When capacity is impaired

If the assessment shows the patient lacks capacity, a decision must be made in their best interest. In determining this, you must consider the following relevant factors:

• whether the lack of capacity is temporary or permanent;
• which options for treatment would provide overall clinical benefit for the patient
• which option, including the option not to treat, would be least restrictive of the patient's future choices;
• the patient's past and present wishes and feelings, in particular any relevant written statement made when the patient had capacity;
• the views of anyone the patient asks you to consult, or who has legal authority to make a decision on their behalf such as a person with Enduring Power of Attorney. However, they do not have the power to demand specific forms of treatment if they are not clinically necessary or appropriate;
• the views of people close to the patient;
• what you know about the patient’s beliefs and values.

If you are of the view that the client lacks capacity, you may make an application to have a substitute decision maker be appointed for your client depending on the specific legal transaction for which instructions are sought.