Decision-making capacity: the legal aspects

Learn about the legal process that follows a capacity assessment.

It follows on from Assessing decision-making capacity - the clinical basics, where we covered the relevant principles when assessing decision-making capacity for consent to healthcare, and demonstrated how to perform a capacity assessment using a 3-stage approach.

This course is part 2 of a 2-part module:

1. In course 1, Assessing decision-making capacity: the clinical basics, we covered the relevant principles when assessing decision-making capacity for consent to healthcare, and demonstrated how to perform a capacity assessment using a 3-stage approach.
2. In this course, you will understand the requirements for a formal assessment.  You need to understand the legal framework for substitute welfare and financial decision-making to support people who may lack capacity to make decisions for themselves. You also need to know how to provide a medical opinion about a person’s capacity in respect of a wide range of legal decisions, and to advise what support measures may be needed so that the person (patient) may, where possible, make decisions for themselves.

At the end of this course, you should be able to:

• Understand the PPPR Act in relation to decision-making capacity assessment.
• Apply the PPPR Act where patients have compromised decision-making capacity.
• Complete the Clinical Opinion of Capacity for making an Enduring Power of Attorney (EPA/EPOA), Certificate of Mental Incapacity EPA for activating an EPA, and Report of Registered Medical Practitioner for applying a personal order, welfare guardianship and property management.

Acknowledgements

This course was created by Dr Gary Cheung (Psychiatrist, FRANZCP, Auckland) and Dr Alisha Vara (Registrar, Auckland Regional Psychiatric Training Programme) in partnership with Alison Douglass (Barrister, LLB MBHL, Dunedin) and Dr Greg Young (Psychiatrist, FRANZCP, Hawkes Bay) in 2018. The wider project team also includes Dr Fred Sundram (Psychiatrist, PhD, Auckland), Dr Marcus Henning (Associate Professor, PhD, Auckland), and Prof Ngaire Kerse (Professor, PhD, Auckland).

We especially acknowledge the contribution of Alison Douglass, 2014 recipient of the New Zealand Law Foundation International Research Fellowship, and her report on updating mental capacity law and practice in New Zealand. This module is based on the Toolkit for Assessing Capacity from Alison’s report co-authored with Dr Greg Young and Professor John McMillan.