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Mental Capacity and the complex nature of decision-making

It’s estimated that the average person makes around 35,000 decisions every single day. While this may seem a huge number, many of these are ‘micro decisions’ that we make without even thinking; the sorts of things that might have required great effort during childhood, but which in adulthood require barely any conscious effort at all.

Retaining information: man looking out of window

When should an RPR make a section 21a application to the Court of Protection?

The role of a Relevant Person’s Representative (RPR) is to be an independent and impartial voice working on behalf of the relevant person under a Deprivation of Liberty Safeguards (DoLS) authorisation. They are there to support inclusion, knowledge, rights and promote the person’s voice within the DoLS process, performing a vital safeguarding role to help monitor its application. As part of this role, an RPR should raise a Section 21a challenge to the Court of Protection if the person they are representing voices an objection to DoLS.

Close up of an elderly woman sat in a cafe

Mental capacity two stage test: Is a formal diagnosis required?

In previous blogs, we have explored some of the many different elements required to assess mental capacity for a specific decision. This brings us then to the two stage test, which is composed of the functional and diagnostic steps that are then bound together as part of the causative nexus (the justifiable link).

Mental capacity assessment: female professional assessing elderly gentleman

Important updates to Form COP3 ‘assessment of capacity’

As of July 2023 there is now a new updated COP3 form (‘assessment of capacity’ for Court of Protection Submissions) available on the UK Government website. We have a growing range of blogs around this topic and area able to provide completition of Part B on referral. For a walkthrough guide of the updated document, please visit.

Woman in wheelchair signing consent form

Mental Capacity and informed consent

Consent refers to a person’s voluntary assent to a particular action, decision or interaction. There are many different types of consent. These include:

  • Implied consent – where no verbal or written consent has been given, but an action by the individual in question suggests their agreement. For example, if a patient offers their arm to have their blood pressure taken.  
  • Informed consent – requires an explicit understanding of all the relevant facts, including risks and available alternatives. Usually, information is provided in order to help the person to understand what is proposed and why. This type of consent is often associated with medical procedures in healthcare settings; it is also often formalised with a physical signature on a consent form.
Supporting capacity with augmentative communication aids

Top 10 blogs on Mental Capacity and the Mental Capacity Act

In the last 18 months, we have published 100 blog posts on topics relating to Mental Capacity and the Mental Capacity Act (2005). In that time, we’ve covered a diverse range of subjects from Lasting Power of Attorney, to least restrictive practice, the causative nexus, and much more besides! We’ve also recently launched a series of mini case studies using characters from famous film and TV shows as a way to think about capacity around decisions.

Manor house on a misty day

Case study: The diagnostic step and the causative nexus

The diagnostic step is a simple but often misunderstood part of the Mental Capacity Assessment. One of the most common errors is to simply list a medical diagnosis without any explanation of how the diagnosis impacts upon decision-making. However, this link – also known as the causative nexus – is the vital point on which the rest of the assessment is based. It is therefore important to understand exactly why the diagnostic step is important and how to document it properly.