Literature Review on Provision of Appropriate and Accessible ...

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In the absence of explicit assessment guidelines, there is a danger that
incapacity might be inferred solely on the grounds that the individual has
a disabling medical or psychiatric condition. The Ontario Ministry of the
Attorney General (2005) states that the Substitute Decisions Act 1992
created the opportunity for the introduction of a standard assessment
protocol, which would reduce bias and introduce consistency in the way
that mental capacity assessments are conducted (Ontario Ministry of the
Attorney General, 2005.) [46]
Support to People with an Intellectual Disability who are
Accessible
and Appropriate of Provision on <strong>Review</strong> <strong>Literature</strong>
Experiencing Crisis Pregnancy
The Department of Health in the UK has published the ‘Good Practice in
Consent Implementation Guide: consent to examination or treatment’
(DH, 2001). The good practice in consent implementation guide
contains a model consent policy and four consent forms, together
with an accompanying information leaflet. The model documentation
was developed as part of the Department of Health’s ‘Good Practice in
Consent’ initiative, with the aim of assisting National Health Service
(NHS) organisations to promote good practice in the way patients are
asked to give their consent to treatment, care or research.
Four consent forms were developed; the fourth one is of particular
relevance to staff working with people with learning disabilities (see
Appendix A). It provides guidance on how an individual practitioner might
assess a person’s capacity and then decide, with support from others,
whether it is in the person’s best interests to carry out the investigation
or treatment. (See also the Mental Capacity Act 2005, Code of Practice
for detailed guidance.)
2.8.3 Supporting decision-making
Hobden & Mills (2008) emphasise the need to properly assess the
capacity of the individual in question to make his/her decision and to
recognise that people with intellectual disabilities may have the capacity
to both give and withhold consent to medical or surgical treatment.
They note that the competent individual has the right to make the
wrong decision, even for reasons that may be irrational or non-existent
to health professionals (Hobden & Mills, 2008). The mere presence of
emotional responses such as that of panic or irrationality does not in
46 Guidelines for Conducting Assessment of Capacity, Capacity Assessment Office,
Ontario Ministry of the Attorney General.