Assisting Someone with Decision Making

Helping someone with their Decision Making

We all need good sources of information and advice to make good decisions for ourselves. The more complex the decision the more likely we will need help and generally the more time we will need to weigh up the alternatives.

Ability to make decisions can be impeded by lack of knowledge, language and literacy barriers, anxiety about the decision to be made, the pressure placed on the person to make a decision quickly, conflicting advice and attitudes of others and/or desire to please others.

Individuals who have some form of illness or disorder which can affect decision making may still be assisted to make decisions for themselves.

What can help someone to make their own decisions?

When helping a person to make their own decision consider the following things-

  • is sufficient information being presented in a way that gives the person the best opportunity of understanding (eg do they need to experience it rather than just read about it)
  • is an interpreter required
  • is the person being given sufficient time to consider their options (eg would the person be able to make a decision with the benefit of repeated presentation of the information and discussion)
  • is the person free from influence or pressure so that they can consider what they want rather than what others want (eg do you see them away from the home environment/in that environment/ on their own/ with an independent support person)
  • can the person show what they want - even if they can’t explain it they may be able to show their likes and dislikes (eg by the way they behave in different situations)
  • is there someone with particular skills who could assist in working out the decision (e.g. a speech pathologist, psychologist, health worker, developmental worker)
  • is there someone who knows the person very well, understands them and could assist

Upholding the rights of people with disabilities to make their own decisions

The United Nations Convention on the Rights of Persons with Disabilities Article 12 Equal Recognition before the law states that people with disabilities should enjoy legal capacity on an equal basis with others in all aspects of life.  This includes personal decision making.  There is much discussion on how people with disabilities can be assisted or supported to make decisions rater than others doing this on their behalf.

The OPA has described a model of decision making based on a review of international developments.  This includes assisted decision making, supported decision making and substitute decision making.  The model is described in our 2010-11 and 2011-12 Annual Reports Read more.

South Australia also conducted a trial of supported decision making between 2010 to 2012 see report.  Similar trials are being conducted in other states.

What happens when people cannot make decisions for themselves because of a mental incapacity?

South Australian law provides for individuals to act as a substitute decision maker  for another person  in a number of ways.  These include

  • In the absence of any alternative legal arrangement - informal arrangements - close family and friends may be able to make some decisions
  • By appointment through a legal document called an Advance Directive - Enduring Power of Attorney (attorney) or a Advance Care Directive
  • By South Australian Civil and Administrative Tribunal appointment as a guardian (guardianship order) or as an administrator (administration order)
  • As a relative authorised in the Guardianship and Administration Act 1993  to provide Medical Consent
  • Through other arrangements for Emergency Treatment 
  • Through special consent to treatment arrangements for people undergoing compulsory treatment under the Mental Health Act 2009.
  • Through special consenting arrangements for prescribed treatments  (sterilisation, termination of pregnancy, electroconvulsive therapy and neurosurgery).