Five key principles of the Mental Capacity Act
- Principle 1: Capacity should always be assumed. A patient’s diagnosis, behaviour, or appearance should not lead you to presume capacity is absent
- Principle 2: A person’s ability to make decisions must be optimised before concluding that capacity is absent. All practicable steps must be taken, such as giving sufficient time for assessments; repeating assessments if capacity is fluctuating; and, if relevant, using interpreters, sign language, or pictures
- Principle 3: Patients are entitled to make unwise decisions. It is not the decision but the process by which it is reached that determines if capacity is absent
- Principle 4: Decisions (and actions) made for people lacking capacity must be in their best interests
- Principle 5: Such decisions must also be the least restrictiveoption(s) for their basic rights and freedoms
Assessing mental capacity

Assessing mental capacity: the Mental Capacity Act
Mental Capacity Act
Sept 2007 from the BMA