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
training, comprehension and implementation – all of which take time. Therefore, it will take
years to understand and assess how successful Amendment 18 to the law has been. At the same
time, it is clear that the adoption and implementation of a model endorsing the alternative of
decision-making support has not only become relevant and accessible for senior citizens – but is
also required and mandated by the new amendment to the law, opening the door to and creating
an opportunity for a real change to guardianship in Israeli society.
B. Support in decision-making: definition and relevancy for senior citizens as an
alternative to guardianship
The conceptual framework of support in decision-making as an alternative to "classic" guardianship
on the one hand and as an alternative to the institution of "substitute decision-making" on the
other, has been known for many years in the realm of guardianship, long before the Convention
on the Rights of Persons with Disabilities was drafted and adopted. Various European models
which were developed as early as in the 70's and 80's of the previous century, adopted a world-
view according to which instead of subordinating senior citizens to the "authority" of a guardian,
a legal mechanism should be created offering an array of public-social services in the framework
of which senior citizens (and persons with disabilities) are provided with a support system in the
form of a "friend" or "supporter" or a sort of assistant, who provide assistance and support in
decision-making processes without depriving the senior citizen of their liberty and legal status
(for an overview of such systems in countries such as Sweden or Germany (see: Doron, I. (2002)
Elder Guardianship Kaleidoscope: A Comparative Legal Perspective. International Journal of
Law, Policy and the Family, 16(3), 368-398).
Although these new legal settings have not conceptualized or defined the term "decision supporter"
in a unified manner, they have clarified its main underlying principles as follows: firstly – it is not a
classic guardianship in the sense that one individual is "subordinated" to the "control" of another;
secondly – the individuals are not "deprived" of their capacity, but rather, continue to have the
capacity and power to make decisions; thirdly – the individuals are not "replaced" by substitute
decision makers who make decisions on their behalf, even if the decisions purport to reflect the
position of the individuals themselves. It is a procedure which acknowledges the fact that legal
capacity is a fluid, gray term that is difficult to identify and conceptualize. It is a procedure
which acknowledges the fact that universally, almost all human beings make decisions following
consultation, assistance and support they receive – obviously, at varying levels and in diverse
manners. Finally – it is a world-view which believes that through empowerment, support, and
provision of information, accessibility and respect, almost any individual will be able to express
his will and preferences in a real and authentic manner, and that said will and preferences must be
respected. These are the principles underlying all new alternatives to guardianship which adopt
one model or another of support in decision-making (unlike guardianship and unlike "substitute
decision-making").
The call for and interest in the development and adoption of a legal mechanism of support in
decision-making as an alternative to guardianship for senior citizens has obviously been greatly
affected by the drafting, accession and adoption of the Convention on the Rights of Persons with
Disabilities. Although senior citizens are not "persons with disabilities" by definition, the vast
majority of senior citizens in whose case guardianship procedures were undertaken fall under
the category of persons with disabilities (for instance, due to their cognitive disability as a result
of dementia). Consequently, a new "trend" of endorsing the development of procedures for the