To reason

Unable to carry out basic mechanics of reasoning, whether to employ flexibility of thought in responding to contrary evidence or concerns; to compare pros/ cons, advantages/ disadvantages or benefits/risks of the decision; or to reason in other ways. In other words, there is impairment in the various processes of reasoning.

The broad category of reasoning is a frequently used rationale in court practice, with subcategories of ‘flexible thinking’, ‘balancing pros and cons’, and other reasoning.

Inability example quote from court practice:

Flexible thinking: If [P} developed a fixed idea about a subject, it was very difficult for her to incorporate counterbalancing or conflicting information [i.e., P is impervious to evidence, unable to consider evidence to the contrary]

Balancing: She cannot at the moment weigh the evidence up, identifying the pros and cons of a particular course of treatment, or really think about it at all. He said that when confronted with the balancing exercise she simply becomes both distressed and disengaged.

Other reasoning: She acknowledged receiving letters from [Q]. But she became significantly distressed, thought-disordered and preoccupied when invited to consider whether she might wish to respond to those letters

Intact ability example quote from court practice:

Flexible thinking: [It is] not the case that [P} has undertaken the decision-making exercise in relation to dialysis solely on the basis of a concrete or ‘black and white’ view taken in respect of her prognosis but rather on the basis of placing in the balance many factors relevant to the decision

Balancing: [P] gave [Dr X] a clear indication that she could weigh up the positives and negatives of whether or not to engage in sexual behaviour

Other reasoning: After consideration, he suggested two solutions which may not be implementable but are reasonable alternatives to consider.  In so doing, he demonstrates an ability to think systematically and problem solve.

Link to MCA criteria in court practice:

In court judgments, this rationale is usually linked to the MCA Criterion Use or Weigh and we suggest that this is the most appropriate link.

Link to impairments of mind or brain in court practice:

‘Reasoning: flexible thinking’ was most relevant to court judgments involving subjects with Autism Spectrum Disorder and Personality Disorder, although numbers were small in the latter. 

‘Reasoning: balancing pros and cons’ and ‘Other reasoning’: No specific pattern in link.

See here for more discussion of the court practice, and here for more discussion of our recommendations.

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