skip to main content

Best Interests Decision — MRCPsych Paper B MCQ

Instant feedback + full explanation. One question, done properly.

ModerateMental Health LawBest Interests DecisionMRCPsych Paper B

A 24-year-old man with intellectual disability in England requires dental treatment under general anaesthesia. Despite information being provided in an accessible form and all practicable support, he is assessed as lacking capacity to decide about this treatment. There is no valid and applicable advance decision, health and welfare lasting power of attorney, or relevant Court of Protection deputy, and there is no dispute among those involved. Who has legal responsibility for deciding whether the dental treatment should proceed?

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

Reveal the answer and explanation

Correct answer: A — The responsible treating clinician, using the Mental Capacity Act best-interests process and appropriate consultation

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

The responsible treating clinician is the decision-maker for the proposed treatment and must decide whether proceeding is in the patient’s best interests under the Mental Capacity Act 2005. The patient must remain involved as far as possible, and the decision must consider his wishes, feelings, beliefs and values, clinical benefits and burdens, alternatives, and the least restrictive course. Relevant family members, carers and professionals should be consulted, but they do not provide consent unless they hold applicable legal authority. Therefore A and E are incorrect. B omits the required person-centred best-interests assessment and consultation. The Court of Protection is not routinely required; it may become necessary for specified exceptional decisions or an unresolved serious dispute. An IMCA is required only in defined circumstances, including qualifying serious medical treatment when nobody appropriate is available to consult.

Reference: Office of the Public Guardian, Making decisions: a guide for people who work in health and social care, sections 6–9, updated 19 May 2026. https://www.gov.uk/government/publications/health-and-social-care-workers-mental-capacity-act-decisions/making-decisions-about-your-health-welfare-or-finances