TY - JOUR
T1 - Interpersonal influences on decision-making capacity
T2 - A content analysis of court judgments
AU - Ariyo, Kevin
AU - Kane, Nuala
AU - Owen, Gareth
AU - Ruck Keene, Alexander
N1 - Funding Information:
All authors are part of the Mental Health and Justice Project, led by G.O., which is funded by a grant from the Wellcome Trust (203376/2/16/Z). N.K. is also supported by a grant from Mental Health Research UK and the Schizophrenia Research Fund.
Publisher Copyright:
© 2023 The Author(s). Published by Oxford University Press.
PY - 2023
Y1 - 2023
N2 - For many purposes in England and Wales, the Court of Protection determines whether a person has or lacks capacity to make a decision, by applying the test within the Mental Capacity Act 2005. This test is regularly described as a cognitive test with cognitive processes discussed as internal characteristics. However, it is unclear how the courts have framed interpersonal influence as negatively impacting upon a person's decision-making processes in a capacity assessment context. We reviewed published court judgments in England and Wales in which interpersonal problems were discussed as relevant to capacity. Through content analysis, we developed a typology that highlights five ways the courts considered influence to be problematic to capacity across these cases. Interpersonal influence problems were constructed as (i) P's inability to preserve their free will or independence, (ii) restricting P's perspective, (iii) valuing or dependence on a relationship, (iv) acting on a general suggestibility to influence, or (v) P denying facts about the relationship. These supposed mechanisms of interpersonal influence problems are poorly understood and clearly merit further consideration. Our typology and case discussion are a start towards more detailed practice guidelines, and raise questions as to whether mental capacity and influence should remain legally distinct.
AB - For many purposes in England and Wales, the Court of Protection determines whether a person has or lacks capacity to make a decision, by applying the test within the Mental Capacity Act 2005. This test is regularly described as a cognitive test with cognitive processes discussed as internal characteristics. However, it is unclear how the courts have framed interpersonal influence as negatively impacting upon a person's decision-making processes in a capacity assessment context. We reviewed published court judgments in England and Wales in which interpersonal problems were discussed as relevant to capacity. Through content analysis, we developed a typology that highlights five ways the courts considered influence to be problematic to capacity across these cases. Interpersonal influence problems were constructed as (i) P's inability to preserve their free will or independence, (ii) restricting P's perspective, (iii) valuing or dependence on a relationship, (iv) acting on a general suggestibility to influence, or (v) P denying facts about the relationship. These supposed mechanisms of interpersonal influence problems are poorly understood and clearly merit further consideration. Our typology and case discussion are a start towards more detailed practice guidelines, and raise questions as to whether mental capacity and influence should remain legally distinct.
UR - http://www.scopus.com/inward/record.url?scp=85178496447&partnerID=8YFLogxK
U2 - 10.1093/medlaw/fwad017
DO - 10.1093/medlaw/fwad017
M3 - Article
SN - 0967-0742
VL - 31
SP - 564
EP - 593
JO - Medical Law Review
JF - Medical Law Review
IS - 4
ER -