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Adults With Incapacity Scotland Act 2000

Background. Came into force 2nd April 2001Safeguard the welfare, and manage the finances and property, of adults (16 or over) who lack the capacity to take some or all decisions for themselves because of mental disorder or inability to communicateAllows others to make decisions on behalf of these

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Adults With Incapacity Scotland Act 2000

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    1. Adults With Incapacity (Scotland) Act 2000 Dr Sam Baldwin Consultant Psychiatrist (Learning Disabilities)

    2. Background Came into force 2nd April 2001 Safeguard the welfare, and manage the finances and property, of adults (16 or over) who lack the capacity to take some or all decisions for themselves because of mental disorder or inability to communicate Allows others to make decisions on behalf of these adults, subject to safeguards.

    3. General Principles Benefit the adult Minimum intervention Past/Present wishes of the individual Consult relevant others Encourage use of residual capacity

    4. Criteria for Incapacity Mental Disorder Incapable of: acting: or making decisions: or communicating decisions: or understanding decisions: or retaining the memory of decisions

    5. Understanding Decisions Understands the consequences of their actions Understands the risks and benefits involved Is aware of any alternatives Is aware this is of personal relevance Is aware of their right to refuse and consequences of refusal

    6. Powers Power of attorney (continuing and/or welfare) Intromission with funds Management of residents finances Intervention order Guardianship (financial and/or welfare) Consent to medical treatment

    7. Where does the buck stop? Power of attorney – solicitor Intervention orders / guardianships – sheriff court Medical treatment – Medical practitioner primarily responsible (hospital=consultant, community=GP to avoid multiple forms!)

    8. Medical Treatment Emergencies (immediacy) – common law Prior to the act, treatment without consent could be considered an assault. Incapacity Certificate – “any procedure or treatment designed to safeguard or promote physical or mental health” Medical practitioner primarily responsible Lasts up to 3 years Principles and criteria of the act apply

    9. Examples of incapacity certificates

    10. Guardianships Potential guardian approaches solicitor (Solicitor seeks brief statement of incapacity from GP or psychiatrist to seek legal aid) Solicitor requires 2 Drs (one of whom is section 22 approved) certificates of incapacity reports and a mental health officers (MHO) report in support of the application. Sheriff Court decides and may wish to appoint a safeguarder.

    11. Guardians With great power comes great responsibility! Guardian makes decisions as if they were the incapacitated person Guardian can withhold consent No treatment to be given without the guardians consent (except emergencies) Guardian can no more demand inappropriate treatment than you or I can

    12. Guardians cont. Guardians regularly reviewed by the MHO If guardian making decisions which are not in the persons best interests this can be challenged by the supervising MHO.

    13. Examples of guardianship applications

    14. Case 1 26 y/o woman Mild LD (IQ 67) Borderline personality disorder Frequent OD’s, threats of self harm, fighting, breach of the peace, court appearances Often associated with alcohol Mother is trigger - abusive

    15. Case 2 24 y/o man Borderline LD (IQ 78) ADHD (untreated) Spends his money frivolously Often no money left for food or bills 3 mobile phones, McFly concert tickets and hotel, spent Ł490 in 1 week last month No idea how he could do things differently No concept of harm (lack of food/ heating)

    16. Case 3 65 y/o woman Severe learning disability No mental illness Very long history of facial picking Lost sight in both eyes due to this Restraint to apply bandages to hands and clip finger nails

    17. Case 4 36 y/o woman Mild to moderate LD (IQ 54) Mixed anxiety/depression Lives in group home Fiercely independent Wonders Dundee at all hours Looks odd and vulnerable (and is), carries a big radio on her walks Hasn’t come to harm (yet)

    18. Case 5 20 y/o man Mild to moderate LD (IQ 52) Autism Poor social skills, not good at reading situations Stands out – very tall, stares at people, especially children (seen at playground staring at children) Quick to anger, will become physically aggressive Storms out of supported accommodation into Hilltown, sometimes late at night

    19. Any questions on AWIA?

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