DHSC, 'The MCA and DOLS during the coronavirus pandemic: additional guidance' (updated 24/12/20)

MCA/DOLS coronavirus guidance This web page contains the following main headings: (1) [Best interests] decisions; (2) Life-saving treatment; (3) Depriving a person of their liberty; (4) Hospitals and care homes; (6) Other settings; (7) Supervisory bodies; (8) Emergency coronavirus health powers. It was updated on 24/12/20 with information under the subheading "Offering a vaccine to someone who lacks the relevant mental capacity". Superseded by: DHSC, 'The MCA and DOLS during the coronavirus pandemic: additional guidance' (updated 12/1/21).

24/12/20 update

The new text is:

Offering a vaccine to someone who lacks the relevant mental capacity

Healthcare professionals offering a COVID-19 vaccine to someone who may lack the mental capacity to consent should take all practicable steps to support the person to make the decision for themselves.

Planning should happen in advance and information should be provided about the vaccine, the likely side effects, what administering the vaccine will involve, and when it will happen. This is so that, where possible, the person can make a decision for themselves. These actions should be recorded (for NHS workers in England there is a required field on the Pinnacle Point of Care system).

Where it has been established that the person lacks capacity to consent, an individual best interests decision should be taken in line with the best interest checklist in section 4 of the MCA. This means that the decision-maker (for example the healthcare professional offering the vaccine) must consider all the relevant circumstances, including the person’s wishes, beliefs and values, the views of their family and what the person would have wanted if they had the capacity to make the decision themselves.

The decision maker should make a record of their best interests decision (for NHS workers in England there is also a required field on the Pinnacle Point of Care system).

Where appropriate, the person’s advocates or those with power of attorney for health and welfare should be consulted. If there is a deputy or attorney with relevant authority then consent must be sought from them to be able to make a decision.

When making a best interest decision on a person’s behalf, decision makers may want to consider the benefits of vaccines to the individual’s health and potential alignment with a decision the person may have taken themselves if they had the relevant capacity.

Consideration should be given to the impacts of administering the vaccine which may inform a decision that receiving the vaccine may not be in the individual’s best interest. Examples include, where administering the vaccine would be significantly traumatic, or where the decision to receive a vaccine would not be one the individual would make, if they had capacity.

These examples are not exhaustive and the decision maker will need to record how they arrived at a best interest decision.

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Type: Coronavirus resource🔍 · Health guidance🔍

Title: The MCA and DOLS during the coronavirus pandemic: additional guidance

Organisation: Department of Health and Social Care🔍

Date: 24/12/20🔍

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