The five Principles of the Mental Capacity Act (MCA) are part of the legislation, so it is a legal obligation to respect these Principles whenever MCA is used.
Principle 1: The Principles assume capacity. Unless you have evidence that someone lacks capacity, you must assume that they can make their own decision. If there are doubts about someone’s capacity this must be assessed rigorously, and you need to find the evidence about their capacity. (Part 6: How to assess capacity)
Principle 2: You need to do everything you realistically can to enable someone to make their own decision. For instance, make sure they are comfortable; explain the information in as many ways as possible, use different communication methods and visit as often as possible. (Part 6: How to assess capacity)
Principle 3: Everyone makes decisions which might seem unwise to other people. An unwise decision should not be taken as an indication of someone’s capacity. For instance, someone may refuse treatment or care which they clearly need. If they have capacity to make this decision this is their right and they can refuse up to the point of death: if they lack capacity others will need to make a best interests decision for them. The person’s capacity for the decision must be carefully assessed and their refusal must not be used as evidence of a lack of capacity. (Part 8: Best interests decisions)
Principle 4: Everything done under MCA must be done in the interests of the individual. This means that a best interests decision made under MCA must be in that person’s interests and not in the interests of their family, of other people on the ward or the general public. (Part 8: Best interests decisions)
Principle 5: Anything done under MCA must be the minimum action necessary, must allow the person as much freedom of choice as possible and must follow their wishes as closely as possible. (Part 8: Best interests decisions)
This page was last modified: 3rd Jan 2014