From principle to practice

: Exploring the role of ethics of care in understanding social work decision-making under the Mental Capacity Act 2005

Abstract

Assessments under the Mental Capacity Act 2005 (MCA05) are a crucial part of statutory adult social work practice. They provide a legal framework for evaluating an individual’s capacity to make informed decisions, safeguarding their rights, autonomy, and well-being, and for determining when decisions can be made on their behalf if they lack capacity. However, these assessments can be complex and often involve ethical dilemmas, particularly in balancing care and autonomy. These challenges require social workers to reconcile conflicts between legal requirements, professional responsibilities, and ethical considerations. This research explores whether Tronto’s (1993) feminist ethics of care framework, which includes the moral qualities of attentiveness, responsibility, competence, responsiveness, and trust, is reflected in adult social workers’ mental capacity assessments. Ethics of care offers a relational and compassionate perspective to help social workers carryout ethically sound, person-centred capacity assessments.
The application of the law requires fairness, impartiality, and autonomy, an ethics of justice approach, providing a consistent legal framework and a method for moral reasoning, which is evidence-based. An approach that may conflict with ethics of care, particularly when the individual’s wishes are overlooked due to the requirement to make a legally defensible decision and safeguard the individual. This research argues that by integrating these two ethical approaches, social workers are supported to complete a legal, holistic assessment of capacity in line with the MCA05, ensuring they are individualised and compassionate, taking into consideration the emotional and social factors that inform an individual’s ability to decide.
This study reports the findings of qualitative research, which took a social constructivist approach, viewing individuals as embedded in relationships that influence and shape them, to evaluate whether ethics of care were evident in social workers’ MCA05 assessments. Sample data collected via 2 practice-near ethnographies, and 13 unstructured interviews with newly qualified to experienced adult social care social workers in one local authority. The analysis was thematic using deductive coding.
The originality of this research stems from applying Tronto’s (1993) theoretical framework to MCA05 assessments, emphasising how ethics of care can improve the social worker’s engagement with individuals and the significance of ethical reflexivity. It argues that ethics of care offers a framework to help social workers consider more deeply the interdependence of the individual and how factors like power and trust influence their ability to engage and make decisions. This research enriches social work theory and practice by encouraging a more compassionate approach to MCA05, aiding social workers in refining their professional judgement, reducing the risk of paternalistic decisions, and fostering collaboration between ethics of care and ethics of justice to ensure a balanced and ethical assessment. Furthermore, the findings are relevant to other professional groups, both within health and social care, who are responsible for conducting MCA05 assessments. Additionally, the findings of this research are relevant to those who undertake training with respect to the MCA05.

Date of Award	Apr 2026
Original language	English
Awarding Institution	University of Brighton
Supervisor	Kelly Alexander (Supervisor), Stephanie Fleischer (Supervisor) & Phil Haynes (Supervisor)