MCA Project


Mental Capacity Act Project
Chief Investigator: Dr Sofia Zarate Escudero, Specialist Trainee in Psychiatry, West London Mental Health NHS Trust, London, United Kingdom

Background
The MCA 2005 was fully implemented in October 2007 and includes a statutory framework for making decisions on behalf of individuals who lack decision-making capacity (DMC).
Prior to this Act, there was no statutory law covering this group of patients with lack of DMC. Those lacking DMC were treated under the common law doctrine of necessity. The MCA 2005 comprises four key principles:
  1. A person must be assumed to have capacity unless it is established that he lacks capacity.
  2. A person is not to be treated as unable to make a decision unless all practicable steps to help him to do so have been taken without success.
  3. A person is not to be treated as unable to make a decision merely because he makes an unwise decision.
  4. An action performed or decision made under this Act, for or on behalf of a person who lacks capacity, must be done, or made, in his best interests. (Mental capacity Act 2005: Deprivation of liberty safeguards)
The MCA is very clear that it is the responsibility of the treating clinician to ascertain the patient's capacity to consent for investigations and medical treatment. This, however, may be a grey area, in particular, when a patient lacks capacity to make decisions regarding complex surgical interventions, especially during emergency situations. In these scenarios, members of the Psychiatric Team are asked to perform Capacity Assessments, which is not within their remit.

Project aim
The aim of this study is to determine the awareness, understanding and confidence to apply the MCA 2005 amongst surgical trainees.

Methodology
Collaborating investigators will survey core and higher surgical trainees at their site using a standard 18-item questionnaire. Completed questionnaires will then be returned to the chief investigator for analysis.

How to get involved
This project has now finished data collection so is not open to new researchers.

For further information please email sofiaz_uk [at] yahoo.co.uk
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