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Supported Decision-Making — MRCPsych Paper B MCQ

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EasyMental Health LawSupported Decision-MakingMRCPsych Paper B

In England and Wales, a patient is deciding whether to have a non-urgent physical health investigation. Because they find written information difficult to understand, the clinician uses simple verbal explanations, pictures and extra time before assessing capacity. Which principle of the Mental Capacity Act 2005 is being applied?

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Correct answer: D — All practicable steps must be taken to support the person to make the decision

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

E is correct. The clinician is providing practical support—accessible verbal information, pictures and time—before deciding whether the person lacks capacity. This is the second statutory principle of the Mental Capacity Act 2005: a person must not be treated as unable to make a decision until all practicable steps to help them decide have been taken without success. B is the separate starting presumption of capacity. D means that a decision others consider unwise does not itself demonstrate incapacity. A and C apply to acts or decisions made for a person after they have been found to lack capacity: these must be in best interests and, where possible, least restrictive.

Reference: Department for Constitutional Affairs. Mental Capacity Act 2005 Code of Practice, chapter 2, principle 2 (section 1(3)), 2007. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/497253/Mental-capacity-act-code-of-practice.pdf