Applying decision-making capacity criteria in practice: A content analysis of court judgments.

<h4>Background/objectives</h4>Many jurisdictions use a functional model of capacity with similar legal criteria, but there is a lack of agreed understanding as to how to apply these criteria in practice. We aimed to develop a typology of capacity rationales to describe court practice in...

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Main Authors: Nuala B Kane, Alex Ruck Keene, Gareth S Owen, Scott Y H Kim
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2021-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0246521&type=printable
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author Nuala B Kane
Alex Ruck Keene
Gareth S Owen
Scott Y H Kim
author_facet Nuala B Kane
Alex Ruck Keene
Gareth S Owen
Scott Y H Kim
author_sort Nuala B Kane
collection DOAJ
description <h4>Background/objectives</h4>Many jurisdictions use a functional model of capacity with similar legal criteria, but there is a lack of agreed understanding as to how to apply these criteria in practice. We aimed to develop a typology of capacity rationales to describe court practice in making capacity determinations and to guide professionals approaching capacity assessments.<h4>Methods</h4>We analysed all published cases from courts in England and Wales [Court of Protection (CoP) judgments, or Court of Appeal cases from the CoP] containing rationales for incapacity or intact capacity(n = 131). Qualitative content analysis was used to develop a typology of capacity rationales or abilities. Relationships between the typology and legal criteria for capacity [Mental Capacity Act (MCA)] and diagnoses were analysed.<h4>Results</h4>The typology had nine categories (reliability: kappa = 0.63): 1) to grasp information or concepts, 2) to imagine/ abstract, 3) to remember, 4) to appreciate, 5) to value/ care, 6) to think through the decision non-impulsively, 7) to reason, 8) to give coherent reasons, and 9) to express a stable preference. Rationales most frequently linked to MCA criterion 'understand' were ability to grasp information or concepts (43%) or to appreciate (42%), and to MCA criterion 'use or weigh' were abilities to appreciate (45%) or to reason (32%). Appreciation was the most frequently cited rationale across all diagnoses. Judges often used rationales without linking them specifically to any MCA criteria (42%).<h4>Conclusions</h4>A new typology of rationales could bridge the gap between legal criteria for decision-making capacity and phenomena encountered in practice, increase reliability and transparency of assessments, and provide targets for decision-making support.
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spelling doaj-art-7067def34b624fc3bcc92f7ac9e4a59a2025-08-20T03:25:37ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01162e024652110.1371/journal.pone.0246521Applying decision-making capacity criteria in practice: A content analysis of court judgments.Nuala B KaneAlex Ruck KeeneGareth S OwenScott Y H Kim<h4>Background/objectives</h4>Many jurisdictions use a functional model of capacity with similar legal criteria, but there is a lack of agreed understanding as to how to apply these criteria in practice. We aimed to develop a typology of capacity rationales to describe court practice in making capacity determinations and to guide professionals approaching capacity assessments.<h4>Methods</h4>We analysed all published cases from courts in England and Wales [Court of Protection (CoP) judgments, or Court of Appeal cases from the CoP] containing rationales for incapacity or intact capacity(n = 131). Qualitative content analysis was used to develop a typology of capacity rationales or abilities. Relationships between the typology and legal criteria for capacity [Mental Capacity Act (MCA)] and diagnoses were analysed.<h4>Results</h4>The typology had nine categories (reliability: kappa = 0.63): 1) to grasp information or concepts, 2) to imagine/ abstract, 3) to remember, 4) to appreciate, 5) to value/ care, 6) to think through the decision non-impulsively, 7) to reason, 8) to give coherent reasons, and 9) to express a stable preference. Rationales most frequently linked to MCA criterion 'understand' were ability to grasp information or concepts (43%) or to appreciate (42%), and to MCA criterion 'use or weigh' were abilities to appreciate (45%) or to reason (32%). Appreciation was the most frequently cited rationale across all diagnoses. Judges often used rationales without linking them specifically to any MCA criteria (42%).<h4>Conclusions</h4>A new typology of rationales could bridge the gap between legal criteria for decision-making capacity and phenomena encountered in practice, increase reliability and transparency of assessments, and provide targets for decision-making support.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0246521&type=printable
spellingShingle Nuala B Kane
Alex Ruck Keene
Gareth S Owen
Scott Y H Kim
Applying decision-making capacity criteria in practice: A content analysis of court judgments.
PLoS ONE
title Applying decision-making capacity criteria in practice: A content analysis of court judgments.
title_full Applying decision-making capacity criteria in practice: A content analysis of court judgments.
title_fullStr Applying decision-making capacity criteria in practice: A content analysis of court judgments.
title_full_unstemmed Applying decision-making capacity criteria in practice: A content analysis of court judgments.
title_short Applying decision-making capacity criteria in practice: A content analysis of court judgments.
title_sort applying decision making capacity criteria in practice a content analysis of court judgments
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0246521&type=printable
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