Diversity, dignity, equity and best practice: a framework for supported decision-making

As part of ongoing work related to the Australian Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability, the Living with Disability Research Centre at La Trobe University has published a huge (and hugely interesting) report seeking to set out a framework for supported decision-making.  The authors (not all of whom are based at La Trobe) are Christine Bigby, Terry Carney, Shih-Ning Then, Ilan Wiesel, Craig Sinclair, Jacinta Douglas & Julia Duffy.  They describe their aim in the opening of the report thus:

This research aimed to understand the significance of supported decision-making to the lives of people with cognitive disabilities, identify its essential elements common to anyone with cognitive disabilities in any context, and locate key implementation issues. For this Report, we understand people with cognitive disabilities to include people with intellectual disabilities, acquired brain injury, dementia and mental health conditions. Synthesising the research findings, this Report articulates the benefits of supported decision-making, sets out nine principles and eight essential elements of a ‘Diversity, Dignity, Equity and Best Practice Framework for Supported Decision-making’ and recommends implementation strategies.

The report may not, perhaps, be quite the last word in this area (it leaves unaddressed, for instance, the question of whether there are some limits to support based not upon risk, but upon the nature of the decision – e.g. very personal decisions such as sex or marriage).  However, it makes essential reading for anyone who wants to understand the point of supported decision-making, why it is a confusing phrase [1] (but how to navigate what it really means), and how to think about it in a practical fashion both within current legal frameworks and for purposes of developing those frameworks.

This also gives me the opportunity to flag the work that has already been done under the auspices of La Trobe University which should be much better known in the UK than it is: the La Trobe Supported Decision-Making Framework, the website and e-learning materials for which can be found here.


[1] Personally, I would much prefer that the language of Article 12 CRPD was used in this context – i.e. support for the exercise of legal capacity – because that is what is required for compliance with the Convention; because it recognises that it is not just a matter of making decisions, but about acting upon decisions and implementing prior decisions; and because it avoids the sometimes bizarre linguistic tangles which arise in explaining that a decision which is (in fact) being constructed by someone else on the person’s behalf may nonetheless represent a supported, rather than a substitute decision.

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