When assessing someone for their capacity to make a specific decision, it is important that they are able to demonstrate that they can sufficiently ‘weigh up’ the decision and so form a reasoned judgement – whether we agree with their final decision or not.
It is, as the term suggests, something of a balancing act. Imagine if you will, a set of scales with weights on either side. As assessors, it is our role to support the individual as needed to identify the pros and cons surrounding the specific decision being made. This should include the immediate as well as the long-term implications, and the individual should be able to demonstrate that they have applied some form of rationale to their decision-making process, taking into account their own personal experiences, beliefs and wishes.
Again, it is important to stress that it is not the decision itself that is important, but rather the fact that they are able to apply some degree of reasoning to balance the various factors for and against a specific decision.
How to assess ‘weighing up’
In order to fully assess someone’s ability to ‘weigh up’ a decision, the questions in a Mental Capacity Assessment should be as open-ended as possible, depending of course on the individual’s communication and cognitive skills. If graded options are needed, then the assessor should ensure that there are sufficient choices available including a balance of ‘good’, ‘bad’ and ‘unrelated’ options, as well as the ‘other’ and/or ‘I don’t know’.
The assessment should also take into account specific details for the individual’s decision-making process if the decision requires it. For example, if assigning a Lasting Power of Attorney, why have they selected person X? Why has person Y not been considered?
Of course, we must ensure that there are no leading questions included that may influence the individual or affect the validity of the assessment itself.
We should also ensure that we make no judgement on the final decision they make. This is particular important because the third principle of the Mental Capacity Act (2005) tells us that an individual is well within their rights to make what some may consider an ‘unwise’ decision – assuming they have capacity.
The role of the assessor
As Mental Capacity Assessors, when we assess for ‘weighing up’, it is our role to establish whether an individual can take account of the relevant positives and negatives surrounding the specific decision being made.
This is perhaps the most vital part of the assessment, as it requires the individual to apply all four criteria:
- Understanding relevant information pertaining to the decision
- Retaining the relevant information
- Considering the broader implications in terms of positives and negatives in order to weigh-up the decision
- Communicate each part of the decision-making process in a language, format and complexity that is suitable to them
If there is doubt as to the individual’s ability to complete any of these steps, then keep asking questions. If you remain unsure, complete the assessment over several sessions. You can always request a second opinion if necessary.