Mental Capacity CEN Summer Study Day

Professor Wayne Martin, Director of the Essex Autonomy Project: SLT Support for the Exercise of Legal Capacity:  A Manifesto

Abstract:   In 2005, Parliament added an additional principle to the Mental Capacity Bill that had been drafted by the Law Commission.   The addition that Parliament deemed essential was that “No one shall be found to be lacking in mental capacity unless all practicable steps have been taken to enable them to make a decision for themselves”  (MCA, sec 1.3).  One year later, the UN General Assembly adopted, and the UK soon thereafter ratified, a landmark human rights convention requiring states parties to "provide access by persons with disabilities to the support they may require in exercising their legal capacity” (CRPD Art 12.3).    As we approach the 20th anniversary of these domestic and legal developments, the promises of these two key legal provisions remain largely undelivered.  But one professional group in particular is uniquely well-placed to effect a breakthrough.

Professor Wayne Martin

Jess Foulkes, Advanced SLT specialising in stroke, trauma & neuro rehabilitation, Cambridge University Hospitals NHS Trust: Using conversation analysis to explore assessments of decision-making capacity in hospital settings

The National Institute of Health Research has called for empirical research into the effective components of capacity assessments in order to inform training for healthcare professionals (HCPs) on how to conduct assessments of decision-making capacity. This study takes the first steps towards that goal. Four naturally-occurring capacity assessments consisting of a range of HCPs and patients with communication difficulties as a result of acquired brain injury were video recorded. Conversation Analysis was used to objectively identify an overall structure of capacity assessment that aligns with best-practice guidance. Variation from this structure was also observed, and potential reasons for this will be discussed. Future larger scale studies are required to generalise findings and inform evidence-based training for effective implementation of the MCA into practice.

Jess Foulkes

Please come prepared to talk about your own cases in small groups, it will be a really useful opportunity to apply what we hear and learn from our speakers to our own clinical practice.

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