Assessment of Knowledge on the Assisted Decision-Making (capacity) act 2015 among Irish Medical professionals in Ireland

Abstract Background The Assisted Decision-Making Act 2015 (The Act) implemented on April 26, 2023, marked a significant change in Irish healthcare law. It emphasises autonomy and supported decision-making for individuals who may lack capacity. Limited evidence exists regarding Irish medical professionals' awareness and understanding of the Act. We aimed to assess knowledge and awareness among medical professionals in Ireland. Methods A cross-sectional survey was conducted among doctors across four hospitals. It included multiple choice and true/false questions to assess knowledge, awareness, and barriers in implementing the Act. Results 96 (n=96) medical professionals completed the survey. Respondents represented various specialties. 15 (15.62%) Consultants, 81 (84.38%) NCHD’s completed the survey. Years of experience ranged from less than 5 to 20+ years in clinical practice. 81 (84.3%) were aware of the Act and reported basic or moderate grasp of the legislation. 4 (4.17%) reported comprehensive understanding, 18 (18.75%) reported no understanding of the Act. 47 (48.96%) indicated that a multidisciplinary team should be responsible for capacity assessments while 8 (8.33%) felt Geriatricians should perform the assessment. 41 (42.71%) were not confident in applying principles of the Act in practice. 90 (93.75%) identified that a person can appoint a decision-making assistant. 76 (79.17%) identified that The Act abolishes the ward of court. 71 (73.96%) have received no training on The Act. 87 (90.62%) expressed desire for further training, with preferred formats including online modules, workshops, and written guidelines. Common barriers in implementing the Act included lack of awareness (n=50), lack of time (n=32), insufficient training (n=66), and issues with complexity (n=44). Conclusion This audit shows that medical professionals widely recognise the Act, there is notable lack of understanding and confidence in applying its principles. Results highlights need for structured training, multidisciplinary support, and policies to effectively implement the Act in clinical practice.