Alex RKAs I prepare to leave the shed for Edinburgh for the World Congress on Adult Capacity (real people in a real place…), I received a reminder to renew my Vimeo subscription which, in turn, made me realise it’s been just over two years since I started doing ‘in conversations’ with people. I have talked to over thirty fascinating people with all sorts of perspectives on matters capacity-related. You can find the recordings here (or on your podcast app of choice), but if you need your memory refreshing, the conversations have been with:
- Mark Taubert, Palliative Care Physician, discussing the law and medicine in the context of advance care planning
- Jakki Cowley, IMCA, asking what IMCA advocacy is, top tips for engaging with medical teams and advocacy for those in Prolonged Disorders of Consciousness.
- Julian Sheather, specialist adviser in ethics and human rights to the British Medical Association, grappling with some of the ethical underpinnings to the Mental Capacity Act 2005
- Dr Gareth Owen, psychiatrist, discussing what makes some capacity assessments complex, some tips for addressing messiness, and the importance of time
- Gill Loomes-Quinn, (in her words) a disabled scholar-activist, with a background in community advocacy, discussing, in particular, her PhD research around advance decision-making in the context of disability
- Dr Lucy Series, academic, discussing in particular, the long and complex history of confinement, and why Cheshire West may be a case of be careful what you wish for.
- Dr Lucy Stephenson, psychiatrist and psychotherapist, discussing advance decision-making tools for people living with bipolar disorder and overcoming fears on the part of both service users and professionals.
- Lorraine Currie, social worker, discussing living the MCA in practice, and building invisible scaffolding as the supporter for her daughter Grace, who lives with an acquired brain injury.
- Dr Camilla Parker, legal and policy consultant, discussing deprivation of liberty and 16/17 year olds, and the practice guidance that we have produced about this issue for Research in Practice.
- Dr Lade Smith CBE, psychiatrist, discussing the ways in which capacity assessments under the MCA do and do not capture the cultural aspects of capacity, and the consequences for discrimination.
- Dr Tania Gergel, philosopher, discussing what philosophy can bring to thinking about decision-making capacity, the (mis)use of the presumption of capacity and advance decision-making and personhood.
- Professor Wayne Martin, philosopher and Director of the Essex Autonomy Project, digging into the concept of ‘insight’ and tease out how it might relate to mental capacity.
- George Szmukler, Emeritus Professor of psychiatry, discussing the ‘fusion law’ concept that he has been instrumental in developing.
- Emma Overton, Policy and Practice Development Lead at North East Lincolnshire CCG, discussing commissioning and joined up thinking, especially in the medical treatment context.
- The Revd Dr Geoff Morgan, Hospital Chaplain, discussing spirituality, advocacy and the MCA.
- Dr Steve Fleming, cognitive neuroscientist and psychologist, discussing metacognition, insight and capacity.
- Dr Scott Kim, psychiatrist and bioethicist, on a critical friend appraisal of the MCA and the consequences of standing in the shoes of the person.
- Chris Danbury, Chris Newdick and Carl Waldmann, in conversation with the editors of Law and Ethics in Intensive Care (2nd edition)
- Dr Nuala Kane, psychiatrist and clinical research associate on the Mental Health and Justice Project, on capacity rationales, accountability and support
- Dr Idris Baker, palliative care specialist, looking at what decisions are from the medical and legal perspective.
- Helen Gilburt, from the King’s Fund, discussing their report on Understanding clinical decision-making at the interface of the Mental Health Act (1983) and the Mental Capacity Act (2005), most easily accessed by this blog here.
- Dr Chris Danbury, discussing the impact of the Supreme Court decision in Aintree v James, the concept of futility, and mediation in clinical negligence and serious medical treatment cases.
- Akiko Hart, discussing responding to MHA reform proposals and the complexities of MHA reform more generally.
- Dr Hanna Kienzler, digging into the complexities of the right to independent living in crisis situations, and how, in the absence of formal support structures, families navigate decision-making for those with mental disabilities.
- Alix Lewer, discussing the work of the Include choir, the role of music in supporting those with communication impairments, and how people can be educated by stealth as to what constitutes practicable steps to support capacity.
- Professor Rosie Harding, discussing accessible information and practicable steps to support decision-making.
- Dr Tim Meek, discussing the role of anaesthetists before and during operations, how they approach DNACPR documents, and new guidelines produced by the Association of Anaesthetists.
- Dr Lucy Series (in a follow-up discussion to that we had in 2020) talking about Deprivation of Liberty in the Shadows of the Institution.
- Jodie Rawles, discussing contraception, support and intellectual disability.
- Dr Bev Clough, discussing whether and how mental capacity law can move beyond the binaries it sometimes seems stuck in.
- Dr Thomas Kabir, discussing do’s and don’ts of involving those with lived experience in research in the mental health context.
- Dr Zoe Fritz, discussing about her work developing the ReSPECT framework to prompt and record discussions about the shared understanding required as between doctors and patients to enable proper advance care planning.
It is invidious to single out any of of these, but I do need to mention Alix Lewer, simply because the charity she founded, the Include Project, has just received The Queen’s Award for Voluntary Service 2022: many, many congratulations!
I hope to be able to nab some of the attendees at the Congress, coming from all points of the compass, to come spend time with me in the shed, so watch this space.
