Supported Decision-Making Service

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Supported Decision-Making Service for Persons with Disabilities | Service Model
The Human Rights Center for People with Disabilitis
2. Internal reporting: The supported decision-making service should include an internal reporting
mechanism regarding risk-related dilemmas, both in order to avoid leaving the supporter with
sole responsibility, and in order to ensure that all considerations relevant to the preferable
intervention by the supporter and the support service are taken into account.
3. Withholding support: The supporter is not a care professional and therefore has different
responsibilities from care professionals. While more stringent rules apply to care professionals
as far as risk prevention is concerned, supporters – by their nature – should refrain from
adopting a paternalistic position and avoid substituting considerations of the person's wishes
with considerations involving their best interests, as viewed by the supporter. At the same time,
supporters can refuse to support a person who wishes to pursue harmful decisions or suggest
bringing another person into the discussion about the decision. In this case too, care must be
taken to avoid over-protection and an overly risk-averse approach.
4. Limiting supporters' liability: The law should expressly provide supporters bear no liability
in case of harm, provided they acted according to these guidelines.
K. Termination of supporter – participant relationships
The initial condition for supported decision-
making is the person's motivation to receive
it. Consequently, the person can decide at any
given moment to terminate the support. Over the
course of the pilot, it seemed that in some cases
the support had been exhausted. So, for instance,
one of the participants asked to continue seeing
her supporter, but for companionship rather
than support. We believe the support process,
which can have ups and downs, should not be
terminated hastily, and that a dormant support
process, that can be reactivated if the need to
make another decision in the person’s life arises,
should be provided for. Finally, in cases of long
term service with no fixed term, it is advisable
to establish points at which the desire and need
for continued support is to be examined.
L. Partners in the support process
It is very important, in the support process, to understand the person's life and to get acquainted
with the important people in their life. These individuals, who form the person's natural and
professional support net, can take part in the support process, but may sometimes act as a barrier
that has to be addressed during the process. The main partners are the person's close environment
(family members, friends and the community) and their professional environment (service
providers, social workers, counselors and other professionals). The work vis-à-vis said partners
must consist of three aspects:
Pilot participant’s parents:
As the pilot progressed we became
aware of small changes in Yair and
in ourselves. Yair started to make
more decisions without parental
intervention and we, the parents,
gradually relinquished our role as
mediators…. Today, Yair understands
perfectly well that we are there for
him but that we are willing to be in
the 'background', assuming the role
of supporters.