MCA Five Principles — MRCPsych Paper B MCQ
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Correct answer: B — Assume capacity; take all practicable steps to support decision-making; do not infer incapacity from an unwise decision; act in best interests; choose the least restrictive effective option
Explanation lettering: D = shown as A · A = shown as B · E = shown as D · B = shown as E
A is correct. Section 1 of the Mental Capacity Act 2005 requires capacity to be presumed unless established otherwise; all practicable steps to support the person to decide must be attempted; an unwise decision alone does not establish incapacity; acts or decisions for a person who lacks capacity must be in their best interests; and the purpose should be achieved in a way that is less restrictive of the person's rights and freedom of action. Option B lists general biomedical ethics principles rather than the statutory MCA principles. Option C contains important professional and legal duties but is not the statutory list. Option D describes healthcare-quality aims, while option E describes elements of routine clinical management.
Reference: Office of the Public Guardian, Making decisions: a guide for people who work in health and social care, section 4: The five principles of the MCA, 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