Mental Capacity & issues that surround the ability to consent
Mental capacity as an issue will come up frequently. Even more so, when there is an ageing population. Alzheimer’s disease comes in frequency with age. Dementia, the symptom - may take many years to develop as full blow. However, once the diagnosis is made, there is often the sense of despondency because of fear.
With a diagnosis of early stages of Alzheimer’s, a ticking clock is running to get the relevant infra structure in situ. It is no longer a matter of if but it is when the decline starts to affect daily living & thus, more importantly the capacity to understand & consent.
Issue of mental capacity is a delicate subject. In most children , there is a distinctive pattern. A developmental chart in which professionals are able to make some kind of assessment to come to an informed decision. In the elderly – especially those with Alzheimer’s – the pattern is often less clear. Many factors such as social or financial can often change the pattern of disease progression.
In a recent case here in Singapore [2nd May 2019], an elderly man living in a home for the Aged in Bukit Batok, was convicted of ”committing a rash act”. He was sentenced to 12 weeks in prison for causing the death of another resident. The man sentenced is known to suffer from Dementia & cognitive impairment. Thus, courts will increasingly have to evaluate the merits of cases on an individual basis.
Mental capacity issues are also seen in cases of Brain Death. In a recent news coverage, a lady regained consciousness after 27 years post diagnosis of Vegetative State. This case opens up a new chapter in Medical Ethics.
Thus, in addressing issues of mental capacity, while it is hopelessly difficult to benchmark, is increasingly important that some new tests, standards & regulations are in place to deal with the deluge to come. An ageing society cannot get away from the implications of having to deal with mental capacity issues as it goes towards every aspect of life.