The Mental Capacity Act 2005 About those who are not able to make decisions for themselves (But not children or people who are mentally ill) About all.

The Mental Capacity Act 2005About those who are not able to make

decisions for themselves(But not children or people who are mentally

ill)About all kinds of decisions (e.g. financial)Not just healthcareNevertheless it includes healthcareIt raises important questions about

withholding and withdrawing medical treatment

The Mental Capacity Act 2005Withholding and withdrawing sometimes

legitimateNot like suicide and euthanasia (always

wrong)Depends of circumstancesDepends on intentionThis makes it difficult to lay down rulesIs there anything we can say?

The Mental Capacity Act 2005(At least) two important goods at stake:Living well and dying wellCherishing Life and accepting deathGiving needed treatment and avoiding futile

(or burdensome) treatmentAvoid under-treatment and over-treatmentSome more anxious about under-treatmentSome more anxious about over-treatmentImportant to remember BOTH these dangers

The Mental Capacity Act 2005How does Mental Capacity Act deal with this?:Five ‘key principles’, essentially two:Presume and support capacity to make decisionsIf no capacity to decide then act in ‘best

interests’ (best interests includes more that physical health)

Two key new powers:Legally binding advance decision to refuse

treatmentAppointment of health and welfare attorney

The Mental Capacity Act 2005From Catholic perspective ‘five key principles’ are

acceptable if understood in Catholic senseAdvance decisions can be legitimate can cause

problemsAttorney can be legitimate can cause problemsThe Guide neither forbids nor recommends theseTwo particularly sensitive issues: Refusing (and respecting refusal of) assisted

nutrition and hydrationRespecting (valid and applicable) clearly suicidal

advance decisions

The Mental Capacity Act 2005Artificial nutrition and hydration commonly taken

as ‘medical treatment’Act (and Code) clearly states that ANH can be

refusedThis particularly problem if person is not dying

(e.g. PVS patient)Understanding of John Paul II and other

authorities is that ANH is basic care, rarely if ever to be withdrawn

Nevertheless at end of life circumstances make even refusal of food and fluids a possible option

The Mental Capacity Act 2005With attorney, be ready to discuss and if

necessary to resist withdrawal against best interest

With advance decision, how to deal with harmful refusal of ANH or clearly suicidal refusal

Must these be respected?Ask carefully if valid and applicableThis aspect of care taken from professional

responsibility. Remaining question: what to do if you do not

agree?