The Dentist Magazine.

To treat or not to treat – who decides?

Published: 8/13/2019 12:00:00 AM

The Mental Capacity Act (MCA) 2005 is designed to protect those who lack mental capacity, putting them at the centre of any decision-making process. However, an Act alone is not sufficient, as carers and healthcare professionals need guidance on how best to practice and protect within the scope of that legislation. 

Daakshini Patel, from the Great Western Hospitals NHS Trust and Malika Hindocha, a GDP in a mixed practice, are exploring this matter at this year’s BDIA Dental Showcase in their lecture entitled ‘To Treat or Not to Treat – who decides?’

Daakshini and Malika will define mental capacity and the causes of incapacity. They will also outline the MCA’s Code of Practice and the five key principles. They will give the audience the tools and understanding needed to apply the two-stage test of capacity and show them how best to manage the best interests of patients who lack capacity, as well as outlining those individuals who have the right to make decisions on their own behalf. They will also explore consent processes for children under 16, including those with and without competence.

Malika takes a keen interest in legal and ethical issues in everyday practice, while Daakshini treats special needs patients with or without competence under both general and local anaesthesia. He commented, “Informed consent forms the fundamental backbone of all healthcare provision. Every adult with capacity has the right to make decisions about their own treatment. The MCA provides the legal framework in England and Wales, for people aged 16 and over who may lack competence. Whilst it provides a definition for mental incapacity, capacity is often time specific and must be assumed until proven otherwise. Thus, the legal responsibility whether to treat or not to treat, lies with the clinician.  Our lecture is intended to give guidance, using everyday examples we’ve encountered in surgery. There will also be a Q&A element where we will be happy to answer any questions you have. This legislation can be confusing, and we hope to give attendees the confidence they need to make the right decision to protect those most vulnerable in our society”.

Malika and Daakshini will be lecturing at BDIA Dental Showcase (17-19 October 2019, Birmingham NEC). To register visit