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2020 Ethical issues linked to legal capacity and decision making (full report)

Antipsychotic medication: Antipsychotics are drugs that are generally used to treat psychosis, which is the medical term used to describe symptoms of psychosis (seeing and hearing things that are not there).

Autonomy: The ability to make an informed and uncoerced choice in accordance with one’s own values and interests, albeit it with necessary support.

Beneficence: All forms of action intended to benefit or promote the good of other people.

COVID-19 pandemic (or coronavirus): COVID-19 is the disease caused by a new coronavirus called SARS-CoV-2.  A pandemic is a worldwide epidemic or one which covers a very wide area. It crosses international boundaries and usually affects large numbers of people.

Covert medication: Covert medication involves the intentional administration of medication in a disguised form, usually in food and drink, resulting in someone unknowingly taking medication (i.e. without their consent).

CRPD: Abbreviation for the United Nations Convention on the Rights of Persons with Disabilities, which came into force in 2006.

Decision-making capacity: The ability to make a decision (with appropriate support if needed).

Dementia: A set of symptoms, including loss of memory, mood changes, and problems with communication and reasoning. There are many causes of dementia, the most common being Alzheimer’s disease and vascular dementia. Dementia is a progressive condition. This means that symptoms become more severe over time and that people with dementia typically need support and eventually care as their dementia advances.

Disability: According to the CRPD, “results from the interaction between persons with impairments and attitudinal and environmental barriers that hinders their full and effective participation in society on an equal basis with others” (CRPD 2006, Preamble e).

Discrimination: Usually, discrimination refers to the situation in which people are treated differently on the basis of certain characteristics and where such differential treatment is considered as being in some way detrimental to them or unfair.

Equality: Equality involves treating everybody in the same way without taking into account differences between people, which may be inherent, linked to circumstances or structurally determined.

Equity: Equity is not about simply providing everyone with the same opportunities but about fairness and equality in outcomes. Issues related to inequity need to be addressed when striving for equal opportunities and outcomes. This often calls for some people to be treated in a different way.

Guardianship: Guardianship, in the context of this report, is the term used to refer to situations where a legal representative (e.g. a guardian, tutor or curator) takes legally binding decisions for a person placed under a protective measure.

Legal capacity: This term is used to refer to the right to make decisions for oneself, within the constraints of the law, which must then be recognised as being legal and hence respected.

Impairments: Any loss or limitation, albeit physical, physiological, cognitive, sensory, psychological or mental in nature, that may contribute (in combination with other factors) to disability.

Non-maleficence: Not doing what might be harmful or hurt somebody.

Power of attorney: A power of attorney is a legal document that allows someone to act on someone else’s behalf (e.g. when the latter loses the decision-making capacity or simply wishes someone else to make decisions or transactions on their behalf).

Psychotropic medication: A psychotropic drug is one that affects behaviour, mood, thoughts or perception. It’s an umbrella term for a lot of different drugs. Psychotropic drugs often given on prescription include, for example, anti-anxiety agents, antidepressants, antipsychotics (see above), mood stabilizers and stimulants. Some of these drugs can have very serious side effects.

Reasonable accommodation: Reasonable accommodation is a term used in the CRPD (see above) to describe reasonable adjustments or adaptations that should be made to ensure that people have the same opportunities (e.g. to use services, access buildings and play a role in society).

Restraint: In this report, the terms restraint is used to refer to any method, device, substance, act or procedure which restricts a person’s freedom of movement in the private or health and social care setting, irrespective of the intent to restrain.

Substitute decision making: A situation in which a person (e.g. with dementia) is unable to make a decision and another person,with the necessary and relevant authority to do so, makes a decision on that person’s behalf.

Supported decision making: Supported decision making involves providing the necessary support for someone to make a decision whereby that person retains their legal capacity, even though they would not have been considered capable of deciding in the absence of that support.

Stigmatization: This is a process and a complex social phenomenon involving the identification and labelling of socially salient attributes, negative stereotyping, cognitive separation, devaluation and negative emotional responses, within the context of unequal power relations.

Testamentary capacity: This is a legal term used to describe a person's legal and mental ability to make or alter a valid will.



Last Updated: Friday 05 March 2021