How Supported Decision Making Respects the Rights of People with Disabilities

Scenario 1: 

Imagine two friends, Sam and Lina. Sam sometimes finds it hard to handle stress, make sense of emotions, or understand complicated information. Sam lives with a psychosocial disability. Lina finds it difficult to understand abstract ideas or remember certain things. Lina lives with an intellectual disability.

Both Sam and Lina are smart in their own ways. They know what they like and don’t like. But sometimes, when it comes to making big life decisions  like choosing a place to live, picking a job, or going to the doctor, they might need support.

There are two very different ways people like Sam and Lina can get help making decisions. Supported Decision Making and Substituted Decision Making. 

Supported Decision Making: Helping without making decisions for..

Supported decision making is like this: Sam wants to move to a new apartment but feels overwhelmed by all the paperwork and choices. Sam asks Alex to help. Alex

reads through the apartment ads together with Sam, explains the contract in simple words, talks through the advantages and disadvantages, helps Sam stay calm and focused. In the end, Sam makes the final choice.

Lina wants to decide what kind of job to try. She asks a support worker to explain the different job types. The worker uses pictures, videos, and simple language. They practice interview questions together. In the end, Lina chooses the job that feels right.

That’s supported decision making, the person stays in charge. They just get the help they need to understand and decide. It’s like having a flashlight in the dark, it lights the way, but you’re still walking your own path.

Substituted Decision Making: Making decisions for…

Scenario 2:

Instead of helping Sam explore options, another friend, Chris, just says, “This is too much for you. I’ll choose for you.” Chris signs the lease and moves Sam into a place without really asking what Sam wants.

Or Lina’s parents say, “You’ll just get confused. We’ll pick a job for you.”Even though Lina had a dream of working in a flower shop, she’s sent to do something she doesn’t enjoy.

This is substituted decision making, when someone else makes the decision for you, even if you could have made the choice with the right help. It’s the same as someone telling you, “You’re not the driver of your own life, sit in the backseat.”

Why Supported Decision Making is important

People with psychosocial and intellectual disabilities have the same rights as everyone else; the right to choose where they live, who they see, what job they want and so forth. 

But for a long time, systems and even families have taken over these decisions often trying to “protect” the person. The problem is that it removes the person’s voice. Would you like someone else picking your clothes, your home, your friends, or your doctor? Probably not.

Real-Life Examples: How Support Looks Different from Substitution

Shopping

Substituted: “These are better for you. Take them.”

Supported: “Here’s your budget. Can I help you  compare the prices?”

Doctor Visits

Substituted: “We’ll choose the treatment for you.”

Supported: “Let’s talk to the doctor together. I’ll help explain the options.”

Work

Substituted: “You can’t work. It’s too stressful and confusing for you.”

Supported: “Let’s find a job you’ll enjoy. We can prepare together.”

What the Law Says

The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) says every person, no matter their disability, has the right to make their own decisions, and get support if they need it. Supporting a decision is a human right. This is also backed up by the Persons with Disabilities Act, 2025. 

People with psychosocial or intellectual disabilities don’t need someone else to take over, they need someone to walk with them. Sometimes, that support means; explaining things in easy words, using pictures or videos, being patient, giving emotional support and helping build confidence.

When we give support instead of taking control, we show respect, love, and belief in someone’s potential.

Article by: Maryanne Emomeri