A guide for 16 and 17 year-olds attending hospital
The Mental Capacity Act 2005
The Mental Capacity Act (MCA) is the law that empowers and protects people over 16 years of age to make their own decisions about their care and treatment.
The law states that people aged 16 and over have the capacity (legal ability) to make decisions about their medical treatment unless there is a known problem or there are concerns about a person’s behaviour, presentation, or circumstances.
For MCA purposes:
- An ‘adult’ is someone who is 18 years or older.
- A ‘young person’ is someone aged 16 or 17 years old.
- A ‘child’ is someone under 16 years old.
The law says that we must help people to make their own medical and treatment decisions wherever possible.
The MCA provides a structure for adults and young people (16 and 17 years old) who cannot make decisions for themselves.
The Code of Practice provides guidance to professionals and carers who have a legal duty to adhere to the Code.
What does ‘mental capacity’ mean?
Having mental capacity means that you are able to make an informed decision for yourself.
To have the capacity to make your own medical decisions, you need to be able to:
- Understand the information being given to you about the medical decision,
- Remember the information long enough to make a decision about your treatment,
- Understand the information the doctor gives you about the risks and benefits of the treatment,
- Communicate your decision in a way that can be understood by the doctor.
If you are able to do this, then you are considered to have the legal ability to make that decision and you will be able to consent to having the treatment yourself.
You may still want the support of your parents, guardians or carers to help you with your decision.
If you are assessed to lack capacity, the MCA ensures that decisions are made in your best interests.
What if I cannot make my own decisions?
If you are found to ‘lack capacity’ it may be that someone else will need to make a ‘best interest’ decision for you.
The staff providing your care will speak with your parents or carers where possible, and where it is appropriate to do so. This will help them to understand what care and treatment will be in your best interests.
Your treatment might also go ahead with consent from your parent or someone who has parental responsibility.
What if I refuse treatment?
If refusing treatment could lead to irreversible damage or death, there is a duty to act in your best interests.
If you are assessed to lack capacity, then treatment can be given in your best interests in order to save your life or prevent permanent harm.
If you are assessed to have capacity, then the law says that the Court of Protection can sometimes override your wishes if there are concerns about the risks to your physical or mental health.
In an emergency
If you lack capacity and require treatment in an emergency, then this will be given in your best interests, even if staff have been unable to speak to your parents or someone with parental responsibility. The most important thing in these situations is to save your life or prevent you from suffering permanent harm.
Advocacy
An Independent Mental Capacity Advocate (IMCA) is an advocate appointed to represent the interests of a person who lacks capacity and who has no family or friends who could be consulted about the decision.
Your Voice Counts provides advocacy services in Gateshead: www.yvc.org.uk
Keeping you involved
We are always keen to involve you in decisions about your care and treatment.
You can consent to treatment if there are no concerns about your ability to make your own decisions (your ‘capacity’). You can tell us what treatments you wish to have in the future. You cannot make an advanced decision to refuse treatment until you are 18 years old.