Improving Practice in Supported Decision-Making and Mental Capacity Assessment

Jayes, Mark ORCID: https://orcid.org/0000-0002-0371-7811 (2019) Improving Practice in Supported Decision-Making and Mental Capacity Assessment. Logopedia e Comunicazione, 15 (1). pp. 27-39. ISSN 1825-6724

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Abstract

Current models of evidence-based practice are predicated on the inclusion of patients / service users in decisions about their healthcare. In the United Kingdom (UK), healthcare policy and legislation requires practitioners to provide support with decision-making and, if necessary, complete mental capacity assessments to identify if service users can make informed decisions. People with communication disabilities may have difficulties understanding, thinking and talking about decisions and may require communication support. In this paper, I discuss the current challenges associated with mental capacity assessment and supported decision-making. I propose that healthcare professionals should look beyond legal and policy imperatives to consider the ethical foundations for their practice, when they face such challenges. I compare two conceptual approaches to ethical reasoning. I describe a practical solution to the clinical challenge – the development of the MCAST, a toolkit to support multidisciplinary staff to assess mental capacity and provide support to service users with communication disabilities during the decision-making process