Dimond Bridgit
University of Glamorgan, Wales.
Br J Nurs. 2007;16(19):1208-10. doi: 10.12968/bjon.2007.16.19.27359.
This article continues the series in analysing the implications of the Mental Capacity Act (MCA) 2005 by looking at how the best interests of a person (P) lacking the requisite mental capacity are determined. While the MCA does not provide a statutory definition of best interests, it does set out the steps which must be taken to decide on what P's best interests are. These steps are taken only after the decision has been made that P lacks the requisite mental capacity. If there is a likelihood that P could eventually make his own decisions then this must be taken account of. The steps to be taken include making no unjustified assumptions based on the person's age or appearance, condition or an aspect of his behaviour. All the relevant circumstances must be taken into account including the person's past and present wishes and feelings, any relevant written statement made by him, the beliefs and values. There must be consultation with specified others not to establish what others would wish to see happen, but to determine what P's best interests are. These steps are then applied to a typical situation in health and social care. Special provisions relating to life-saving treatment and restraint are also noted.
本文是该系列文章的延续，通过探讨如何确定缺乏必要心智能力的个人（P）的最大利益，来分析2005年《精神能力法案》（MCA）的影响。虽然MCA没有对最大利益给出法定定义，但它确实规定了为确定P的最大利益而必须采取的步骤。这些步骤只有在确定P缺乏必要心智能力之后才会采取。如果有可能P最终能够自己做出决定，那么就必须考虑到这一点。要采取的步骤包括不基于个人的年龄、外貌、状况或行为的某个方面做出无根据的假设。必须考虑所有相关情况，包括该人的过去和现在的愿望和感受、他做出的任何相关书面陈述、信仰和价值观。必须与特定的其他人进行协商，不是为了确定其他人希望发生什么，而是为了确定P的最大利益是什么。然后将这些步骤应用于健康和社会护理中的典型情况。还提到了与救生治疗和约束有关的特殊规定。
