Implementing the Mental Capacity Act in nursing homes: between obligation and application

Menezes, Bunota; Tadros, George

doi:10.1002/gps.1970

Cited by 5 publications

(3 citation statements)

References 2 publications

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“…9,16 Not surprisingly, inadequate treatment, or not being able to attend to and care for the patient in a proper way due to lack of resources, is reported as one of the most prominent ethical challenges in nursing homes and home care services. 9,11,16 Reduced decision-making capacity represents another central ethical challenge to clinicians' attempt to respect the patients' autonomy, 9,17 and various kinds of restraints are frequently used in nursing homes. 18 Finally, end-of-life care represents many prominent ethical challenges and sometimes conflicts.…”

Section: Introductionmentioning

confidence: 99%

Ethical challenges and how to develop ethics support in primary health care

2012

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Ethics support in primary health care has been sparser than in hospitals, the need for ethics support is probably no less. We have, however, limited knowledge about how to develop ethics support that responds to primary health-care workers' needs. In this article, we present a survey with a mixture of closed- and open-ended questions concerning: How frequent and how distressed various types of ethical challenges make the primary health-care workers feel, how important they think it is to deal with these challenges better and what kind of ethics support they want. Five primary health-care institutions participated. Ethical challenges seem to be prominent and common. Most frequently, the participants experienced ethical challenges related to scarce resources and lack of knowledge and skills. Furthermore, ethical challenges related to communication and decision making were common. The participants welcomed ethics support responding to their challenges and being integrated in their daily practices.

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Section: Introductionmentioning

confidence: 99%

Ethical challenges and how to develop ethics support in primary health care

2012

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“…A review of the literature relating to mental capacity issues, and the practical application of mental capacity legislation was conducted by the Mental Health Foundation (2012). Factors associated with impaired capacity were seen to be specific to the illness or disability and consequently varied according to service user group; specific findings have been made in relation to capacity issues and mental health (Goss et al, 2008;Hamann et al, 2009;Patel and Bakken, 2010), learning disability (Antaki et al, 2008;Dunn et al, 2010) and dementia (Gregory et al, 2007;Menezes and Tadros, 2008). More generally, it was found that factors involving the assessment of capacity which resulted from a person's emotional state or physical functioning tended not to be accounted for within standardised capacity assessments (Mackenzie and Watts, 2011).…”

Section: Literature On Assessing Mental Capacitymentioning

confidence: 98%

Key components of supporting and assessing decision making ability

Webb

Davidson

Edge³

et al. 2020

International Journal of Law and Psychiatry

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“…According to these laws, health care may be provided if it is deemed to be in the patient’s best interests and the patient gives or would have given permission to such care. When the patient lacks decision-making capacity, which is often the case when making end-of-life decisions in nursing homes [ 2 , 7 ], the next of kin has a legal right to be informed about the patient’s medical condition. Further, the relatives should be asked to elicit information about the patient’s preferences.…”

Section: Introductionmentioning

confidence: 99%

How do nursing home doctors involve patients and next of kin in end-of-life decisions? A qualitative study from Norway

2016

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BackgroundEthically challenging critical events and decisions are common in nursing homes. This paper presents nursing home doctors’ descriptions of how they include the patient and next of kin in end-of-life decisions.MethodsWe performed ten focus groups with 30 nursing home doctors. Advance care planning; aspects of decisions on life-prolonging treatment, and conflict with next of kin were subject to in-depth analysis and condensation.ResultsThe doctors described large variations in attitudes and practices in all aspects of end-of-life decisions. In conflict situations, many doctors were more concerned about the opinion of next of kin than ensuring the patient’s best interest.ConclusionsMany end-of-life decisions appear arbitrary or influenced by factors independent of the individual patient’s values and interests and are not based on systematic ethical reflections. To protect patient autonomy in nursing homes, stronger emphasis on legal and ethical knowledge among nursing home doctors is needed.

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Implementing the Mental Capacity Act in nursing homes: between obligation and application

Cited by 5 publications

References 2 publications

Ethical challenges and how to develop ethics support in primary health care

Ethical challenges and how to develop ethics support in primary health care

Key components of supporting and assessing decision making ability

How do nursing home doctors involve patients and next of kin in end-of-life decisions? A qualitative study from Norway

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