The Right to Decide and People with Cognitive Disabilities: Current Legal and Ethical Issues
Shih-ning Then1, Sam Boyle1, Julia Duffy1, Katrine Del Villar1, Michelle King2, Australian Centre for Health Law Research, QUT Brisbane2, Brisbane Queensland 1Australian Centre for Health Law Research, QUT, Brisbane, Queensland, Australia 2UQ, Brisbane, Queensland, Australia
Abstract
Most people agree with the statement that ‘everyone should have a right to make decisions affecting their own lives’. It is a core aspect of personal autonomy, which is one of the foundational values of modern society. Being able to make one’s own decisions is core to human dignity and self-expression. However, what does this really mean for people who have cognitive disabilities affecting their decision-making capabilities and how should this right to make decisions be realised?
Legal frameworks that enact substitute decision making, such as guardianship and involuntary mental health laws operate to deny this right to make decisions to people with a range of cognitive disabilities, including people with mental illness, intellectual disability, dementia or other cognitive impairments. These legal frameworks affect decisions on a range of personal and financial matters, including on medical treatment, care and accommodation.
More recently, the legal and policy landscape has sought to incorporate supported decision-making as a way of allowing decisions to occur by some people with cognitive disability. However, the boundaries between substituted decision-making and supported decision-making may not be as clear as first thought. Developments in human rights agendas over the last decade are making us re-examine concepts that underpin these laws, like ‘dignity’, ‘risk’, ‘autonomy’ and ‘least restrictive’ approaches to decision-making.
In this in-conversation panel five experts from the Rights, Social Justice and Health research group of the Australian Centre for Health Care Research will discuss current understandings and controversies around decision-making.
Biography
Bio to come