David Matthews examines the thorny issue of consent and capacity as it affects people with learning disabilities

In all caring services, it is inevitable that a number of dilemmas will arise when important decisions have to be made about issues that impact on individuals’ lives. A dilemma occurs when a decision needs to be taken, or a course of action proposed, where there is no clear choice about which option is the correct one. Many practitioners will be familiar with a feeling that whatever option is chosen it will be the wrong one – even when one has read the latest guidance from one’s governing body (NMC 2002).