The Adults with Incapacity (Scotland) Act Who Knows? Who Cares?

Abstract

The Adults with Incapacity (Scotland) Act 2000 provides new guidelines on obtaining consent for adults who are incapable of providing informed consent. This article surveys current practice of health workers when obtaining consent from such individuals, and theresults arecompared to the Incapacity Act and local guidelines. The survey results suggest that practice of the guidelines is variable and often legally inadequate Aims: To quantify awareness andpractical application of the Adults with Incapacity (Scotland) Act in surgical wardsin a central Glasgow teaching hospital, 2 years after the Act's introduction. Methods: An interviewer ledanonymous questionnaire was presented to all degree educated staff encountered on random visits to acute and elective surgical and orthopaedic wardsin a split siteteaching hospital. Results: 17 out of 50 staff approached (34%) had not heard of the Adults with Incapacity Act. There was a Significantly higher level of awareness amongst staff based on acute wards (85%) when compared with those from elective wards (54%) (p <0.05, chi-square) There wasa complete absence of formal training in using the Act and knowledge was sometimes in accurate or incorrect. Most staff that had heard of the Act could suggest causes of incapacity, but some included physical disability. There was a persistence of the belief that a relative canconsent for an incapable adult patient, and this was expressed by some of the staff despite knowledge of the Act.

Conclusions: This study shows that a significant number of ward staff have no knowledge of the Act; and understanding is variable amongst staff who have heard of it. The Adults with Incapacity (Scotland) Act 2000 is a unique piece of legislation toprotect the interests of incapable patients, and doctors treating them; but is of no use if medical and nursing staff are un aware of its existence.