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Assisted Decision Making

category national | health / disability issues | opinion/analysis author Monday December 02, 2013 22:07author by Sean Crudden - impero Report this post to the editors

Guidance for Mental Patients

The United Nations' convention on the rights of persons with a disability does not confer any particular right on anyone. As a mental patient I have no more rights with it as I might have without it. However the UNCRPD has a political effect. The Irish Government must repeal the Lunatics Act of the 19th century to make Irish Law consonant with the UNCRPD. That old act is long and detailed and makes elaborate provision to prevent the exploitation of lunatics i.e. mental patients. But, it seems, a new law is required introducing assisted decision making by patients rather than providing an authority to make decisions on our behalf.

“Thus conscience does make cowards of us all
And the native hue of resolution is sicklied o’er
With the pale cast of thought.”

When it comes to decisions I suppose the best thing is to think about it but not to think too much. Many crucial decisions are made in a split second, in the blink of an eye. The thinking done beforehand, perhaps, or the principal brave enough to depend on instinct.

I attended a colloquium in Queen’s University during the last snow. Innocently I explained my question. “I do not like making decisions. Is there any way I could get someone else to relieve me of the burden and make decisions for me?” I should mention that the title of the colloquium was, “Emotion and Law.” Quick as a flash a retired professor jumped in with an answer to my question. “Yes, there is a way. It’s called marriage.”

None of us nor any child is born with a steering wheel attached for some kind of driver to steer us in some direction to suit himself and without regard for our wishes. Most people do not like being told what to do.

However there is obviously a dearth of talent where decision making is involved and uncertainty. We have only to remember the Oracle at Delphi or the modern fascination with horoscopes and fortune tellers.

It seems to me that the mentally ill and the intellectually disabled communities will have to be prepared to cope with a litany of wrong decisions if this projected law involving “assisted” decision making ever finds its way onto the statute books.

The angst and heavy responsibility seen by existentialists to be involved in decision making is often belied in real life. Decisions get made and often we do not know how the decisions came to be. Most people do not dwell on the quality of decisions made but get on with life and work their way around them.

When I was going to school there was a very strong emphasis on obedience. Respect for authority. Personal responsibility was not seen as a mitigating factor. This despite the then fairly recent judgements in the Nuremberg trials.

The common market introduced a yearning for consensus and collaboration. Personally I think this was a pious hope and it is more honoured in the breach than in the observance.

The nearest practical example of assisted decision making as public policy came with the appointment in the 1970’s of school guidance officers. The general idea at a political level was to steer pupils in the right direction. Nowadays I think the principal work of school guidance officers is to help pupils fill out the CAO form. If there has been a more fertile result I have yet to hear about it.

“There is a divinity that shapes our ends,
Rough-hew them how we will.”

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