An act done or decision made under the Mental Capacity Act 2005, for or on behalf of a patient lacking capacity, must be done, or made, in his best interests1. The exception to this is where the patient, after the age of 18, has made an advance decision to refuse medical treatment while they had the capacity to do so2. In trying to work out what is in the best interests of a patient all the relevant circumstance must be considered and the patient must be encouraged to participate in the decision as much as possible3. The Mental Capacity
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