• Supported decision-making is an alternative to guardianship that promotes self-determination and independence among individuals with disabilities.
  • It is based on the principles of respect, dignity, and inclusion, and recognizes the importance of autonomy and self-determination.
  • Legislation and policy context play a significant role in the implementation of supported decision-making, and there is a growing movement to promote its adoption in various U.S. states.

Largely in part due to the news surrounding Britney Spears, guardianship, conservatorship and other types of legal arrangements are getting more publicity.

It’s a really big deal to take away someone’s autonomy and decision making authority over oneself. As it should be! Legal guardianship is not an arrangement that should be entered into lightly.

A man in a maroon hat is engaging in supported decision making with his dad

But, until recent years, it often was the only option available. Parents with disabled adult children want to keep their children safe and that often meant that their autonomy had to be traded for safety.

Supported decision-making is an alternative to guardianship that aims to promote self-determination and independence among disabled adults. It is a process by which disabled people can make choices about their own lives with the support of a team of people they choose.

This team of supporters, which may include friends, family members, or professionals, helps the disabled individual to weigh the pros and cons of a decision, review potential outcomes, and finally make a choice.

Understanding supported decision-making requires an understanding of the importance of autonomy and self-determination, which are fundamental human rights.

Supported decision-making is based on the principles of respect, dignity, and inclusion, and recognizes that disabled adults have the right to make their own decisions and to live their lives in the way they choose. For many of us, this seems like common sense.

But, history tells us otherwise. It is not that long ago that disabled people were routinely institutionalized. Disabled babies were routinely taken away from their mothers in the hospital and sent to live elsewhere.

Even once the practice of separating moms and babies stopped, routinely sending adults away to live elsewhere was very common.

Legislation and policy context play a significant role in the implementation of supported decision-making, and there is a growing movement to promote its adoption. But, we’re not quite there yet as far as legality.

A couple utilizing supported decision making embraces each other amidst the serene woods.

Understanding Supported Decision Making

Supported Decision Making (SDM) is an alternative to guardianship that allows disabled individuals to make choices about their own lives with support from a team of people they choose. It emphasizes the importance of disabled people making and communicating their own decisions about their lives.

SDM is a way to get help making choices. It means that the individual makes their own choices, with the help of supporters who they choose. Supporters can be family, friends, or staff who are there to help the individual understand and make their choices.

Many people use supported decision making in their daily lives. For example, they consult family and friends before making big decisions, such as where to live. This is similar to how SDM works, but with the added benefit of having a formal agreement in place that outlines the roles and responsibilities of everyone involved.

SDM agreements are not contracts, but authorizations that identify the people who will support the individual in making their own decisions. These agreements can be tailored to meet the specific needs of the individual and can cover a range of decisions, such as medical treatment, finances, and living arrangements.

It is important to note that SDM is not appropriate for everyone. Some individuals may require a higher level of support, such as guardianship, to ensure their safety and well-being.

It is important to assess each individual’s unique needs and abilities to determine the most appropriate decision-making support. It’s also important to note that a family can seek legal help at any time and change the arrangement. An autistic adult may not have the skills to live on their own at 18, but they may learn and grow and have those skills at 28.

So, you can always redo a contract or agreement to support the individual needs.

SDM is a valuable tool for disabled adults to exercise their autonomy and make decisions about their own lives with the support of trusted individuals.

A woman in a wheelchair is being supported next to a fence.

Legislation and Policy Context

Supported decision-making is a concept that has gained increasing attention in recent years, both at the international and national levels.

This section will provide an overview of the legislative and policy context surrounding supported decision-making, with a focus on international and national laws. The reason I am sharing international laws is because in many ways, the USA lags behind other countries in this.

A man utilizing supported decision making to sign a document with a pen.

International Laws

Supported decision-making is recognized as a fundamental right under international law. Article 12 of the United Nations Convention on the Rights of Persons with Disabilities (CRPD) recognizes the right of all persons with disabilities to enjoy legal capacity on an equal basis with others, and requires that States Parties take appropriate measures to provide access to the support necessary to exercise this right.

