This episode breaks down one of the most challenging areas in the MSRA SJT: lawful, structured capacity assessment under the Mental Capacity Act. You’ll learn how to support autonomy, apply the two-stage test, avoid common traps, and make safe best-interest decisions using the least restrictive option.

0:00 Introduction
0:22 Why capacity matters
1:05 Core MSRA exam mindset
1:40 MCA five principles
2:40 Two-stage legal test overview
3:10 Stage 1: Diagnostic impairment
3:40 Stage 2: The four abilities
5:00 Understanding and retaining information
6:10 Weighing information correctly
7:00 Communication considerations
7:40 Decision-specific and time-specific capacity
8:10 Five-step high-yield framework
8:35 Step 1: Support understanding
9:20 Step 2: Apply two-stage test
10:10 Step 3: Best-interest decisions
11:00 ADRT + LPA essentials
11:40 IMCA triggers
12:10 Least restrictive option
12:50 Documentation and review
13:40 SCALE mnemonic
14:40 Classic exam patterns
16:10 Major traps and decoys
18:00 Rapid-fire clinical drills
20:20 Final key takeaways

• Capacity must always be supported before assessed.
• Two-stage legal test: diagnostic impairment + four functional abilities.
• An unwise decision is not incapacity.
• Best-interest decisions follow MCA Section 4, not clinical intuition.
• Use least restrictive options wherever possible.
• Document everything clearly, including rationale and review plan.
• IMCA is mandatory for serious decisions with no family/LPA.

SCALE mnemonic:
S – Support understanding
C – Check for impairment
A – Apply the four abilities
L – Least restrictive best interests
E – Evidence in the notes

Links:
• passthemsra.com – Complete MSRA revision, notes, mocks, flashcards
• freemsra.com – Free podcasts, threads and rapid-learning guides
• msra.io – Smart MSRA Qbank with analytics

#MSRA #SJT #MedicalEthics #CapacityAssessment #MentalCapacityAct #UKDoctors #MedicalRevision #passthemsra #freemsra #msraio #ClinicalLaw #GMC