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Understanding mental capacity
Understanding mental capacity

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2 Unwise decisions

Does making an unwise decision mean that you lack capacity? We can all think of examples of decisions of our own which, in retrospect, were unwise. But people may think of someone else’s decision as ‘unwise’ for a number of reasons: because it makes them feel uncomfortable, or puts that person’s welfare at risk, or just because that person is too old, mentally impaired, too young or commercially inexperienced. The video below illustrates the tensions that can arise when someone who is being cared for decides to do something that seems unwise to their carer.

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A video about ‘unwise decisions’
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The video also illustrates a key point about unwise decisions: people have the right to make decisions that others may consider unwise and should not automatically be judged as lacking the capacity to make decisions as a result.

Activity 2 Ironic and light-hearted unwise decisions

Timing: Allow about 5 minutes

In 2016 a social media hashtag #unwisedecisions was used to mark National Mental Capacity Action day. Take a look at some of the ‘unwise decisions’ in the feed #unwisedecisions [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] . They are light-hearted and range from eating the wrong sort of food, to not taking exercise, to getting a tattoo, to wearing the wrong kind of clothes in a particular social situation.

Some unwise decisions have very serious consequences. What if an alcoholic is judged to have capacity but decides to drink himself to death and refuse all treatment? Or an anorexic woman has signed an advanced directive to refuse treatment and wants to die? In these circumstances it becomes difficult to know what best to do, especially when people have conflicting attitudes and values. It can be very difficult and painful for friends and family. You will now explore examples of these cases.

Activity 3 Unwise decisions that have serious consequences

Timing: Allow about 10 minutes

Read the three newspaper articles below that have appeared in The Guardian and which relate to the right to die, contraception and addiction. Consider the range of decisions that can arise when someone’s capacity is in doubt and the difficulties with decisions that, for those not making the decision, seem unwise and harmful.

Comment

An ‘unwise’ decision can have very serious consequences for the person making it. However, they should not be stopped from making that decision just because it seems unwise to the person helping them decide, and nor should they automatically be judged to be lacking capacity because of that unwise decision.

But what happens when a person lacks mental capacity or when their mental capacity fluctuates? Who is the ‘decision maker’ then?