Determining best interests under the mental capacity act 2005

Medical Law Review

Volumn 19, Issue 2, 2011, Pages 304-313

  Donnelly, Mary ^a  

^a UNIVERSITY COLLEGE CORK   (Ireland)

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EID: 79957862481     PISSN: 09670742     EISSN: 14643790     Source Type: Journal    
DOI: 10.1093/medlaw/fwr012     Document Type: Note

References (40)

1. The authority of the Court in this respect derives from MCA, s 16.
2. Prior to the MCA, decisions regarding property and affairs were made in accordance with the statutory framework outlined in the Mental Health Act 1983, Part VII, while decisions about health and welfare were made in accordance with the declaratory jurisdiction established in Re F: (An Adult: Sterilisation) [1990] 2 AC 1.
3. Re G (Patients) [2007] EWHC 1861 (Ch); [2008] WTLR 599.
4. Re D(J) [1982] Ch 237, 243-4 (per Megarry VC).
5. [2007] EWHC 1861 (Ch) [62].
6. [2010] EWHC 3005 (COP).
7. Under the Court of Protection Rules, SI 2007/1744, r 90, the Court of Protection operates in private; however, the Court may authorise full publication or publication of a summary of a judgment: r 91.
8. On the human rights implications of publication in the MCA context, see Independent News Media v A [2009] EWHC 2858 (Fam); [2010] EWCA Civ 343 (CA).
9. MCA, s 4(2).
10. [2000] 1 FCR 193.
11. For examples of balancing in operation, see A National Health Trust v C unreported, High Court (Family Division), 8 February 2000 (in the context of non-consensual sterilisation); Simms v Simms and Anor; A v A and Anor [2002] EWHC 2734 (Fam), [60]-[64] (in the context of experimental treatment for vCJD); A Hospital NHS Trust v S [2003] EWHC 365 (Fam), [47] (in the context of receipt of a kidney transplant).
12. In the Matter of G (TJ) above, n 6 [36].
13. Other parts of s 4, which are not of immediate relevance to the discussion here, are: s 4(1) which prohibits decision-makers from making determinations of best interests on the basis of a person's age, appearance, or a condition or aspect of behaviour which might lead others to make unjustified assumptions; s 4(3) which requires the decision-maker to consider whether the person is likely to regain capacity; and s 4(5) which requires that a decision to remove 'life-sustaining treatment' must not be motivated by a desire to bring about the death of the person lacking capacity.
14. Above, n 6 [26].
15. On participation as best practice, see Kirsty Keywood and others, Best Practice?: Healthcare Decision-making By, With and For Adults with Learning Disabilities (National Development Team, Manchester 1999).
16. Jonathan Herring, 'Losing It, Losing What?: The Law on Dementia' (2009) 21 CFLQ 3, 26.
17. The United Nations Convention on the Rights of Persons with Disabilities, (2006) General Assembly Resolution 61/106, Article 12(3) requires that States Parties must 'take appropriate measures to provide access by persons with disabilities to the support they may require in exercising their legal capacity'. See also Council of Europe Recommendation No R (99) 4 of the Committee of Members to Member States on Principles Concerning the Legal Protection of Incapable Adults (adopted February 23 1999), Principle 9.
18. Above, n 6 [45].
19. [2008] EWHC B16 (Fam), [2009] WLTR 315.
20. [2009] EWHC 163 (Ch), [2010] Ch 33.
21. [2009] EWHC 2525 (Fam), [2010] 3 All ER 682.
22. Under MCA, s 18(1)(i), the powers of the Court of Protection extend to the execution of a will on behalf of a person lacking capacity.
23. In Re P (Statutory Will) above, n 24 [38] (Lewison J).
24. Above, n 23 [55].
25. See In Re P (Statutory Will) above, n 24 [41]; In re M above, n 24 [35].
26. See Mary Donnelly, Healthcare Decision-Making and the Law: Autonomy, Capacity and the Limits of Liberalism (Cambridge: Cambridge University ress, 2010), 207-9.
27. Rebecca Dresser, 'Missing Persons: Legal Perceptions of Incompetent Patients' (1994) 46 Rutgers LR 609, 612.
28. [2010] EWHC 1217 (Fam).
29. [2010] EWHC 2746 (COP).
30. See Donnelly above n 34, 201; 221-23.
31. Above, n 6 [65].
32. See for example the United States' Uniform Health-Care Decisions Act 1994, s 5 (which has been widely adopted by individual states).
33. See MCA, s 25(2) which provides that an advance decision is not valid if the person 'has done anything else clearly inconsistent with the advance decision remaining his fixed decision': see Alasdair Maclean, 'Advance Directives and the RockyWaters of Anticipatory Decision-Making' (2008) 16 Med L Rev 1, 20.
34. Donnelly above n 34, 196.
35. J. Samanta 'Lasting Powers of Attorney for Healthcare under the Mental Capacity Act 2005: Enhanced Prospective Self-Determination for Future Incapacity or a Simulacrum?' (2009) 17 Med L Rev 377, 402.
36. Above, n 6 [56].
37. In re P (Statutory Will) above, n 24 [44]; In re M above, n 25 [37]-[38].
38. Above, n 6 [64].
39. Herring above n 20, 26.
40. See Louise Harmon, 'Falling Off the Vine: Legal Fictions and the Doctrine of Substituted Judgment' (1990) 100 Yale LJ 1.