Understanding mental capacity
Understanding mental capacity

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Understanding mental capacity

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.

Download this video clip.Video player: A video about ‘unwise decisions’
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Transcript: A video about ‘unwise decisions’

[MUSIC PLAYING]
[BIRDS SINGING]
MAN
Oh.
[SETTING DISH ON TABLE]
WENDY
What do you want for lunch? I'm doing eggs, all right? Are you in a bad mood with me, Raymond? Look, I'll be out of your hair in 10 minutes. Then you'll be rid of me till Monday.
RAYMOND
That'll be nice.
WENDY
Wendy.
RAYMOND
What?
WENDY
That'll be nice, Wendy.
RAYMOND
Oh.
WENDY
It is my name. I'm sure you weren't meaning to be rude. Well, Raymond, it's been a pleasure as always. Have a nice weekend. Yeah.
RAYMOND
Eh, the lottery.
WENDY
Well, seeing as you asked so nicely, how can I possibly refuse?
RAYMOND
Here.
WENDY
Haven't you got anything smaller?
RAYMOND
All of it.
WENDY
Raymond, you only put two pounds a week on the lotto.
RAYMOND
I want 50 lucky dips.
WENDY
50 pounds is a lot of money.
RAYMOND
I know how much 50 pounds is.
WENDY
You can't afford it.
RAYMOND
It's my money.
WENDY
Yeah, but you have to buy food. You have to pay the bills.
RAYMOND
It's my money.
WENDY
I know it's your money, Raymond. But have a think about this for a minute, yeah? Well, what happens if you lose all of it?
RAYMOND
What happens if I win, eh? Yeah. I would be able to afford proper servants then, not pushy girls like you, telling me what to do all the time.
WENDY
I am not a pushy girl. And I'm certainly not your servant. This is madness.
RAYMOND
I am not mad. I'm old.
WENDY
I didn't mean that. I just mean that I've got a responsibility to make sure you're OK.
RAYMOND
To tell me what to do, you mean?
WENDY
All right. You obviously know your own mind-- if you think you can afford it.
RAYMOND
I can afford it.
WENDY
All right. Do what you like. I'm logging this in the book.
RAYMOND
Oh, yeah.
WENDY
I'm not taking responsibility for how you waste your money, Raymond. Spend it how you like.
RAYMOND
I will.
WENDY
Let me tell you this for free. Chucking your money away like this won't make you happy, whatever.
RADIO ANNOUNCER
And the first ball tonight is number four, one of the most frequently selected balls on the Saturday lotto draw, number four.
RAYMOND
Four. Four. Yeah. Got four. [LAUGHS] Yay.
RADIO ANNOUNCER
27.
RAYMOND
27, 27, yeah. There's one, and there. Woo-hoo! Hey, hey! Yeah, yep, yep. Ha! Ooh, another one. There.
RADIO ANNOUNCER
12.
RAYMOND
12, 12. Wait, wait, wait, slow down. Slow down, will you? Eh, four, 27, 12. Yeah, there you go. Ha!
RADIO ANNOUNCER
So tonight's final lotto number is 13. That's 1-3. 13.
[PAPER CRINKLING]
Good luck, everybody.
WENDY
Well, that was a waste of money.
RAYMOND
13, 13-- ah. Come in, number 13. Your time is up. Ha ha! 13 is my lucky number. Ha! Woo-hoo! 13, yes, 13.
End transcript: A video about ‘unwise decisions’
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?

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