Supported decision-making and personal autonomy for persons with intellectual disabilities: article 12 of the UN convention on the rights of persons with disabilities

J Law Med Ethics. 2013 Winter;41(4):792-806, Table of Contents. doi: 10.1111/jlme.12090.


Making decisions is an important component of everyday living, and issues surrounding autonomy and self-determination are crucial for persons with intellectual disabilities. Article 12 (Equal Recognition before the Law) of the UN Convention on the Rights of Persons with Disabilities addresses this issue of decision-making for persons with disabilities: the recognition of legal capacity. Legal capacity means recognizing the right to make decisions for oneself. Article 12 is also moving in the direction of supported decision-making, as an alternative to substituted decision-making. The objective of this paper is to show conceptually the connection between supported decisionmaking and the preservation of personal autonomy for persons with intellectual disabilities. This paper discusses supported decision-making based on Bach and Kerzner's model: (a) legally independent status, (b) supported decision- making status, and (c) facilitated decision-making status. Arguments will be made based on John Stuart Mill's concept of autonomy and arguments against it using Sarah Conly's argument for paternalism.

MeSH terms

  • Decision Making*
  • Disabled Persons / legislation & jurisprudence*
  • Humans
  • Intellectual Disability*
  • Mental Competency / legislation & jurisprudence*
  • Personal Autonomy*
  • United Nations