1. Foundations: capacity, autonomy and the presumption of ability
Build a rights-based, decision-specific approach to mental capacity and avoid assumptions based on age, diagnosis, disability or disagreement.
Learning programme · #P7
Mental Capacity: Decision-Making in Clinical Practice
Ten modules covering supported decision-making, assessment, substitute decisions, proxies, advance planning, liberty safeguards, documentation and escalation across UK jurisdictions.
Who this programme is for
For healthcare professionals who make or support decisions with adults whose decision-making ability may be questioned. Modules can be completed individually or as a structured course.
Certificate process: Integrated final assessment + optional private reflection + course completion certificate
Sign in to record progress and qualify for a programme certificate.
2. Supported decision-making in practice
Use practical communication, timing and environmental adjustments to maximise a person’s ability to participate before concluding that they cannot decide.
3. When should capacity be assessed?
Recognise when a formal capacity assessment is proportionate, and avoid using capacity assessment simply because a person refuses, disagrees or lives with a particular diagnosis.
4. How to assess the specific decision
Apply a structured, decision-specific assessment that identifies relevant information, tests the required functional abilities and records the reasoning rather than relying on a checklist or cognitive score.
5. Fluctuating and complex capacity
Recognise fluctuating or complex decision-making ability and adapt timing, reassessment and multidisciplinary support to the person’s clinical state and the urgency of the decision.
6. Decision-making when the person lacks capacity
Use the correct jurisdiction-specific substitute-decision framework, involve the person as far as possible and distinguish consultation from legal authority.
7. Attorneys, deputies, guardians and other proxies
Verify whether another person has lawful decision-making authority, understand its scope and limits, and avoid the unsafe assumption that “next of kin” can consent for an adult.
8. Advance and future decision-making
Distinguish legally binding advance refusals from broader statements and clinical plans, and check validity, applicability and jurisdiction before relying on a future decision-making document.
9. Restraint, restriction and deprivation of liberty
Understand the distinction between restriction, restraint and deprivation of liberty, and apply the current post-June-2026 multifactorial Article 5 approach rather than outdated shorthand.
10. Documentation, disagreement and escalation
Create records that show the decision-making pathway, transfer essential information safely and escalate unresolved disagreement through proportionate clinical, safeguarding, ethics or legal routes.
Course completion
Sign in to complete the integrated final assessment and receive the course certificate.
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