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The impact of the 2005 Mental Capacity Act on social workers' decision making and approaches to the assessment of risk
- Author:
- McDONALD Ann
- Journal article citation:
- British Journal of Social Work, 40(4), June 2010, pp.1229-1246.
- Publisher:
- Oxford University Press
While there is no body of law relating directly to older people, the 2005 Mental Capacity Act in England and Wales has introduced a statutory system for assessment and substituted decision making for people lacking the capacity to make independent decisions, including decision making by older people with dementia. This paper, based on research into the early impact of the Act on social work practice, identifies three distinct types of approach to risk emerged: legalistic; actuarial; and rights-based. These three types of social work practice are discussed in the context of modernist assumptions of rationality and self-interest, the demands of a risk society for proficiency at decision making, and the relationship between moral and legal dialogue where social workers intervene when capacity is challenged. The author highlights how the outcomes are relevant to the changing context of social work with people with dementia, the introduction of individual budgets replacing directly provided services and the development of a National Dementia Strategy. The author argues that, although risk-based and actuarial types currently govern practice, rights-based approaches are necessary to support older people in making choices, counteract stereotypes and promoting well-being.