Oral presentation at the International Spring School for Human Rights and Mental Health, University of Bochum. April, 2019.
A contentious aspect of decision making capacity (DMC) in the English and Welsh Mental Capacity Act (MCA) 2005 is the ability to ‘use or weigh’ information relevant to the decision. Here we explore neuroscientific research on decision-making to identify features of decision making that help conceptualise this requirement.
We focus on studies of the neural and computational basis of model based control – the ability to anticipate the consequences of actions, and metacognition – the ability to monitor how those consequences will likely affect oneself, and suggest that these aspects may share neurocomputational features with the ‘use or weigh’ requirement. We use this neuro-computational framework of the ‘use or weigh’ requirement to distinguish between different types of decision processes which may lead to similar outcomes but rely on different decision processes.
We suggest that understanding how multiple mechanisms drive decision making holds promise for targeting decision-making support and improving our understanding of the use and weigh requirement in cases of contested capacity.