Healthcare decision-making by adults with learning disabilities: ongoing agendas, future challenges

This contribution reviews recent developments in the law and policy of healthcare decision-making by, with and for adults with learning disabilities. In particular, it considers the impact of the Mental Capacity Act 2005 and the reforms outlined in the Department of Health's (2005) White Paper Our Health, Our Care, Our Say: A New Direction for Community Services, and the Local Authority Circular (2008) Transforming Social Care. Pressing issues such as the concept of choice for vulnerable adults and the challenges for professionals in assessing decision-making ability are assumed within these policy frameworks. Other issues, such as the importance of creating time to engage and involve vulnerable adults in decision-making about their health, continue to present challenges for healthcare policy and practice.