For example, a person may lack the relevant mental capacity to consent to testing and self-isolation, before or after an appointment or surgery as an NHS inpatient. In some cases, testing and other necessary measures will be needed for the purposes of procedures like elective surgery. It is reasonable to conclude that most people leaving hospital for a care home, with the relevant mental capacity to take the decision, would have agreed to testing, for the protection of their own health, and others around them. No automatic assumption should be made that was in the best interests of one patient will be in the best interests of another, even if the 2 cases share similar characteristics.įor many people, a best interests decision to test for COVID-19 will align with the decision that we could have expected the person to have taken themselves if they had the relevant capacity. Best interests decisions should be made on an individual basis. You should make a record of their decision. When doing so, the decision-maker must consider all the relevant circumstances, including the person’s wishes, beliefs and values, the views of their family and what the person would have wanted if they had the capacity to make the decision themselves. However, if this is not possible or is unsuccessful, then it may be appropriate to make a best interests decision under the MCA. ![]() In the first instance, all practicable steps should be taken to support the person to make the decision to be tested for COVID-19 for themselves. ![]() Testing someone who lacks the relevant mental capacity without their consent These examples are not exhaustive and the decision maker will need to record how they arrived at a best interest decision. Examples include, where administering the vaccine would be significantly traumatic, or where the decision to receive a vaccine would not be one the individual would make, if they had capacity. When making a best interest decision on a person’s behalf, decision makers may want to consider the benefits of vaccines to the individual’s health and potential alignment with a decision the person may have taken themselves if they had the relevant capacity.Ĭonsideration should be given to the impacts of administering the vaccine which may inform a decision that receiving the vaccine may not be in the individual’s best interest. If there is a deputy or attorney with relevant authority then consent must be sought from them to be able to make a decision. Where appropriate, the person’s advocates or those with power of attorney for health and welfare should be consulted. The decision maker should make a record of their best interests decision (for NHS workers in England there is also a required field on the Pinnacle Point of Care system). This means that the decision-maker (for example the healthcare professional offering the vaccine) must consider all the relevant circumstances, including the person’s wishes, beliefs and values, the views of their family and what the person would have wanted if they had the capacity to make the decision themselves. ![]() Where it has been established that the person lacks capacity to consent, an individual best interests decision should be taken in line with the best interest checklist in section 4 of the MCA. These actions should be recorded (for NHS workers in England there is a required field on the Pinnacle Point of Care system). This is so that, where possible, the person can make a decision for themselves. Planning should happen in advance and information should be provided about the vaccine, the likely side effects, what administering the vaccine will involve, and when it will happen. Healthcare professionals offering a COVID-19 vaccine to someone who may lack the mental capacity to consent should take all practicable steps to support the person to make the decision for themselves. Best interest decisions Offering a vaccine to someone who lacks the relevant mental capacity
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