The CRPD has been ratified by over 180 countries, making it one of the most widely ratified human rights treaties in history.

In addition to the CRPD, supported decision-making is also recognized in other international human rights instruments, such as the Universal Declaration of Human Rights and the International Covenant on Civil and Political Rights.

Many countries have enacted legislation to promote and protect the right to supported decision-making. In the United States, several states have passed laws that create a legal framework for supported decision-making.

These laws provide individuals with disabilities with the legal right to enter into supported decision-making agreements, and establish safeguards to protect against abuse and exploitation.

In addition to the United States, other countries have also enacted laws to promote supported decision-making.

For example, Canada’s British Columbia province passed the Representation Agreement Act, which allows individuals to appoint a representative to make decisions on their behalf, while still retaining legal capacity.

Similarly, Australia’s Victoria state has enacted the Powers of Attorney Act, which allows individuals to appoint a supportive attorney to assist them in making decisions.

Overall, the legislative and policy context surrounding supported decision-making is constantly evolving, with an increasing number of countries recognizing the fundamental right to legal capacity and the importance of providing support to enable individuals with disabilities to make their own decisions.

A collection of flags displayed outside a building.

Importance of Supported Decision Making

Supported decision-making is a process that allows people with disabilities to make their own decisions with the help of trusted advisors. This process is gaining attention as an alternative to guardianship and other forms of surrogate decision-making for people with cognitive disabilities.

One of the most significant benefits of supported decision-making is that it promotes self-determination, control, and autonomy. It fosters independence, which is crucial for people with disabilities who want to live their lives on their own terms.

By using supported decision-making, people with disabilities can retain their decision-making capacity and make choices that align with their values and preferences.

Another important aspect of supported decision-making is that it respects the human rights of people with disabilities. According to the United Nations Convention on the Rights of Persons with Disabilities, disabled people have the right to enjoy legal capacity on an equal basis with others.

This means that they should not be denied the right to make decisions just because they have a disability. Supported decision-making upholds this right by providing people with disabilities with the support they need to make decisions that affect their lives.

Supported decision-making also has practical benefits. For example, it can help people with disabilities navigate complex systems, such as healthcare or social services. It can also help them make decisions about their finances, housing, and employment.

By using supported decision-making, disabled people can access the resources they need to live fulfilling lives.

A man utilizing supported decision making while holding a dog in front of a tree.

Principles of Supported Decision Making

Supported decision-making (SDM) is a process that involves helping individuals with decision-making disabilities make their own choices. The following principles are the core of SDM:

1. Respect for Autonomy

Respect for autonomy is the foundation of SDM. It means that individuals have the right to make their own decisions, even if those decisions are not what others would choose for them. SDM focuses on empowering individuals to make their own choices and to exercise control over their lives.

2. Inclusion

Inclusion means that individuals with decision-making disabilities should be included in all aspects of decision-making. This includes being involved in discussions, having access to information, and being able to express their opinions and preferences. Inclusion also means that individuals should have the opportunity to participate in decision-making to the fullest extent possible.

3. Support

Support is a critical component of SDM. Supporters are individuals who help the person with a decision-making disability understand the information they need to make a decision, and provide assistance with weighing the options. Supporters can be family members, friends, advocates, or professionals.

4. Flexibility

SDM is a flexible process that can be tailored to meet the needs of each individual. The process can be adapted to the individual’s preferences and abilities, and can be used in a variety of settings and situations.

5. Least Restrictive

The principle of least restrictive means that SDM should be used as an alternative to guardianship or other forms of decision-making support that restrict an individual’s autonomy. SDM should be used as the first option, and other forms of support should only be considered if SDM is not effective.

Overall, the principles of SDM are designed to promote autonomy, inclusion, and support for individuals with decision-making challenges. By following these principles, individuals can make their own choices and exercise control over their lives, while still receiving the support they need to make informed decisions.

