• if a person doesn’t have capacity, act in their best interest
• try your best to assess if he has capacity and give him the opportunity to have it?
• if someone makes a crazy decision, that is not a reason for lacking capacity, can be why you decide to assess them tho
• can use the mental health act to provide people with treatment to treat their mental disorder and not under any other case
• Children can only be Gillick competent to say yes to something that is in their best interests whereas for adults if they have capacity and consent, they can consent to something not in their best interest.
• Once you’re 16 and 18, your competent refusal can be overridden, as it is still under the child protection act
• you can accept parental consent from one parent
  • if dad refuse but mum said no then you can let them know that what will happen, you should be honest unless there is an overwhelming reason or the situation suggest you shouldn’t
• if both parents refuse and the child will die (emergency life threatening, if not then you can go to court if you have more time to deliberate) you can act in best interests and override their refusal, but it is good to have parental consent
• Advance decisions is only applicable if they had capacity at the time of making it - signed and witness (don’t have to be family witness)
• You can’t make an advanced decision to refuse basic care such as eating and drinking, only refuse artificial medical intervention
  • Under the MCA an advance refusal of basic nursing care/natural feeding is not valid,
• you don’t need consent to not give them something such as withholding CPR
• an advance decision can be verbal but they have to be consent to be valid
• confidentiality can be lawfully breached if it is necessary; we have a justification as opposed to a legal duty to
  • legal to do so in a couple of scenarios such as abortion act, road traffic act, notifiable diseases, terrorism
  • tell patient you will break confidentiality but if harm then don’t
  • professional obligation might be more strict than legal; patient wants to harm another so you tell police, but if you don’t tell police might be a breach of professional duty but not a breach of legal and GMC will hit you.
• to knowingly affect someone with HIV (can be GBH or manslaughter if the person dies)
• even if there is a justification to breach it is only for those who need to know, for example DVLA (only the info they need) only and not the employer and you tell the patient that you will break confidentiality (not for consent but just to tell them)