Section 11 amends the 1983 Act to insert section 56A. This introduces a duty on the approved clinician in charge of the patient’s treatment to consider certain matters and take a number of steps when deciding whether to give treatment under Part 4. The duty applies to all treatment given under Part 4 of the 1983 Act to any patient, including patients who are consenting, lacking capacity or competence to consent, or withholding consent to treatment.
	The duty or ‘clinical checklist’ includes, among other things, the need to consider the patient’s past and present wishes and feelings as far as reasonably ascertainable, take reasonably practicable steps to assist and to encourage the patient to participate in treatment decisions, consult those people close to the patient, and identify and evaluate any alternative forms of medical treatment (see subsection (1)). The intention of this section is to help ensure that, as far as possible, clinical decisions are tailored to the patient’s wishes, preferences, and individual needs (including those expressed in the past, for example in an Advance Choice Document or any other relevant written statement made by the patient when they had the relevant capacity), in line with the guiding principle of choice and autonomy. This is to address the fact that some patients have reported in the past that that their wishes have not been given proper consideration, or that insufficient efforts have been made to establish what it is that they want.
	Subsection (2) of the duty means that, where the patient lacks the relevant capacity or competence, the clinician must in addition to the matters mentioned in subsection (1)- consider any wishes, feelings, views or beliefs they think the patient might have had, if they had the relevant capacity or competence to consent to treatment. This is to ensure that, even where a patient is considered to lack capacity or competence to consent to treatment, efforts are still made to personalise their treatment by, for example, looking at their medical history or past expressions of their wishes and feelings (e.g. those recorded in an Advance Choice Document or any other relevant written statement made by the patient when they had the relevant capacity).
	Section 11 also amends other provisions in Part 4 so that, where certification of any treatment is required under the 1983 Act, the second opinion appointed doctor or, if applicable, the approved clinician, must confirm in writing whether treatment was given in accordance with the duty under s.56A (sub (3)-(5)) (i.e. the clinical checklist). This is to ensure that the new clinical checklist is followed and that there is written evidence of it having been completed by the approved clinician in charge of the patient’s treatment.
Treatment Section: Making treatment decisions