Supported Decision-Making: A Viable Alternative to Guardianship?

Ageism and Autonomy in Health Care: Explorations Through a Relational Lens

“…For a general overview of the benefits of a state appointed advocate system for people with disabilities, see [33]. 45 See, for example, [49,68]. 46 [1] The case concerned the application of Aintree University Hospitals NHS Foundation for a declaration that it would be in David James' best interests to have certain intrusive medical treatments withheld in the even of a deterioration in his clinical condition (he was, at the time of the application, in a state of low consciousness).…”

Supported Decision-Making for People with Cognitive Impairments: An Australian Perspective?

“…However it becomes much more difficult to find that balance when there is so little evidence about "what works", or for whom, or to what degree. This is true not only of international experience with different forms of supported decision-making enshrined in or specifically recognised by law [7,36], but also in understanding the efficacy or otherwise of informal schemes [22]. As the former Chief Justice of the High Court of Australia Sir Anthony Mason warned regarding the perils of embarking on policy-making or legislative reform absent a sound evidence-based approach "[a]s things currently stand, [current] proposals seem to reflect little more than ideals that have not been carefully thought through, with the risk that they will result in experimental law-making" ( [93], p. 173).…”

“…In part this caution about wholesale adoption of supported decision-making is warranted, in that international evidence of what types of assisted decision-making regime "work" is lacking [6,7,14,36], along with information about its possible differential appeal based on personal characteristics of people involved (e.g., a cultural preference for collaboration: [6], p. 124) or between disability categories (see [6], pp. 135-36, suggesting its greatest appeal is for people with intellectual disabilities).…”

Prioritising Supported Decision-Making: Running on Empty or a Basis for Glacial-To-Steady Progress?

“…Like the socio-economic right to health (generally Tobin 2012;Magnusson 2017), SD however presently remains a fairly 'empty' right, even in first world economies. While there are many law reform blueprints (e.g., VLRC 2012; ALRC 2014; Law Commission of Ontario 2017), concepts and principles remain in flux (Carney 2014), legislation is scant, 2 and-despite a proliferation of legislative and non-legislative programs and schemes Boundy and Fleischner 2013;Browning 2010;Power et al 2013 effectiveness (Kohn and Blumenthal 2014;Kohn et al 2013;Carney 2015b;Davidson et al 2015). Why is this so?…”