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My child is 18, they are unable to make any decisions for themselves, do I still have parental responsibility?

No, the young person is now legally an adult.  But if someone other than yourself is making a decision on their behalf, they have an obligation to consult with you.

Ensure you have told staff that you wish to be present at any decision making discussions. If you don’t feel able to be involved ask for more help. Most hospitals have a Learning Disability nurse who works with adults who should be able to support you and your son or daughter.

As a parent I know the intricacies of my child and expectations of what could happen how can I ensure I am listened to?

Ensure whenever you meet a new health professional including admission to hospital that you say you wish to be involved in any decision making. They should welcome your knowledge and experience.

As a parent I fear the future for my daughter when I am not here who will safeguard her needs for the future?

The ‘best interests’ decision maker working with others who know her well. The Mental Capacity Act provides a legal framework for making decisions where a person cannot give consent for themselves in their ‘best interests’.

Who should make a best interest decision for the young person?

A  Best interest decisions should always be collaborative and take into consideration the culture, previous wishes and actions of the person involved.  Ultimately the person carrying out the action is responsible for the decision. E.g. a district nurse giving an injection would decide at the time if it was appropriate to give the injection.

Best interest if it becomes court decision are the family considered to have more information regarding what the person wants, wishes, beliefs?

It has to be a shared collaborative decision making partnership decision between professionals, family and others engaged in caring for the young person.

If someone is over 18 and lacks capacity to consent for surgery whose signature is seen as acceptable? Could it be someone who is not the parent if they are not available?

Acting in a patient’s best interests without the patient’s consent, the surgeon would where possible seek affirmation from a consultant colleague and discuss their intended actions with the patient’s supporter.

What happens if you as a parent disagree with a medical decision?

Try and arrange to speak to the Doctor involved, best interests for good and proper decision making states Decision makers have a duty to consult to speak to anyone caring for young person or is interested in their welfare.

Advance decision to refuse treatment – does this have to be done through a solicitor?

Not always if the person has lost or never had capacity to make an advanced decision the Court of Protection may appoint a Deputy but it expects decisions to be taken collaboratively by the clinicians with the family and others engaged in caring or interested in their welfare. Any serious disputes would be referred to Court.

If I have deputyship can I make all the decisions for the young adult concerned?

Any decisions made would still have to be considered in their best interest.  For instance you could not demand a treatment that a medical professional considered to be against their best interest.  You cannot authorise any deprivation of liberty, for instance short breaks or residential care, without this being assessed by the local authority in your role as deputy, although if you have parental responsibility for the young adult, you may be able to give consent to a deprivation of liberty.  Ultimately, as deputy though, the court of protection is responsible for the young adult and you are acting on their behalf and are responsible to the court.

Can more than one person have deputyship?

Yes. An application can be made in more than one name.

Do I need a DoLS Authorisation if have been awarded Deputyship by the Court of Protection or if I have Lasting Power of Attorney?

Yes. A deprivation of liberty is only lawful if it is authorised either under DoLS, by the Court of Protection, or in certain circumstances for patients between the age of 16-18, with the consent of those with parental responsibility.  The agreement of either an Attorney or a Deputy to some or all of the restrictions that amount to the deprivation of liberty does not change this (eg consenting to the use of cot sides).  However, if a valid Attorney or Deputy opposes a DoLS authorisation, this will prevent the DoLS system being used and only the Court of Protection would be able to authorise the deprivation of liberty.

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