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Learning Disability Consent — ORE Part 1 MCQ

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ModerateBehavioural Sciences & EthicsLearning Disability ConsentORE Part 1

An adult with a learning disability attends for a dental examination accompanied by a carer. The dentist explains the purpose and nature of the examination using information the patient can understand. The patient sits in the chair, opens their mouth and gives no indication of refusal. There is no reason to doubt capacity for this decision. What is the most appropriate action?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Proceed with the examination, recording the patient’s non-verbal consent

Explanation lettering: E = shown as A · D = shown as B · A = shown as C · C = shown as D · B = shown as E

A is correct. Under the Mental Capacity Act 2005, an adult is presumed to have capacity unless there is evidence otherwise; capacity is specific to the decision and time. A learning disability does not itself mean that capacity is absent. Here, the patient has been given an accessible explanation and communicates agreement by cooperative non-verbal behaviour. For a straightforward examination, the dentist may proceed and should record how consent was obtained. B and C are wrong because a parent or carer has no automatic authority to consent for an adult. D is wrong: court involvement is reserved for particular serious, disputed or complex matters, not routine examination. E wrongly equates learning disability with incapacity.

Reference: Office of the Public Guardian, Mental Capacity Act 2005 Code of Practice, chapters 4 and 6 (2007; GOV.UK publication page updated 14 October 2020): https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/497253/Mental-capacity-act-code-of-practice.pdf