Capacity and supported decisions
Capacity is decision-specific and may fluctuate. Support understanding and apply the relevant legal framework when a person cannot decide.
Understand
Capacity is specific to the decision and time; a person may understand one choice but not another. Support must be offered before concluding capacity is lacking.
Assess
Explain information in an accessible form, check understanding, retention, use or weighing and communication of a decision under the relevant law.
Apply
If capacity is lacking, follow the applicable best-interests or equivalent legal process, considering wishes and least restrictive options. Do not treat disagreement alone as incapacity.
Key distinctions
The test of capacity is applied to a particular decision at a particular time under the relevant UK jurisdiction's framework. Information must be presented accessibly, with time and support. A patient can make a decision others regard as unwise while still having capacity. When capacity is absent, consultation and a legally valid best-interests or equivalent process must guide the least restrictive option.
Think through a case
A person with dementia explains a simple examination but cannot weigh the risks of a complex operation today. Capacity may differ between those decisions.
The distinction to remember
Do not use a diagnostic label or a disagreement with the clinician as proof of incapacity.
Test your recall
Does a diagnosis of dementia automatically remove capacity?
Show answer
No; assess the particular decision at the time.