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Q01025: What is a ‘cannabis-based medicinal product’?

Answer
A ‘cannabis-based medicinal product’ is all of the following - 
 
  • The product is or contains cannabis, cannabis resin, cannabinol or a cannabinol derivative
  • It is produced for medicinal use in humans; and
  • It is a product that is regulated as a medicinal product, or an ingredient of a medicinal product.
 
These products are subject to strict prescription requirements and may only be prescribed by specialist clinicians listed on a register administered by the General Medical Council.  See related links.
 
If a cannabis product does not meet the requirements above or is not administered through the legal routes such as via prescription, then an individual will commit offences such as possessing, supplying or producing a drug. 
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In UK law, mental capacity is the ability to make a specific decision at the time it is needed. This involves being able to understand the information, retain it, weigh up options, and communicate the decision. The Mental Capacity Act 2005 provides a legal framework for England and Wales to protect and empower individuals who lack mental capacity.

How is mental capacity assessed?

A person is assumed to have capacity unless it is proven they lack it. Someone lacks capacity if their mind is impaired in some way, preventing them from making a decision at that specific time. They lack capacity if they cannot do one or more of the following:
  • Understand the relevant information about the decision.
  • Retain the information long enough to make the decision.
  • Use or weigh up the information as part of the decision-making process.
  • Communicate their decision in any way. 
Important principles

Capacity is specific and time-bound: A person may have capacity for one decision but not another, and may have capacity at one time but not another.

Don't assume a lack of capacity: A person is not treated as unable to make a decision just because they are 16 or over, have a mental health condition, or make an unwise decision. All practicable steps must be taken to help them make their own decision first.

Act in the person's best interests: Any act or decision made on behalf of a person who lacks capacity must be done in their best interests.

Least restrictive option: Decisions must be made in the way that is least restrictive of the person's rights and freedom of action.
 
For further information please see the links in Related Information.

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Deprivation of Liberty Safeguards (DoLS) are a legal framework in England and Wales, under the Mental Capacity Act 2005, designed to protect the human rights of vulnerable adults who lack the capacity to consent to their care arrangements. They apply to individuals over 18 in a hospital or care home who are under continuous supervision and control and are not free to leave.
 
DoLS ensure that any deprivation of liberty is in the person's best interests, necessary to keep them safe, and authorized through a formal process.

How does DoLS work?

Who they protect: Adults aged 18 or over who have a mental disorder and lack the capacity to make decisions about their care or treatment in a hospital or care home.

What they do: They provide a legal framework to authorise a deprivation of liberty if it is the only way to protect the person from harm and is in their best interest.

The process: Care homes and hospitals must apply for a "standard authorisation" from a local authority to deprive someone of their liberty. The application comprises of 6 assessments (please see the Social Care Institute link in Related Information for these assessments) and even when granted there are key safeguards in place to protect the person.

Authorisation: A deprivation of liberty can only be authorised if the person lacks the capacity to consent to their care arrangements, and the arrangements are in their best interests.

Key Principles

A deprivation of liberty occurs when a person who lacks capacity is under continuous supervision and control and is not free to leave.

The safeguards are a last resort and should only be used when absolutely necessary. The process ensures that decisions are made in the person's best interests and in consultation with relevant authorities. There are provisions for family members and others close to the person to be involved and have a say.
 
For further information please see the links in Related Information.

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The number to ring is 111. You can dial this number if you urgently need medical help or advice but it's not a life-threatening situation. If you think your case is an emergency, dial 999 and ask for an ambulance.

NHS 111 is available 24 hours a day, 365 days a year. Calls are free from landlines and mobile phones.

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The NHS website in Related Information provides details of how to access out-of-hours medicines outside of your GP surgery's normal opening hours.

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Yes, a competent adult can refuse treatment in a hospital, even if the refusal could result in death. Healthcare professionals are required to discuss the decision with you, answer your questions, and make sure you understand the risks before accepting your refusal. If you lack the capacity to make a decision, and have not made an advance decision (a "living will"), doctors will decide what is in your best interests, consulting with relatives where possible. 

The British Medical Association's Core Ethic Guidance states that persons may refuse treatment -

'...except where compulsory treatment for the patient’s psychiatric disorder is authorised by mental health legislation. The situation is different for patients under the age of 18; for guidance on children and young people under 16, and guidance on 16 and 17-year-olds, see key resources. Doctors must respect a patient’s decision to refuse treatment, even if they do not agree with it or when it could lead to permanent injury or death. For example, a Jehovah’s Witness can refuse a blood transfusion even where this is essential for survival. Providing treatment without valid consent, and in the face of a competent refusal, would leave the doctor open to legal and professional sanctions. A refusal of treatment should not be interpreted as a refusal of all treatment or care. It is essential that steps are taken to keep the patient comfortable and that any symptoms or distress are appropriately managed. Patients are not required to justify their decision to refuse consent, but healthcare professionals should seek to ensure that patients base their decisions on accurate information and that they have corrected any misunderstandings. Patients also need to know if refusing treatment now will limit their future options.
Doctors must not put pressure on patients to decide in a particular way, but should allow them time to consider a decision with potentially serious consequences.'
 

More information can be found on the websites in Related Information.

 

 

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Q01025: What is a ‘cannabis-based medicinal product’?

Answer

A ‘cannabis-based medicinal product’ is all of the following - 
 
  • The product is or contains cannabis, cannabis resin, cannabinol or a cannabinol derivative
  • It is produced for medicinal use in humans; and
  • It is a product that is regulated as a medicinal product, or an ingredient of a medicinal product.
 
These products are subject to strict prescription requirements and may only be prescribed by specialist clinicians listed on a register administered by the General Medical Council.  See related links.
 
If a cannabis product does not meet the requirements above or is not administered through the legal routes such as via prescription, then an individual will commit offences such as possessing, supplying or producing a drug. 
 
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