Presumption of Capacity — MRCPsych Paper B MCQ

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EasyMental Health LawPresumption of CapacityMRCPsych Paper B

In England and Wales, which statutory principle of the Mental Capacity Act 2005 requires a clinician to assume that a person has capacity to make a particular decision unless it is established otherwise?

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Correct answer: E — Presumption of capacity

The correct answer is E, presumption of capacity. This is the starting principle of the Mental Capacity Act 2005: a person aged 16 or over must be assumed to have capacity for the particular decision unless lack of capacity is established. Supported decision-making requires all practicable steps to help the person decide before concluding that capacity is absent. An apparently unwise decision does not by itself demonstrate incapacity. Best interests and the least restrictive option become relevant when decisions or actions are being taken on behalf of a person who has been established to lack capacity.

Reference: NHS England. Guidance to support implementation of the Mental Capacity Act in all NHS commissioned settings for adults with a learning disability, section '5 core principles of the MCA 2005'. Updated 17 June 2026. https://www.england.nhs.uk/long-read/guidance-to-support-implementation-of-the-mental-capacity-act-in-acute-trusts-for-adults-with-a-learning-disability/