An Investigation Of Surrogate Decision-Making In Relation To Dementia Patients In Care Homes And The ‘Best Interests’ Test Under The Mental Capacity Act 2005

This work is an investigation of the nature of surrogate decision making in care home placements by family carers of dementia patients under the best interests provision of the Mental Capacity Act 2005 (MCA). It addresses the subjective and objective applications of the best interests decision- making standard while looking at the role that autonomy and welfare play in the assessment of best interests during surrogate decision -making. This work addresses the operation of the best interests standard in the background of the consideration of care home placement for the dementia patient by family carers where the interests of the family carer are linked with the interests of the dementia patient. It therefore addresses the issues of joint and intertwined interests. The pursuit of this research therefore is to answer the question of whether a robust application of the law would be legally and ethically justified under these circumstances. This is in terms of the features of relationship and the significance of a relational approach in the context discussed in this work. The sections of the law considered in this work are section 1 (5) and section 4 of the MCA, with particular focus on section 4 (6)- (7) in respect of the analysis on the subjective and objective nature of best interests. While the ethical underpinning of autonomy and welfare is also considered from the philosophical point of view.