Least restrictive environment applies to disabled adults, not just the classroom. This came from a SCOTUS case called Olmstead.

Models of Supported Decision Making

Supported decision making is a process that involves helping individuals with disabilities, particularly cognitive disabilities, to make significant decisions while drawing on the support of a network of people or an individual.

There are different models of supported decision making that can be used to help individuals with disabilities make decisions that affect their lives.

Informal Support Models

Informal support models are based on the idea of involving family members, friends, and other trusted individuals in the decision-making process. These models are often used in situations where the individual with a disability has a close relationship with a family member or friend who can provide support and guidance.

One example of an informal support model is the Circle of Support model. This model involves a group of people who are chosen by the individual with a disability to provide support and guidance in the decision-making process.

The circle may include family members, friends, advocates, and professionals who have expertise in the areas that the individual needs help with.

Formal Support Models

Formal support models involve the use of professionals or organizations to provide support and guidance in the decision-making process. These models are often used in situations where the individual with a disability does not have a close relationship with a family member or friend who can provide support.

One example of a formal support model is the Supported Decision Making Agreement (SDMA) model. This model involves the use of a legal agreement that outlines the decision-making process and the roles and responsibilities of the individual with a disability and the supporters involved.

The SDMA can be used to provide support in a variety of areas, including healthcare, education, and financial decisions.

Another example of a formal support model is the Co-Decision Making model. This model involves the use of a co-decision maker who works with the individual with a disability to make decisions together. The co-decision maker is often a professional who has expertise in the areas that the individual needs help with, such as healthcare or finance.

Overall, both informal and formal support models can be effective in helping individuals with disabilities make decisions that affect their lives. The choice of model will depend on the individual’s needs and preferences, as well as the availability of support from family members, friends, and professionals.

Implementing Supported Decision Making

Role of Supporters

The role of supporters in implementing supported decision making is crucial. Supporters can be family, friends, or staff who help the person with a disability understand and make their own choices.

Supporters should respect the person’s autonomy and provide them with the necessary information to make informed decisions. They should also ensure that the person’s wishes are communicated clearly and accurately.

Supporters should help the person with a disability identify their goals and priorities and assist them in weighing the pros and cons of different options. They should also help the person understand the potential consequences of their decisions.

Supporters should be available to the person whenever they need help with decision making, but they should not make decisions for the person.

Decision Making Process

The decision making process in supported decision making involves several steps. The person with a disability is the one who makes the final decision, with the help of their supporters. The following steps can be followed to implement supported decision making:

  1. Identify the decision that needs to be made
  2. Gather information about the options available
  3. Weigh the pros and cons of each option
  4. Consider the potential consequences of each option
  5. Make a decision based on the information and preferences of the person with a disability
  6. Communicate the decision clearly to others involved

It is important to note that the decision making process may take longer in supported decision making compared to other decision making models. However, the person with a disability should be given the time they need to make an informed decision.

In conclusion, implementing supported decision making requires the active involvement of supporters who respect the autonomy of the person with a disability and provide them with the necessary information to make informed decisions.

The decision making process should be followed carefully to ensure that the person’s wishes are communicated clearly and accurately.

Challenges in Supported Decision Making

Supported decision making is a process that involves multiple parties and can be challenging to implement. Some of the challenges include:

Lack of Awareness

One of the significant challenges in implementing supported decision making is a lack of awareness. Many people are not aware of the concept and its benefits. As a result, they may not be willing to participate in the process.

This lack of awareness can be due to a lack of education and training for professionals and the general public.

Legal Issues

Another challenge is the legal framework surrounding supported decision making. In some cases, the legal system may not recognize supported decision making as a valid alternative to guardianship or other forms of surrogate decision making.

This can make it difficult for individuals to exercise their right to make decisions with support.

