A Guide to the Mental Capacity Act for Paramedics

Emergency care practitioner for South Western Ambulance Service NHS Foundation Trust.

Abstract

The Mental Capacity Act 2005 is one of the key pieces of statutory legislation used in modern paramedic practice. To the unprepared, the Act can seem complex and daunting; but it is a powerful tool which helps paramedics to deal with often complex and challenging situations in a way which is both ethically and legally safe. What follows is a walk-through of the Act itself looking at the parts which are relevant to paramedic practice and discussing issues relating to them which, it is hoped, will enable paramedics and others involved in delivering pre-hospital emergency medical care to apply the Act with confidence in their practice.

Since its introduction into practice in 2007, the Mental Capacity Act 2005 (MCA) has become the primary piece of legislation governing the management of patients who lack the capacity to give or refuse consent to medical treatment or other aspects of their care. The MCA details the legal standards to be adhered to by anybody involved in caring for this patient group. The MCA is considered so central to good practice that a ‘clear understanding’ of it is a specific requirement in the Paramedic Scope of Practice policy (College of Paramedics, 2017).

In the discussion that follows, the information will be drawn, as far as possible, directly from either the MCA or its accompanying Code of Practice document. In order to allow the reader to easily review these documents themselves, the relevant sections from each document will be referenced by either MCA sections (shown in the form MCA Sec 1[1]) or Code of Practice paragraphs (shown in the form CoP 1.1).