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Guidance on mental capacity decisions in diagnostic imaging and radiotherapy

11 November, 2018
Topics: Advanced practitioners, Assistant practitioners, Consultants, Imaging, Managers, Patients with additional needs, Radiotherapy, Students


The purpose of the guidance is to offer advice about implementation of the consent process in clinical practice.

It refers to three areas of legislation, the Mental Capacity Act which applies to cases in Wales and England; The Adults with Incapacity (Scotland) Act 2000 which is applicable for practitioners in Scotland and; the Mental Capacity Act (Northern Ireland) 2016 which applies in Northern Ireland.

The guidance will enable radiographers, assistant practitioners and students working in clinical imaging and radiotherapy departments to understand their responsibilities with regards to mental capacity legislation.
An ethos of all mental capacity legislation is to empower those with impaired capacity. In particular, it is important to remember that a person’s mental capacity is both time and decision specific; capacity to consent can fluctuate. NHS England (2014) offers four points for clinical practice that re-iterate the principles of the mental capacity legislation across the UK:
  • Begin each meeting with a patient with the belief that they can make their own decision.
  • Give each person both the time and support that they need to make their own decision about consent to treatment (diagnostic and therapeutic procedures).
  • If you or someone else does not agree with the patient’s decision, you cannot decide that the patient is incapable of making that decision. A person is not to be deemed incapable to consent because of an unwise decision.
  • When a patient cannot make a decision then they will need help from someone to make it in the best way for them. A decision must be the least restrictive option that does not limit the person’s rights of freedom more than necessary. It may be necessary to delay procedures that are not emergencies in cases where there are any concerns.
The guidance document provides a review of the principles to be used in clinical practice.

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