Who is the best interests decision maker?

Wherever possible all individuals should be involved in decisions about their care and treatment.
Every effort should be made to ensure that their views are sought and shared.

Where individuals are unable to express there wishes a Best Interest decision should be made.

The decision about who is the Best Interests decision maker is a crucial point, and the unhelpful answer is that it depends on the decision.

For day to day decisions about care or activities of daily life, it is likely to be the person’s primary carer.  (This will often be the parent(s) who may have already cared for that young adult all their lives making decisions under parental responsibility.  But from the age of 16, this is governed by the MCA, and not a right under parental responsibility).

For decisions about serious medical treatment, the law regards the decision maker as being the person responsible for delivering the treatment – eg the key surgeon or doctor.

Understandably, this can cause distress and conflict where a parent who has made every decision all the child’s life is then told that the parent is not the sole decision maker when a child over 16 needs serious medical treatment.