24 Hours in A&E puts dealing with diminished mental capacity in the ‘spotlight’

This week’s episode of 24 hours in A & E gave us a perfect illustration of how the Mental Capacity Act should work in practice.

Barrie was a 78 year old man with dementia who had been brought to hospital by his wife, Irene, with breathing difficulties.

Barrie had difficulty describing his symptoms to the doctor, and Irene explained that he had severe memory problems.

The doctor took Irene to one side to ask her whether Barrie should be resuscitated if he suffered a stroke or heart attack.

Irene said that she would consult with Barrie and there followed a very poignant scene where Irene asked Barrie whether he would want to be resuscitated if he suffered a severe deterioration.

What was interesting was that Barrie was then able to engage in a discussion about the level of disability and quality of life that he may have if resuscitated. He said that he did not want to be a burden on Irene and decided that he would not want to be resuscitated if he was in a critical condition.

The Mental Capacity Act 2005 deals with how decisions should be made on behalf of people who lack mental capacity. The first principle is that a person will be assumed to have capacity unless it is proved otherwise.

In this case it initially appeared that Barrie had very little capacity but Irene was right to consult with him and it was a revelation to see that he was able to understand the information relevant to the decision, retain and use that information and then communicate his decision.

The Act states that any decision made on behalf of an incapacitated person should be made in their best interests, and they should be consulted where possible.

This was a good example of one of the basic tenets of the Act, namely that before making any decision on behalf of an incapacitated person, you should take steps to ascertain whether the person has capacity in relation to the specific matter that has to be decided.

At the end of the programme it was a relief to see that Barrie had made a good recovery and was back at home with Irene.