A model of substitute decision-making

Abstract

Substitute decisions are those made on behalf of people who are not able to make decisions for themselves. From an ethical point of view it is important that substitute decision-making involving another person's health and well-being be approached methodically. The decision-making model outlined in this article was developed during a study which investigated substitute menstrual management decision-making for young women who had intellectual disabilities and high support needs. The decision-making literature provided relevant theoretical bases for structuring the components of the model. On the basis of the model, a definition of informed substitute decision-making is proposed. Although the model and definition were developed in relation to a specific area of substitute decision-making, they appear to be applicable to a range of decisions involving a person's health and well-being that are undertaken by substitute decision-makers.