A critical assessment of supported decision-making for persons aging with intellectual disabilities

Disabil Health J. 2014 Jan;7(1 Suppl):S40-3. doi: 10.1016/j.dhjo.2013.03.005. Epub 2013 Jun 14.


Supported decision-making is increasingly being promoted as an alternative to guardianship for persons aging with intellectual disabilities. Proponents argue that supported decision-making, unlike guardianship, empowers persons with disabilities by providing them with help in making their own decisions, rather than simply providing someone else to make decisions for them. To evaluate the empirical support for these claims, we reviewed the evidence base on supported decision-making. Our review found little such empirical research, suggesting that significant further research is warranted to determine whether--and under what conditions--supported decision-making can benefit persons with intellectual disabilities. Indeed, without more empirical evidence as to how supported decision-making functions in practice, it is too early to rule out the possibility it may actually disempower individuals with disabilities by facilitating undue influence by their alleged supporters. We therefore suggest several key areas for future research.

Keywords: Aging; Guardianship; Intellectual disability; Law; Supported decision-making.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Aging*
  • Decision Making*
  • Disabled Persons*
  • Human Rights*
  • Humans
  • Intellectual Disability*
  • Patient Participation*
  • Personal Autonomy*