Supported Decision-Making in Community Life Support for People with Severe or Profound Intellectual Disability: Focusing on Consent for Treatment

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  • 重度・最重度知的障害のある人の地域生活支援における意思決定支援の問題と今後の課題――医療同意に焦点を当てて――
  • ジュウド ・ サイジュウド チテキ ショウガイ ノ アル ヒト ノ チイキ セイカツ シエン ニ オケル イシ ケッテイ シエン ノ モンダイ ト コンゴ ノ カダイ : イリョウ ドウイ ニ ショウテン オ アテテ

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Abstract

<p>From an advocacy standpoint, this study aims to examine the issues and tasks related to supported decision-making (SDM) for people with severe or profound intellectual disability, including consent for treatment. Analyzing previous studies and building on them, this study discusses consent for treatment based on an episode taken from a field-note. First, the risks associated with SDM implementation within the “institutionalization of community” context were identified. The tasks included ensuring an equal basis with others (people with no disabilities). Moreover, the level of intimacy between the person and the supporter was found to vary in degree and quality among the supporters; therefore, it is essential to create a “circle of support.” Furthermore, since family opinions take precedence in consent for treatment, the intention of the supporter, who shares a close relationship with the individual with a disability, must be included in the SDM process. Future tasks, including consent for treatment, involve securing an equal basis with others, ensuring the continuity of SDM throughout all stages of life, and increasing responsivity among supporters through promoting the organization’s development.</p>

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