Communication Barriers

Effective communication is essential in supported decision making. However, communication barriers can make it challenging for individuals to express their wishes and preferences.

Communication barriers can include language differences, cognitive impairments, and physical disabilities.

Power Imbalance

Supported decision making requires a power shift from professionals to the individual. However, power imbalances can exist between the individual, their supporters, and professionals.

These imbalances can affect the decision-making process and undermine the individual’s autonomy.

Resource Constraints

Finally, resource constraints can be a challenge in implementing supported decision making. Resources such as funding, training, and support services may be limited or unavailable. These constraints can limit the availability and quality of support provided to individuals.

In conclusion, supported decision making is a valuable process that can benefit individuals with cognitive disabilities. However, challenges such as lack of awareness, legal issues, communication barriers, power imbalances, and resource constraints need to be addressed to ensure that individuals can exercise their right to make decisions with support.

Future of Supported Decision Making

Supported decision making has the potential to transform the way society views and interacts with individuals with cognitive impairments.

As society becomes more aware of the potential of supported decision making, it is likely that more individuals will choose to use this approach to make decisions about their lives.

One potential future development is the increased use of technology to support decision making. For example, individuals may use apps or other digital tools to help them make decisions, or they may use virtual assistants or other technology to communicate with their support network.

This could make the process of decision making more efficient and accessible for individuals with cognitive impairments.

Another potential development is the expansion of supported decision making to new areas of life. Currently, supported decision making is most commonly used in the context of healthcare and financial decision making.

However, there is potential for this approach to be applied to other areas of life, such as education, employment, and relationships.

As supported decision making becomes more widely adopted, it is important for society to ensure that individuals have the necessary support and resources to make decisions that align with their values and goals.

This may involve changes to laws and policies to better support individuals with cognitive impairments, as well as increased awareness and education about the potential benefits of supported decision making.

Overall, the future of supported decision making is promising, with the potential to empower individuals with cognitive impairments to make decisions about their lives and participate more fully in society.

Supported Decision Making Agreement

Please consult with legal professionals and authorities in your jurisdiction to ensure that this agreement complies with local laws and regulations related to supported decision-making.

This sample is provided for informational purposes only and is not a legally binding contract, nor does it serve as an alternative to one.

Frequently Asked Questions about Supported Decision Making

What is the Supported Decision-Making Act and how does it work?

The Supported Decision-Making Act is a law that allows individuals with disabilities to make their own decisions with the assistance of a supporter. The supporter can be a family member, friend, or professional.

The supporter provides information and advice to the individual with a disability, but ultimately the decision is made by the individual. This model promotes independence and autonomy for individuals with disabilities.

Which states have implemented supported decision-making?

Currently, Texas is the only state that has formally recognized supported decision-making as a legal option. However, other states are exploring the use of supported decision-making and may implement it in the future.

What are some examples of supported decision-making models?

There are several models of supported decision-making, including creating lists of pros and cons, role-playing activities to help the person understand choices, bringing a supporter into important appointments to take notes and help the person remember and discuss their options, and opening a joint bank account to manage financial decisions together.

How can individuals be supported in making their own decisions?

Individuals can be supported in making their own decisions by having access to information, resources, and support. Supporters can help individuals understand their options, provide information on the pros and cons of each option, and help the individual weigh the options and make a decision. Additionally, supporters can help individuals communicate their decisions to others and advocate for their wishes.

What resources are available for implementing supported decision-making?

There are several resources available for implementing supported decision-making, including training programs for supporters, toolkits for individuals and families, and legal resources for understanding the legal implications of supported decision-making.

What are the benefits of supported decision-making compared to other decision-making models?

Supported decision-making promotes independence and autonomy for individuals with disabilities, while also providing them with the support they need to make informed decisions. It is a more inclusive and person-centered approach to decision-making, compared to traditional models such as guardianship or power of attorney. Additionally, supported decision-making can help individuals avoid the loss of rights and freedoms that can occur with other decision-making models.