Inclusion under the Mental Capacity Act (2005): A review of research policy guidance and governance structures in England and Wales

Hayley Ryan, Rob Heywood, Oluseyi Jimoh, Anne Killett, Peter E. Langdon, Ciara Shiggins, Karen Bunning

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
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Objective: To investigate how people with communication and understanding difficulties, associated with conditions such as dementia, autism and intellectual disability, are represented in research guidance supplementary to the Mental Capacity Act (MCA: 2005) in England and Wales.
Methods: A documentary survey was conducted. The sample comprised the MCA Code of Practice (CoP: 2007) and 14 multi-authored advisory documents that were publicly available on the Health Research Authority website. Textual review of key words was conducted followed by summative content analysis.
Results: Representation of people with communication and understanding difficulties was confined to procedural information and position statements that focused mainly on risk management and protection. Whilst a need to engage potential participants was recognised, guidance provided was imprecise.
Conclusions: Tensions exist between the protection versus empowerment of people with communication and understanding difficulties in research. The development of structured, evidence-based guidance is indicated.
Patient or public contribution: People with communication and understanding difficulties and carers participated in a working group to explore, discuss and interpret the findings.
Original languageEnglish
Pages (from-to)152-164
Number of pages13
JournalHealth Expectations
Issue number1
Early online date27 Nov 2020
Publication statusPublished - Feb 2021


  • Code of Practice
  • Mental Capacity Act
  • capacity
  • communication
  • consent
  • ethics

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