Decision-making capacity: the legal aspects

Estimated Duration: 
1 hour

In this course, you will learn about the legal process that follows a capacity assessment. It follows on from Assessing decision-making capacity - the clinical basics, where we covered the relevant principles when assessing decision-making capacity for consent to healthcare, and demonstrated how to perform a capacity assessment using a 3-stage approach.

Assessing capacity under the Protection of Personal and Property Rights Act 1988 (PPPR Act)

In course 1 we covered off how to conduct a capacity assessment. We illustrated the capacity assessment interview with a case study about Mrs Jones, and decided that she lacked the capacity to refuse home-based support.

This course is part 2 of a 2-part module:

  • In course 1, Assessing decision-making capacity: the clinical basics, we covered the relevant principles when assessing decision-making capacity for consent to healthcare, and demonstrated how to perform a capacity assessment using a 3-stage approach.
  • In this course, Decision-making capacity: the legal aspects you will understand the requirements for a formal assessment.  This is important as you need to understand the legal framework for substitute welfare and financial decision-making to support people who may lack capacity to make decisions for themselves. You also need to know how to provide a medical opinion about a person’s capacity in respect of a wide range of legal decisions, and to advise what support measures may be needed so that the person (patient) may, where possible, make decisions for themselves.

At the end of this course, you should be able to:

  • Understand the PPPR Act in relation to decision-making capacity assessment.
  • Apply the PPPR Act where patients have compromised decision-making capacity.
  • Complete the Clinical Opinion of Capacity for making an EPOA/EPA, Certificate of Mental Incapacity EPOA/EPA for activating an EPOA/EPA, and Report of Registered Medical Practitioner for applying a personal order, welfare guardianship and property management.

Capacity assessment under the End of Life Choice Act 2019 legislation is not covered in this course. Information, guidance, and training resources about assisted dying for health professionals are hosted on the MOH LearnOnline training platform.

Please note: This course does not take the place of legal advice. Where a formal assessment has been requested, the referrer should clarify to you: the legal test, the particular questions to be answered, and that you have been given all the necessary information to be able to complete the assessment.


Once you have completed this short course, you can download your certificate for 1 Continuing Professional Development (CPD) hour.


This course was created by Dr Gary Cheung (Psychiatrist, FRANZCP, Auckland) and Dr Alisha Vara (Registrar, Auckland Regional Psychiatric Training Programme) in partnership with Alison Douglass (Barrister, LLB MBHL, Dunedin) and Dr Greg Young (Psychiatrist, FRANZCP, Hawkes Bay) in 2018. The wider project team also includes Dr Fred Sundram (Psychiatrist, PhD, Auckland), Dr Marcus Henning (Associate Professor, PhD, Auckland), and Prof Ngaire Kerse (Professor, PhD, Auckland).

We especially acknowledge the contribution of Alison Douglass, 2014 recipient of the New Zealand Law Foundation International Research Fellowship, and her report on updating mental capacity law and practice in New Zealand. This module is based on the Toolkit for Assessing Capacity from Alison’s report co-authored with Dr Greg Young and Professor John McMillan.

The material is presented by the Goodfellow Unit (GFU), an accredited continuing medical education/ continuing professional development (CME/CPD) provider for the Royal New Zealand College of General Practitioners and functions under a tripartite agreement between the Goodfellow Foundation, the College and the University of Auckland. The Unit is located within the Department of General Practice and Primary Health Care, and within the School of Population Health.


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