ReviewClinical rehabilitation2019
Making healthcare decisions in a person's best interests when they lack capacity: clinical guidance based on a review of evidence.
Review in Clinical rehabilitation, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
13 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Involuntary Clozapine Treatment: A Systematic Review.Acta psychiatrica Scandinavica · 2026Pooled it
- Enhancing shared and surrogate decision making for people living with dementia: A systematic review of the effectiveness of interventions.Health expectations : an international journal of public participation in health care and health policy · 2021Pooled it
- Navigating Autonomy: Enhancing Accuracy in Medical Decision-making Capacity Assessment.Annals of African medicine · 2026Review
- Factors Associated With Family Caregivers' Attitudes Toward Withholding Life-Sustaining Treatment in Older Adults With Dementia: A Cross-Sectional Study.Nursing open · 2026Article
- The decision-making process for sedation in specialist palliative care: a qualitative interview study with team members, relatives, and patients.BMC palliative care · 2026Article
- Sector-differences in Adults' Dental Care Service Utilisation: 11-year Register-based Observations.International dental journal · 2025Article
- Informed consent practices for acute stroke therapy: principles, challenges and emerging opportunities.Journal of neurology · 2024Review
- Observational
- The Nurse or Midwife at the Crossroads of Caring for Patients With Suicidal and Rigid Religious Ideations in Africa.Frontiers in psychology · 2021Review
- Conflict before the courtroom: challenging cognitive biases in critical decision-making.Journal of medical ethics · 2020Article
- Legal and Ethical Aspects of 'Best Interests' Decision-Making for Medical Treatment of Companion Animals in the UK.Animals : an open access journal from MDPI · 2020Article
- "International journal of environmental research and public health · 2020Article
- A Typical Perplexing Life-sustaining Therapy Decision at the End of life: A Case Report from Sri Lanka with Attributes Potentially worth Adopting from the UK Legislature.Indian journal of palliative careArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo clarify the concept of best interests, setting out how they should be ascertained and used to make healthcare decisions for patients who lack the mental capacity to make decisions. CONTEXT: The legal framework is the Mental Capacity Act (MCA) 2005, which applies to England and Wales. THEORY: Unless there is a valid and applicable Advance Decision, an appointed decision-maker needs to decide for those without capacity. This may be someone appointed by the patient through a Lasting Power of Attorney, or a Deputy appointed by the court. Otherwise the decision-maker is usually the responsible clinician. Different approaches exist to surrogate decision-making cross-nationally. In England and Wales, decision-making is governed by the MCA 2005, which uses a person-centred, flexible best interests (substituted interests) approach. OBSERVATIONS: The MCA is often not followed in healthcare settings, despite widespread mandatory training. The possible reasons include its focus on single decisions, when multiple decisions are made daily, the potential time involved and lack of clarity about who is the responsible decision-maker. SOLUTION: One solution is to decide a strategic policy to cover more significant (usually health-related) decisions and to separate these from day-to-day relational decisions covering care and activities. Once persistent lack of capacity is confirmed, an early meeting should be arranged with family and friends, to start a process of sharing information about the patient's medical condition and their values, wishes, feelings and beliefs with a view to making timely treatment decisions in the patient's best interests.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.