The Singapore Family Physician

Back to issue Vol 48 No. 2 - Geriatric Care 2022

Mental Capacity Assessment, LPA, Court Appointed Deputy Application, and Ethical Issues related to Mental Capacity Act – 2022 UPDATE

Tan Tze Lee
The Singapore Family Physician Vol 48 No 2 - Geriatric Care 2022
1 March 2022
The Mental Capacity Act (MCA) addresses the need for authorised individuals (donees) to act on behalf of persons who are unable to make decisions for themselves. One of the consequences of Singapore’s rapidly ageing population is the rise in the number of patients suffering from stroke and age-related neurodegenerative diseases. As their cognitive function deteriorates, they also lose their ability to make independent decisions, which makes them at risk of potentially detrimental decisions made by them or others. Conflicts and uncertainty may come about because of a lack of clarity concerning the individual's wishes with mental incapacity. There is a growing concern amongst individuals that, on losing their mental capacity, they also lose their right to make decisions based on. The MCA has two mechanisms to address such issues, namely, (1) Lasting Power of Attorney (LPA) Certification and (2) Court-appointed Deputy Application for Patients. The former allows for cognitively intact persons to appoint one or more persons to act on their behalf should they lose their mental capacity in the future. The Court-appointed Deputy Application for Patients is required for persons who have not made an LPA before losing mental capacity. The court-appointed deputy can make certain decisions on their behalf. A deputy can be an individual or a licensed trust company under the Trust Companies Act (Cap.336). There are also five ethical issues related to the MCA of 2008 to be discussed.