Spotlight issue: Supported decision-making
A supported decision-making process is undertaken in collaboration with the person and their family, supporters or guardian, to provide the person with information in a way they can understand and the means of communicating their will and preferences in response.
A person with intellectual disability can meaningfully contribute to decision-making, even if a substitute decision-maker is required. Under the CRPD:
- Every person has the right and legal capacity to express their will and preference
- A person with disability has the right to make decisions
- A person with disability can expect to have access to appropriate support to make decisions.
A supported decision-making process may facilitate shared decision-making and informed consent in health care.
Important NSQHS actions
| Action 2.04 | The health service organisation ensures that its informed consent processes comply with legislation and best practice. |
|---|---|
| Action 2.06 | The health service organisation has processes for clinicians to partner with patients and/or their substitute decision-maker to plan, communicate, set goals and make decisions about their current and future care. |
| Action 2.07 | The health service organisation supports the workforce to form partnerships with patients and carers so that patients can be actively involved in their own care. |
Strategies for improvement
Strategies to support Actions 2.04, 2.06 and 2.07 include:
- Incorporating supported decision-making principles and practices into clinical practices to enable shared decision-making and informed consent
- Including supported decision-making in disability awareness training, with a focus on how it can be incorporated into shared decision-making and informed consent procedures
- Encouraging clinicians to ask if a supported decision-making process can be used, particularly where there are family members, guardians or disability advocates to support the person’s own decision-making process
- Supporting clinicians with the resources to facilitate reasonable adjustments, such as extra time and accessible information.
Resources
- NSW Council for Intellectual Disability Supported Decision Making Framework
- NSW Council for Intellectual Disability My Rights Matter Hub – Supported Decision Making
- The La Trobe Support for Decision Making Practice Framework Learning Resource
- NDIS Supported decision making policy
- Australian Law Reform Commission National Decision-Making Principles.