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Dr. Anthony Kearns, Consultant Forensic Psychiatrist, Senior Clinical Lecturer Academic Department of Psychiatry Trinity College Dublin, Central Mental Hospital, Ireland. Abstract: People with intellectual disability and other neurodevelopmental disorders are now part of mainstream society. Therefore such individuals’ ability to make decisions and take responsibility for their actions has been receiving increasing attention from service-providing agencies and the law. For service providers, consideration has to be given to the tension between the person’s right to have freedom of movement and action and, for the law, to participation in variety of legal proceedings, including consideration of responsibility for putatively criminal acts. I will be exploring these issues and focusing on the areas of decision-making competence with reference to deprivation of liberty, fitness to stand trial and criminal responsibility, with particular as applying to persons with intellectual disability and autism disorders. I will be reviewing a 2-year cohort of referrals to a national forensic intellectual and developmental disability service and review our advising on these issues. I will refer to legislative provisions in other jurisdictions for comparative purposes. I will discuss recent work in our forensic service on the devising of a capacity assessment instrument, the DUNDRUM capacity ladders. I will provide anonymised illustrative case histories. I will consider possible future developments. Medicine and Law (2018) 37:2(2) (Guest Editor: Oren Asman), WAML and The Bioethics and Law Initiative, Tel Aviv University