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MCA Best Interests No Family Available — FRCA Final MCQ

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EasyMedicolegal & EthicsMCA Best Interests No Family AvailableFRCA Final

An 80-year-old woman (ASA III) with cognitive impairment requires hip fracture fixation. She does not have capacity to consent. Her family are unavailable. According to the Mental Capacity Act 2005, who should make the treatment decision?

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Correct answer: D — The most senior doctor available, acting in the patient's best interests

Under the Mental Capacity Act 2005, if a patient lacks capacity and has no lasting power of attorney, advance decision, or court-appointed deputy, the treating clinician (most senior doctor) makes a best interests decision. This involves: considering the patient's past/present wishes, consulting staff involved in care, and weighing the benefits and risks. For urgent/emergency treatment, this decision can proceed without delay. An IMCA may be instructed for serious treatment decisions where the patient has no one to consult (other than paid carers).

Reference: Mental Capacity Act – 2005; GMC – 2020 – Decision making and consent