Literature Review on Provision of Appropriate and Accessible ...
Literature Review on Provision of Appropriate and Accessible ...
Literature Review on Provision of Appropriate and Accessible ...
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PAGE 68<br />
itself indicate incompetence. Similarly, fear can affect a pers<strong>on</strong>’s ability<br />
to make a decisi<strong>on</strong>, but it is important to look behind the resp<strong>on</strong>se <strong>and</strong> to<br />
assess the individual. A pers<strong>on</strong> may decline a procedure, as they believe<br />
it will be very <str<strong>on</strong>g>Literature</str<strong>on</strong>g> painful <strong>and</strong> <str<strong>on</strong>g>Review</str<strong>on</strong>g> they <strong>on</strong> do Provisi<strong>on</strong> not want <strong>of</strong> <strong>Appropriate</strong> to experience <strong>and</strong> that <strong>Accessible</strong> pain. But<br />
it may be the Support case, that to People with with careful an Intellectual explanati<strong>on</strong> Disability about the who procedure are<br />
<strong>and</strong> with opti<strong>on</strong>s Experiencing for pain Crisis relief, Pregnancy his or her fears may be allayed, <strong>and</strong><br />
thus they can c<strong>on</strong>sent to the treatment. Other temporary factors such as<br />
shock, drugs <strong>and</strong> c<strong>on</strong>fusi<strong>on</strong> may also impinge <strong>on</strong> some<strong>on</strong>e’s competence<br />
(Hobden <strong>and</strong> Mills, 2008).<br />
D<strong>on</strong>nelly (2007) emphasises the need for a rigorous approach to expert<br />
evidence (i.e. evidence from the medical pr<strong>of</strong>essi<strong>on</strong>) <strong>and</strong> a participative<br />
element when formally assessing capacity. She discusses the problems<br />
which can arise with the quality <strong>of</strong> expert evidence (due in part to<br />
a general lack <strong>of</strong> awareness <strong>of</strong> the legal positi<strong>on</strong> am<strong>on</strong>g medical<br />
pr<strong>of</strong>essi<strong>on</strong>als), such as for example, adopting a status approach where<br />
the expert gives evidence that the individual has a mental c<strong>on</strong>diti<strong>on</strong><br />
such as schizophrenia <strong>and</strong> then c<strong>on</strong>cludes <strong>on</strong> this basis that he/she is<br />
incapable rather than applying the legal test for capacity (Grisso, 2002).<br />
In additi<strong>on</strong>, a participative element in the process by the individual<br />
c<strong>on</strong>cerned will lead to better decisi<strong>on</strong>-making <strong>and</strong> will also assist in<br />
minimising the negative impact <strong>of</strong> the process <strong>on</strong> the individual involved<br />
(D<strong>on</strong>nelly, 2007). The 2005 Guidelines include key points in relati<strong>on</strong> to the<br />
assessment <strong>of</strong> capacity [47] as follows:<br />
1. People with intellectual disabilities are not a separate group<br />
<strong>of</strong> human beings who think, feel <strong>and</strong> act in a similar fashi<strong>on</strong>.<br />
Their individual likes, dislikes, choices, talents, strengths <strong>and</strong><br />
weaknesses are varied as elsewhere in society.<br />
2. Difficulties in communicati<strong>on</strong> should not be c<strong>on</strong>fused with<br />
incapacity.<br />
3. Presence <strong>of</strong> intellectual disability must not undermine the<br />
presumpti<strong>on</strong> <strong>of</strong> capacity.<br />
47 Adapted from Ontario Ministry <strong>of</strong> the Attorney General, 2005.