Assessments of mental capacity: upholding the rights of the vulnerable or the misleading comfort of pseudo objectivity?

Rogers, Jim and Bright, Lucy (2019) Assessments of mental capacity: upholding the rights of the vulnerable or the misleading comfort of pseudo objectivity? Journal of Adult Protection . ISSN 1466-8203

Full content URL: https://doi.org/10.1108/JAP-10-2018-0026

This is the latest version of this item.

Documents
The Journal of Adult ProtectionAssessments of mental capacity: upholding the rights of the vulnerable or the misleading comfort of pseudo objectivity?
Publishers PDF

Request a copy
Assessments of mental capacity: upholding the rights of the vulnerable or the misleading comfort of pseudo objectivity?
Accepted Manuscript
[img]
[Download]
[img] PDF
JAP-10-2018-0026.pdf - Whole Document
Restricted to Repository staff only

181kB
[img] PDF
Assessments of mental capacity- upholding the rights of the vulnerable or the misleading comfort of pseudo objectivity .pdf - Whole Document

114kB
Item Type:Article
Item Status:Live Archive

Abstract

Purpose
The purpose of this paper is to present findings from a research project which investigated the approaches of different groups of assessors to the mental capacity assessments which are required to be conducted as part of Deprivation of Liberty Safeguards (DOLS)
Design/Methodology/Approach
Four case study vignettes were given to participants.Three groups involved in the DOLS assessment process were interviewed by telephone about the factors that may influence their capacity assessments.
Findings
Most assessors did not refer to the required two stage test of capacity or the 'causative nexus' which requires that assessors must make clear that it is the identified 'diagnostic' element which is leading to the inability to meet the 'functional' requirements of the capacity test.

The normative element of capacity assessments is acknowledged by a number of assessors who suggest that judging a person's ability to 'weigh' information, in particular, is a subjective and value based exercise, which is given pseudo objectivity by the language of the MCA. A number of elements of good practice were also identified.

Research limitations.
In this exploratory study, participant numbers were small (n= 21), and we relied on self-report rather than actual observations of practice or audit of completed assessments
Practical Implications
The findings are of relevance to all of those working in health and social care who undertake assessments of mental capacity, and will be helpful to all of those tasked with designing and delivering training in relation to the Mental Capacity Act 2005 (MCA). They also have relevance to policy makers in the UK who are involved with reforms to DOLS regulations, and to those in other countries which have legislation similar to the MCA.
Originality/Value
Much existing literature exhorts further training around the MCA. We suggest that an equally important task is for practitioners to understand and be explicit about the normative elements of the process, and the place of ethics and values alongside the more cognitive and procedural aspects of capacity assessments.

Keywords:Mental capacity, Deprivation of Liberty Safeguards, Case study vignettes, Professional values, Safeguarding, Best interests
Subjects:L Social studies > L500 Social Work
Divisions:College of Social Science > School of Health & Social Care
ID Code:35339
Deposited On:16 Apr 2019 08:36

Available Versions of this Item

Repository Staff Only: item control page