Capacity and supported decision-making in ID — structured clinical viva

This is a rights-sensitive ID capacity viva combining mild ID, autism-related communication needs, and acute psychosis. The decision is starting antipsychotic medication now, not a global medical status.[1][4]

Supports first. Short chunks, plain language, visual side-effect sheets, quieter room, extra time, father as supporter only if she agrees — he must not answer for her. Anxiety and literal interpretation of "control my brain" need exploration (fear of coercion vs delusional belief vs misunderstanding).[4]

Four abilities. Test understanding of voices/illness and medicine purpose; appreciation that this applies to her; weighing benefits (reduce distress) vs risks (metabolic, EPS — principle-level, cite monitoring plans in clinical care); communication of a choice. Psychosis may impair appreciation; if so, document which ability fails after supports. Mild ID alone does not equal incapacity.[1][4]

UNCRPD / SDM. Legal capacity on equal basis; support to exercise it; will and preferences; safeguards. Clinically: maximise her decision-making; do not rush to plenary guardianship because a parent is distressed.[2][3]

Father's demand. Empathic validation of concern; educate that ID ≠ global incapacity; guardianship is least-restrictive, limited, reviewable, and not same-day clinician "placement under guardianship" by verbal request. If capacity absent for this decision after supports, consider lawful pathways under local consent/guardianship legislation and/or mental health legislation if statutory psychiatric criteria are met — separate tracks; no invented sections.[2][5]

Documentation. Decision named; supports; ability findings; pathway; review when psychosis settles for re-consent.[1][4]