Supported Decision Making

What is Supported Decision Making?

Historically, people with intellectual and/or developmental disabilities have experienced a lack of control over making decisions about the things that affect their lives. Well intended friends, family, and supporters might believe that by making decisions for people they are protecting them from the consequences of poor choices or from being victimized. However, research shows us just the opposite; when people have the opportunity to fail and learn from mistakes, they gain the skills and confidence need for making better decisions. When people are denied opportunities to learn from their own mistakes, they tend to experience more challenges, less satisfaction with life, and a higher risk for neglect and abuse than people who have been supported and encouraged to mold their own lives. When people are empowered to make life decisions, and are assisted, when needed, to make decisions based on their own values and preference, they tend to experience healthier, happier, more independent lives.

Supported Decision making was designed as a less restrictive alternative to guardianship. It offers people the assistance they need to make their own decisions. It involves receiving assistance from one or more trusted friends, family members, professionals or advocates to help a person understand the situations they face and choices and options they have so they can make their own decisions.

The values of Supported Decision Making place a large emphasis on legal capacity as a right; that is that a person has authority under law to live the life of their choosing and make decision based in their own values and preferences. Supporters honor the person’s autonomy. Even when a person is unable to make a decision, the supporter aims to make the decision that the person would have made had they been able to do so. The goal is always to help the person make their own decision. The person should have full control over decision making, the final decision being theirs.

Supported Decision Making also provides for meaningful involvement by the person needing support. The person should be involved as much as possible throughout the process of researching and weighing options. Assistance is only given in areas that the person needs and wants support. Supporters stay out of areas that the person does not need or want assistance. Decision making agreements can be made in advance to ensure that there is a plan for making decisions and that the person’s control and autonomy is respected. Circles of support can be identified and developed, choosing the right supporters who will honor the person’s rights and presume the person’s competency as an expert on their own life.

It takes more time to support a person through making their own decisions, but it’s worth it. Research tells us that people who experience more control over their lives tend to have healthier lives. They tend to be more independent, well-adjusted, have better jobs, more friends, and better able to recognize and resist abuse. “Making decisions is central to a person’s autonomy and the essence of what is regarded as personhood¹.”² When people are supported to make their own decisions, they are essentially supported to become their own person. All people deserve this as their human right. 

¹ Personhood: the state or fact of being a person. the state or fact of being an individual or having human characteristics and feelings.
²(Supported Decision-Making for Persons with Mental Illness: A Review Soumitra Pathare, MD, Laura S. Shields, MsC, Public Health Reviews, Vol. 34, No 2)

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