Scholar
4 Centre for Reviews and Dissemination. Systematic Reviews. CRD's Guidance for Undertaking Reviews in Health Care. University of York, 2009.Google Scholar
5 Pluye, P, Gagnon, MP, Griffiths, F, Johnson-Lafleur, J. A scoring system for appraising mixed methods research, and concomitantly appraising qualitative, quantitative and mixed methods primary studies in mixed studies reviews. Int J Nurs Stud 2009; 46: 529–46.Google Scholar
6 Thomas, J, Harden, A. Methods for the thematic synthesis of qualitative research in systematic reviews. BMC Med Res Methodol 2008; 8: 45.Google Scholar
7 Gale, NK, Heath, G, Cameron, E, Rashid, S, Redwood, S. Using the framework method for the analysis of qualitative data in multidisciplinary health research. SMC Med Res Methodol 2013; 13: 117.CrossRefGoogle Scholar
8 Badger, J. Making Choice a Reality: The Impact of the Mental Capacity Act on Young People in Transition to Adulthood. Scope, 2009.Google Scholar
9 Badger, J, Parnell, R. A Long Road To Travel: The Impact of the Mental Capacity Act on Adults with Complex Needs in Residential Settings. Scope, 2009.Google Scholar
10 Jevon, T. Report on a Survey of Private Welfare Guardians (2014). Mental Welfare Commission for Scotland, 2014.Google Scholar
11 Jingree, T. Duty of care, safety, normalisation and the Mental Capacity Act: a discourse analysis of staff arguments about facilitating choices for people with learning disabilities in UK services. J Community Appl Soc Psychol 2015; 25: 138–52.Google Scholar
12 Killeen, J, Myers, F. The Adults with Incapacity (Scotland) Act 2000: Learning from Experience. Chapter 4. Research on Parts 2 and 3 of the Act. Scottish Executive Social Research, 2004.Google Scholar
13 Killeen, J, Myers, F. The Adults with Incapacity (Scotland) Act 2000: Learning from Experience. Chapter 5. Research on Part 6 of the Act. Scottish Executive Social Research, 2004.Google Scholar
14 Manthorpe, J, Samsi, K, Rapaport, J. When the profession becomes personal: dementia care practitioners as family caregivers. Int Psychogeriatr 2012; 24: 902–10.Google Scholar
15 Mental Welfare Commission for Scotland. Supervising Guardians. A Report on the Support and Supervision of Private Welfare Guardians under the Adults with Incapacity (Scotland) Act 2000. Mental Welfare Commission for Scotland, 2012 (http://www.mwcscot.org.uk/media/91547/supervising_guardians_2012.pdf).Google Scholar
16 Myron, R, Gillespie, S, Swift, P, Williamson, T. Whose Decision? Preparation For and Implementation of the Mental Capacity Act in Statutory and Non-Statutory Services in England and Wales. Mental Health Foundation, 2008.Google Scholar
17 Samsi, K, Manthorpe, J. 'I live for today': a qualitative study investigating older people's attitudes to advance planning. Health Soc Care Community 2011; 19: 52–9.Google Scholar
18 Samsi, K, Manthorpe, J. Everyday decision-making in dementia: Findings from a longitudinal interview study of people with dementia and family carers. Int Psychogeriatr 2013; 25: 949–61.Google Scholar
19 Williams, V, Boyle, G, Jepson, M, Swift, P, Williamson, T, Heslop, P. Making Best Interests Decisions: People and Processes. Mental Health Foundation, 2012.Google Scholar
20 Greenhalgh, T. How to Read a Paper (5th edn). BMJ Books, 2014.Google Scholar
21 Berg, BL. Qualitative Research Methods for the Social Sciences (4th edn). Allyn & Bacon, 2001.Google Scholar
22 Committee on the Rights of Persons with Disabilities. General comment No. 1. Article 12: Equal Recognition before the Law. United Nations, 2014.Google Scholar
23 United Nations General Assembly. Resolution No. 61/106. Convention on the Rights of Persons with Disabilities. United Nations, 2007.Google Scholar
24 Pearl, AL. Article 12 of the United Nations Convention on the Rights of Persons with Disabilities and the legal capacity of disabled people: the way forward? Leeds J Law Criminol. 2013; 1: 130.Google Scholar
25 Freeman, MC, Kolappa, K, Caldas de Almeida, JM, Kleinman, A, Makhashvili, N, Phakathi, S, et al. Reversing hard won victories in the name of human rights: a critique of the General Comment on Article 12 of the UN Convention on the Rights of Persons with Disabilities. Lancet Psychiatry 2015; 2: 844–50.Google Scholar
26 Martin, W, Michalowski, S, Stavert, J, Ward, A, Keene, AR, Caughey, C. Three Jurisdictions Report. Towards Compliance with CRPD Art. 12 in Capacity/Incapacity Legislation across the UK. Essex Autonomy Project, 2016.Google Scholar
27 House of Lords. Select Committee on the Mental Capacity Act 2005. Report of Session 2013-14. Mental Capacity Act 2005: Post-Legislative Scrutiny. TSO (The Stationery Office), 2014.Google Scholar
28 Patrick, H. Authorising Significant Interventions for Adults who Lack Capacity. Mental Welfare Commission for Scotland, 2004.Google Scholar
29 Series, L. Power and the Mental Capacity Act. The Small Places, 2015 (https://thesmallplaces.wordpress.com/2015/02/18/power-and-the-mental-capacity-act/).Google Scholar
30 HL v UK 45508/99 (2004) ECHR 471.Google Scholar
31 Scottish Law Commission. Report on Adults with Incapacity (Scot Law Com No. 240). TSO (The Stationery Office), 2014.Google Scholar
Submit a response

eLetters

No eLetters have been published for this article.