The Mental Capacity Act 2005 and decision-making: best interests.

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.