Capacity Toolkit

Checklist Overview

Introduction Purpose Guidance (not legal advice) Definition of capacity Legal test for capacity

Key Practice Points Presumption of capacity Capacity is decision/time specific Assess the ability NOT the decision Supported decision making Substitute decision making Tikanga Māori & cultural diversity Form of assessment Who should carry out assessments

Capacity Assesment Overview Preparing Assesment Interview After the Interview

The Legal Framework Overview Mental capacity law Relevant legal test PPPR Act : capacity thresholds Activating EPOAs HDC Code: capacity to consent to treatment Right 7(4) of the HDC Code Capacity to make a Will Refusal to undergo assessment

Useful Resources Legal resources Education video Cultural competence International guides to assessment Authors & Acknowledgments

WHO SHOULD CARRY OUT AN ASSESSMENT

If the assessment is about a medical decision, the clinician who is providing the treatment should assess the person’s capacity to consent to that treatment, though they may consult others for assistance.

Where the decision is about other matters such as personal welfare, living arrangements or property matters, it is usually best for a clinician who is well-known to the person, for example, the family GP, to do the assessment. Where this is not the case, particular attention will need to be given to the process of engagement, and, in the case of Māori, whakawhanaungatanga.

In cases of doubt, or in relation to complex major decisions, it may be advisable to collaborate with other health practitioners with experience in relation to the needs of the person, such as a nurse, occupational therapist, psychologist, or speech and language therapist.

Final responsibility for obtaining effective consent for treatment rests with the person intending to carry out the proposed medical procedure, not with other health practitioners advising about capacity.