Capacity to refuse treatment: Assess

Ashley Cutter is 40 years old. Ashley is serving the second year of a 10-year prison sentence for GBH and possession of class A drugs with intent to supply.  Ashley was brought from the prison to the A&E with a self-inflicted large wound on the abdomen.  The wound has cut the skin, the fatty layer and superficially. It has not penetrated the abdominal wall or affected the peritoneum. The A&E wants to close the wound. Ashley is refusing treatment. No major harm will come if surgery is refused.

The prison mental health services diagnosed Ashley with Mixed personality disorder with dissocial, narcissistic, and emotionally unstable traits. Ashley is a prolific cutter. Ashley was under constant observations in the hospital wing of the prison. Last week that was reduced to one check every 10 minutes.  The prison psychiatrist who saw Ashley before the transfer confirmed that Ashley is not depressed or psychotic.

Please assess Ashley’s capacity to refuse treatment.