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Capacity and Supported Decisions
Decision-making capacity concerns a particular choice, while appropriate support can help people understand and express their decisions.
#Capacity concerns this decision at this time
The GMC explains mental capacity as the ability to make a particular decision at a particular time. Difficulty with one complex choice does not establish inability to make every choice, now or in the future. Its guidance begins with the presumption that an adult patient has capacity.
Read which decision is being considered and when it needs to be made. Capacity is not a permanent label attached to a diagnosis. The GMC material is UK professional guidance; assessment must follow the relevant national law and circumstances.
Evidence: GMC: mental capacity and decision support / GMC: principles of decision making and consent
#Disagreement is not evidence of incapacity
The GMC says capacity should not be rejected solely because of age, disability, appearance, behavior, medical condition, beliefs or a decision a professional considers unwise. Its framework concerns understanding, retaining and using relevant information and communicating the decision.
Read how an assessment distinguishes disagreement from an inability to make the particular choice. A person's preferences may differ from the professional's without demonstrating incapacity. This educational summary is not an assessment tool or a substitute for the applicable legal process.
#Support can make a decision more accessible
The GMC describes sharing information in a suitable format and at a suitable time, using interpreters where needed and giving time to consider it. A patient may want a relative, friend, carer or advocate involved. Reasonable adjustments can help people understand, retain, use or communicate information.
Read what support was offered before drawing conclusions from a communication difficulty. Support helps the person take part; it should not be confused with automatically transferring their decision to someone else. Needs and helpful adjustments vary between people and decisions.
#Protection should preserve participation
The GMC's principles say that care choices for a person lacking capacity should be of overall benefit and made in consultation with those close to them or advocating for them. People whose consent is affected by law should still be supported to participate and exercise choice where possible.
Read who has authority under the applicable law and how the person's wishes and involvement are considered. This page does not decide whether someone lacks capacity or whether a family member may consent for them. Mynd provides general education, not capacity assessments or legal advice.
Evidence: GMC: principles of decision making and consent / GMC: mental capacity and decision support
Source note
The sections above were checked against the linked sources. No clinical review has been performed. This is general research education, not a clinical guideline.