Moving From 'Best Interests' to 'Will and Preference': A Study of Doctors' Level of Knowledge Relating to the Assisted Decision-Making (Capacity) Act 2015.

Aims Irish decision-making capacity legislation is due to fundamentally change from 2022, with the commencement of the Assisted Decision-Making (Capacity) Act 2015, removing 'best interests' decision-making and replacing it with a 'will and preference' basis. This study aimed to investigate awareness amongst doctors regarding this Act, and specific knowledge relating to capacity assessment and advanced healthcare directives. Methods The study utilised a cross-sectional anonymised self-report questionnaire within a second tier hospital located in a rural part of Ireland. Results Only 2% of doctors had received any formal training on the Act, 25% were unsure of their role and 45% were unsure of a patient's role in decision-making. 37% believed that best interests was retained in decision-making. 50% were unaware of their obligations in assessing capacity, 23% were unable to assess capacity correctly and 47% were unsure of any consultative obligations in decision-making. 90% were unaware of what constituted a valid Advanced Healthcare Directive. Conclusion Further training is urgently required if the Act is to be successfully implemented in 2022.