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Ethics and the law: making advance decisions about care
  1. Rob George and
  2. Bridgit Dimond
  1. Ethical aspects: Rob George is Consultant in Palliative Medicine and Senior Lecturer in Biomedical Ethics, University College London.
  2. Legal aspects: Bridgit Dimond is Emeritus Professor, University of Glamorgan


The case in this issue brings to a close our series on the Mental Capacity Act (MCA) 2005. Arguably, the cardinal purpose of the MCA is to establish a legal framework to promote and extend the potential of patients to determine their care in circumstances where they are incapable of consenting to, or refusing, treatments. In particular, patients can now express, or have put in writing, specific wishes, although such ‘advance statements’ or ‘advance decisions’ have different legal force dependent upon certain criteria. However, the MCA is also a useful guide to good practice and a vehicle by which certain problems may be driven forward when there is confusion. The Case scenario (see box) in this article is a good example of how to use the MCA to navigate an obstruction on the road of a patient’s journey.

  • Advance decision
  • Capacity
  • Consent
  • Lasting power of attorney
  • Mental Capacity Act 2005

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