Medication Pathway

Section D Challenging the decision to prescribe medication

Decision making for adults

The basic principles about decision making for individuals over 16 years old are:

  • When a decision needs to be made about an individual, it is important to start from the viewpoint that they are able to make the decision for themselves.
  • If a person may be considered to lack capacity, a capacity assessment should be carried out to find out if the individual is able to make the decision. They may need support to make the decision.
  • If a person does have capacity and they should be given support to make the decision and given information in an accessible way. Their decision should be respected, even if others think it is unwise.

The exception is if your relative has been detained under the Mental Health Act (1983), when it is legal for your relative to be given medical treatment without their consent. After three months they have the right to a second opinion about the medication, from a Second Opinion Appointed Doctor (SOAD).

  • When an individual does not have the capacity to decide, then a decision should be made by others in their best interests:
    • This can be done by a discussion between those involved, such as a doctor, the person’s parents and the manager of the person’s support service
    • If the decision is more complex, involves more people or if there are different opinions, then a best interest meeting should be held
    • The least restrictive option for the person should be chosen
    • The individual’s wishes and preferences should be taken into account as far as they are known.
    • Family members have a right to have their views considered in the best interest process.

When making a best interest decision about prescribing medication, everyone involved in your relative’s care should discuss whether the medication is the best thing for them. The benefits and risks of taking the medication should be weighed up. You must consider whether the medication is less restrictive than other possible support options, or whether there is something else that is reasonable to put in place.