Last updated 27 July 2022

Most people can be assisted or supported to make their own decisions. Substituted decision making is a last resort option.

Supported decision making is helping someone to make their own decisions so that they have control over the things that are important to them, thus safeguarding their autonomy, independence and dignity. Support needs are different for everyone and every decision. There are steps in the decision-making process and different people will need different amounts of support for each step and may need more supports if the steps are complex or the environmental issues make it difficult to communicate their needs.

Principles for dealing with people with impaired decision-making capacity

The Guardianship Act sets out a number of general principles that must be applied by any person or entity acting on behalf of someone with impaired decision-making capacity (s 11B Guardianship Act):

  • An adult is presumed to have capacity to make their own decisions unless incapacity for that particular decision is established.
  • Each individual has the same basic rights including the protection of individual liberty and access to services.
  • Each person should be valued as an individual, and their human worth and dignity should be respected.
  • An adult has a right to be valued as a member of society.
  • A decision maker must acknowledge the importance of encouraging the adult to take part in general community activities and to be as autonomous and self-reliant as possible.
  • A decision maker must apply the least restrictive option that is consistent with the adult’s proper care and protection.
  • The adult has the right to participate, to the greatest practicable extent, in the decisions affecting their own life.
  • If it is possible to determine the adult’s views or wishes from their previous actions, then the decision maker must take these into account in any decision.
  • A decision maker must recognise the importance of maintaining the adult’s existing supportive relationships.
  • A decision maker must recognise the importance of maintaining the adult’s cultural and linguistic environment, including religious beliefs and lifestyle choices.
  • Assistance given to an adult must meet their current needs and be adapted to their individual characteristics.
  • A decision maker must recognise the adult’s right to confidentiality in relation to personal information.

Any person or entity making a decision about the adult’s health care must also exercise their authority in accordance with the health care principles (s 11C Guardianship Act), which include:

  • electing the option that is least restrictive of the adult’s rights, is necessary and appropriate and is in the adult’s best interests, while taking into account the adult’s views
  • maintaining or promoting the adult’s wellbeing, which must take into account the information given by the adult’s health provider.