The concept of supporting people to make their own decisions is not new. We all need assistance at times to make decisions, whether those decisions are about our health, where we live, or what we buy.
But there is now much greater focus on the need to do more to support people, particularly people with cognitive disability, to make their own decisions. There is also an ever-stronger call for substitute decision making to be used only in situations of absolute necessity.
Substitute decision making occurs when someone makes a decision for another person. This can happen informally, when a person simply makes decisions for another person without being appointed to that role. Or it can happen through a formal legal process, when, for instance:
- a person is appointed to make decisions for another person under an adult guardianship or administration order; or
- a compulsory mental health treatment order is made; or
- an enduring power of attorney is activated; or
- a statutory health attorney makes a medical treatment decision for a patient.
While there have always been people with cognitive disability who have been supported by family members or friends to make their own decisions, over the last fifteen years Australia has implemented a range of legal, policy and practice developments and initiatives to see this happen more often.
It is fair to say that the right to be supported to make your own decisions has become one of the most important human rights of people with cognitive disability.
But how can supported decision making be implemented effectively to achieve greater autonomy for people with cognitive disability?
The Public Advocate has undertaken two projects which demonstrate how supported decision-making principles can be put into practice:
- Expanding Horizons, Examples of Supported Decision Making in Queensland, a publication which showcases the supported decision-making practices of a number of Queensland agencies ; and
- A Supported Decision Making Demonstration Project , conducted by Multicap, in partnership with the Public Advocate and the Office of the Public Guardian, which engaged five guardianship clients in the process and practice of supported decision making.