MC2 Unwise decisions

Does making an unwise decision mean that you lack capacity? We can all think of examples of decisions of our own which, in retrospect, were unwise. But people may think of someone else’s decision as ‘unwise’ for a number of reasons: because it makes them feel uncomfortable, or puts that person’s welfare at risk, or just because that person is too old, mentally impaired, too young or commercially inexperienced.

The video below illustrates the tensions that can arise when someone who is being cared for decides to do something that seems unwise to their carer.

The video also illustrates a key point about unwise decisions: people have the right to make decisions that others may consider unwise and should not automatically be judged as lacking the capacity to make decisions as a result.

In 2016 a social media hashtag #unwisedecisions was used to mark National Mental Capacity Action day. They are light-hearted and range from eating the wrong sort of food, to not taking exercise, to getting a tattoo, to wearing the wrong kind of clothes in a particular social situation.

Some unwise decisions have very serious consequences. What if an alcoholic is judged to have capacity but decides to drink himself to death and refuse all treatment? Or an anorexic woman has signed an advanced directive to refuse treatment and wants to die? In these circumstances it becomes difficult to know what best to do, especially when people have conflicting attitudes and values. It can be very difficult and painful for friends and family.

But what happens when a person lacks mental capacity or when their mental capacity fluctuates? Who is the ‘decision maker’ then?