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Diversity, dignity, equity and best practice: a framework for supported decision-making

  • Research program
Publication date

Diversity, dignity, equity and best practice: a framework for supported decision-making – Research Report


The Disability Royal Commission has published a report about supported decision-making for people with cognitive disability. Cognitive disability refers to intellectual disability, acquired brain injury, mental health conditions or dementia.

The researchers who wrote the report reviewed lots of documents about supported decision-making. They also talked to 77 people including:

  • people with cognitive disability

  • advocates

  • family members

  • service providers.

Supported decision-making means that a person with cognitive disability is supported to make their own decision by a ‘supporter’.

A supporter could be a family member, friend or volunteer; or someone who is paid to provide support as part of their job.

The supporter helps the person:

  • understand the choices

  • think about what they want

  • think about what may happen as a result of the decision

The person with cognitive disability remains in control of the decision.

A framework for supported decision-making

The report talks about a framework for supported decision-making. The framework is a guide to making sure supported decision-making is available to all people with cognitive disability wherever they are and whatever the decision is.

The report says there are nine principles of this framework. Some of these are:

  • All adults have the right to make decisions about their lives

  • Everyone should get the support they need to make decisions.  

  • When it is hard for a person to say what they want, supporters must try to understand what they want.  

  • Taking risks by trying new things is important. But, when what a person wants might harm them, the supporter should help the person understand the risk and how it could be managed. If the person cannot understand the risk even with support, an authorised person can make a decision for them but only in very limited circumstances.

The report says eight elements are needed to make supported decision-making happen. Some of these are:

Diversity – People need different types of support to make decisions. The type of support depends on many different things. These include the person’s ability, the decision they are making and what is happening in the person’s life at that time.

Part of existing systems Supported decision-making needs to be part of all services that people use every day. This means there must be many changes to make sure supported decision-making is always given to people who need it. Laws and policies will need to be changed. Service systems such as health care, disability services, voting, and aged care should make plans so that supported decision-making is part of what they do.  

Making sure supporters do the right thing Supporters are very important to supported decision-making. There must be ways of making sure they provide good support. They can learn more by doing training. There must also be ways that people can complain about supporters and the way they provide support.

Co-design People with cognitive disability and supporters should be part of setting up supported decision-making.

More information

To read the full research report, visit our website. Go to the ‘Publications’ section and click on ‘Research program’.