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References

Mental Capacity Act 2005.London: HMSO;
Guides for Commissioning Dental Specialties – Special Care Dentistry. NHS England. 2015;
Adults with Incapacity (Scotland) Act 2000.: Parliament TSO;
Mental Capacity Bill Bill 49/11-16.: Northern Ireland Assembly; 2016
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Consent and capacity – considerations for the dental team part 2: adults lacking capacity

From Volume 44, Issue 8, September 2017 | Pages 762-772

Authors

Suzanne Burke

BDS(Hons), MFDS RCSEd

Specialty Trainee in Special Care Dentistry

Articles by Suzanne Burke

Andrew Kwasnicki

BChD, MFDS RCSEd, MSND RCSEd, Cert Sed(Liv) FHEA

Consultant/Honorary Clinical Lecturer in Special Care Dentistry, Liverpool University Dental Hospital, Royal Liverpool and Broadgreen Hospitals NHS Trust, Pembroke Place, Liverpool L3 5PS, UK

Articles by Andrew Kwasnicki

Shelagh Thompson

BDS, MPhil, PhD, MSND RCSEd, MFDS RCSEng

Associate Specialist in Special Care Dentistry, University Dental Hospital, Cardiff.

Articles by Shelagh Thompson

Tom Park

BDS(Hons), MFDS RCSEd

Dental Core Trainee in Special Care Dentistry, Liverpool University Dental Hospital, Royal Liverpool and Broadgreen Hospitals NHS Trust, Pembroke Place, Liverpool L3 5PS, UK

Articles by Tom Park

Avril Macpherson

BDS, FDS RCSEd, MFDS RCSEd, MSND RCSEd, DipConSed FHEA

Consultant/Honorary Senior Clinical Lecturer in Special Care Dentistry, Special Care Dentistry Department, Liverpool University Dental Hospital, Royal Liverpool and Broadgreen Hospitals NHS Trust, Pembroke Place, Liverpool L3 5PS, UK

Articles by Avril Macpherson

Abstract

Abstract: Assessment of capacity is a fundamental part of everyday clinical dental practice in all settings. The legal and ethical principles underpinning assessment of capacity, and our responsibility to act in our patients' best interests must be understood by the dental team. The dental team must be aware of how and when to act in the best interests of the adult patient who lacks capacity, and where it is appropriate to seek further advice. The dental profession is in the privileged position of making decisions on behalf of patients, and must fulfil its responsibilities to this potentially vulnerable patient group.

CPD/Clinical Relevance: This paper defines common terms relating to capacity, provides an overview of UK capacity legislation, and discusses how to provide care for adults who lack capacity to consent for their treatment.

Article

Dentists must gain consent from their patients for examination and treatment. However, when faced with situations where patients either lack capacity, or their capacity is questioned, the dental team should be aware of the legal and ethical considerations involved in assessment of capacity and acting in a person's best interests. Where an adult lacks capacity to consent for treatment, this should not become a barrier to provision of care. Clinicians should be aware of the processes and procedures involved, including where onward referral or involvement of other professional bodies may be indicated.

Capacity is the ability of an individual to make a particular decision.1 Capacity is decision and time specific, and is determined by the type of decision, understanding of consequences, and ability to weigh up options.

A person may not have capacity for complex decisions or those with serious consequences, but can be perfectly able to make choices related to daily living, for example meals, activities, clothing and recreational activity.

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