Best interests decisions

Professional practices in health and social care

Datos Bibliográficos

ID12290298
AutoresVal Williams (0000-0002-8608-7842, Norah Fry Research Centre; University of Bristol; Bristol UK, autor de correspondencia), Geraldine Boyle (0000-0002-8185-1354, Centre for Applied Social Research; University of Bradford; Bradford UK), Michael Jepson (0000-0003-3261-1626, University of Bristol), Marcus Jepson (Norah Fry Research Centre; University of Bristol; Bristol UK), Paul Swift (Independent Consultant; Bristol UK), Toby Williamson (Mental Health Foundation; London UK), Pauline Heslop (0000-0002-8628-6868, Norah Fry Research Centre; University of Bristol; Bristol UK)
Año2013
Volumen22
Número1
Páginas78-86
Fecha de publicación2013-08-24
Peer ReviewedSí
Open AccessSí
TipoARTICLE
RevistaHealth & Social Care in the Community (JOURNAL)
Identificadores de la revistaISSN: 0966-0410 • E-ISSN: 1365-2524
EditorialWiley (PUBLISHER • GB)
DOI10.1111/hsc.12066
PMID23981053
OpenAlexW2098191975
IdiomaEN
Citas recibidas9
Referencias citadas19

This paper reports on data collected in 2011 from a national study about the operation of the best interests principle, a key feature of the Mental Capacity Act (MCA) 2005 for England and Wales. The objective was to provide a picture of current professional practices in best interests decision-making. Four contrasting sample sites were selected, in which National Health Service trusts, social care and other organisations were recruited to participate. A multimethod design was followed, including an online survey with 385 participants, followed by qualitative research through a telephone survey of 68 participants, and face-to-face semi-structured interviews following up 25 best interests cases, with different perspectives on the process in 12 of those cases. The current paper reports only on the qualitative findings. The findings indicate that the MCA was successful in providing a structure for these practitioners, and that the five principles of the MCA were in general adhered to. A variety of perceived risks led to best interests processes being undertaken, and a typical scenario was for a period of hospitalisation or ill health to trigger a best interests decision process about a social care and or a life decision. The study supported previous research in finding the notion of capacity the most difficult aspect of the MCA, and it provides evidence of some specific capacity assessment practices, including problematic ones relating to 'insight'. Best interests decisions were often made by consensus, with practitioners taking on different roles within the process. Meetings played a key part, but other ways of involving people lacking capacity and significant others were also important. It was recommended that the issues highlighted in this research could be clarified further in the Code of Practice, or within risk guidance

Best interests · Best practice · Health care · Medical education · Mental health · Political science · Process (computing · Psychiatry · Public relations · Qualitative research · Sociology · Variety (cybernetics · Computer Science · Ethics and Legal Issues in Pediatric Healthcare · Healthcare Decision-Making and Restraints · Medicine · Nursing · Palliative Care and End-of-Life Issues · Psychology