SMA Courses
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<September 2020>

Online CME: Assessment of Mental Capacity under the Mental Capacity Act

01 May 2017 - 31 Dec 2019

Course Code:  OPG01
Time:  NA
Course Fees:  NA

Online Module

The objectives of this Tool and Guide is to provide the learning materials for a concise understanding of the principles in the Mental Capacity Act (Cap 177A); the application of these principles in the assessment of the individual; and the issuance of medical reports on mental capacity as required under the Mental Capacity Act. A good understanding of this Guide and the Code of Practice is an essential pre-requisite for achieving competence in conducting mental capacity assessments.

The Mental Capacity Act (MCA) enables people to plan ahead and gives them the power to make choices for their future before they lose their mental capacity. It addresses the need to make decisions for persons who are 21 years and older when they lack mental capacity to make these decisions for themselves.

Mental capacity is the ability of a person to make a specific decision at a particular time. It is assessed on a case-by-case basis. It cannot be assumed to be based only on the person’s particular medical condition. Furthermore, a person’s lack of mental capacity cannot be based only on age, how a person looks, his condition or any aspect of behaviour. Also, a person may have the capacity to make some decisions for a particular task and not others.

Singapore has a rapidly ageing population with a corresponding rise in age related and degenerative diseases which cause decline or loss of mental capacity. It is estimated that the number of residents aged 65 years or older will multiply threefold from the current 300,000 in 2012 to 900,000 in 2030. By then, one out of every five residents will be a senior. A National mental study of the elderly in 2003 showed that the prevalence of dementia in Singapore to be 5.2% (95% CI 3.6 – 6.7), 6.0% (95% CI 4.0 – 8.0), and 13.9% (95% CI 7.9 – 19.9) for residents aged 60 to 64, 65 to 74, and 75 and over respectively. As such, clinicians will face many patients in the clinic, the hospitals and other healthcare institutions who lack capacity for effective medical decision making. Understanding and acquiring the skills of medical decision making in persons lacking capacity becomes an essential competency in practice of medicine.

All medical practitioners are encouraged therefore to make use of every opportunity to study and understand the contents of this course, to be able to apply the principles of the MCA confidently, and to be able to issue medical reports that are complete, objective, and of help to the Courts for decision making and judgment.