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End of life care: Flow chart for decision making when patients may lack capacity

The  mental capacity decision making flow chart (pdf) is a printable flowchart that takes you through the steps you should take when treating a patient who may lack capacity. Can the patient understand, retain, use and weigh up the information needed to make the decision in question, and communicate their wishes? Can the patient now make and communicate their decision? Has the patient made a valid and applicable advance refusal of any of the treatments that you consider clinically appropriate? Does someone else hold legal authority to make the decision about the patient’s treatment and care? End of life care guidance, paragraphs 24-27 End of life care guidance, paragraphs 31-32 End of life care guidance, paragraph 38 End of life care guidance, paragraphs 11-12 End of life care guidance, paragraph 14 End of life care guidance, paragraph 12 End of life care guidance, paragraphs 28-30 End of life care guidance, paragraphs 35-36 End of life care guidance, paragraph 15 End of life care guidance, paragraphs 70-74 End of life care guidance, paragraphs 68-69 End of life care guidance, paragraph 16 (c) End of life care guidance, paragraph 16 (d)-(e) End of life care guidance, paragraphs 34-35 End of life care guidance, paragraph 43 End of life care guidance, paragraph 15 (c) End of life care guidance, paragraph 16 (d)-(e) End of life care guidance, paragraph 61 End of life care guidance, paragraphs 75-77 End of life care guidance, paragraphs 17-21 End of life care guidance, paragraphs 22-23 End of life care guidance, paragraph 16 (g) Seek information about the partner's wishes, preferences, feelings, beliefs, and values Seek information about the partner's wishes, preferences, feelings, beliefs, and values Seek information about the partner's wishes, preferences, feelings, beliefs, and values Seek information about the partner's wishes, preferences, feelings, beliefs, and values End of life care guidance, paragraph 13 End of life care guidance, paragraph 16 (a)-(c), (f)-(h) End of life care guidance, paragraphs 40-46

Please Note

The vignettes attached to the flow chart are fictional and for illustration purposes only.

They provide examples of how the decision-making model in the guidance might work in practice.

They do not represent GMC guidance or policy in themselves, nor are they intended to replace Treatment and care towards the end of life: good practice in decision making (2010) or any other GMC guidance.

All paragraph numbers refer to the GMC's guidance

Treatment and care towards the end of life: good practice in decision making (2010).