Best Interests Decision
A best interests decision is a decision made on behalf of a person who lacks the mental capacity to make that decision themselves, as required by the Mental Capacity Act 2005. Decision-makers must consider the person's past and present wishes, feelings, values, and beliefs, and involve relevant people in their life. For serious decisions involving deprivation of liberty or significant medical treatment, an application to the Court of Protection may be required.
The Mental Capacity Act 2005 sets out a statutory checklist for best interests decisions (section 4). Decision-makers must not make assumptions based on age, appearance, condition, or behaviour; must consider whether the person may regain capacity; and must involve the person as far as possible. They must consult anyone named by the person, carers, family members, and any attorney or deputy. An Independent Mental Capacity Advocate (IMCA) must be instructed for serious medical decisions or changes of accommodation where there is no one else to consult. Decisions must be the least restrictive option. Deprivation of Liberty Safeguards (DoLS) — or the Court of Protection under the Liberty Protection Safeguards expected to replace DoLS — are required where a person in a care home or hospital is deprived of their liberty, even in their best interests.