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Supported decision-making

What is supported decision-making?

This refers to the process in which a person is provided with as much support as they need in order to be able to:

  • Make decisions for themselves; and/or
  • Express their will and preferences within the context of substitute decision-making (for example, Lasting Power of Attorney and Advance Decisions to Refuse Treatment).


What are the benefits of supported decision-making?

Supported decision-making improves a person’s ability to participate in decisions concerning them.

It protects and maximises a person’s right to autonomy, independence, choice and control. It enables a person to plan for their future in case they cannot make decisions for themselves. This is empowering as it means that a person can ensure that what they want to happen will still happen, even when they cannot decide or communicate their views.


Planning for the future

The Mental Capacity Act 2005 covers important decision-making relating to a person’s property, financial affairs, and health and social care. It enables a person to plan for their future in a number of ways, including:


Lasting Power of Attorney

Advance Decisions to Refuse Treatment

Advance Statements


For more information on the Mental Capacity Act 2005, please go to Mental Capacity Act Directory, SCIE


Lasting Powers of Attorney (LPA) is a way of giving a person you trust the legal authority to make decisions on your behalf, if you lack mental capacity at some time in the future or no longer wish to make decisions for yourself. There are two types of LPA:

  • LPA for property and financial affairs - this gives the attorney or attorneys the power to make decisions about the person's financial and property matters, such as selling a house or managing a bank account.
  • LPA for health and welfare - this gives the attorney or attorneys the power to make decisions about the person's health and personal welfare, such as day-to-day care, medical treatment or where they should live.


Advance Decision to Refuse Treatment (ADRT) enables a person to create an advance decision to refuse treatment. This allows a person to state the types of treatment that they do not want, should they lack the mental capacity to decide this for themselves in the future. This may include refusal of life-sustaining treatment. Valid advance decisions are legally binding and must be followed by health professionals, provided the treatment and circumstances set out by the advance decision apply to the situation in question.

Before making an ADRT, it is recommended that advice is sought from a person who understands the process, such as a GP or consultant.


Advance statement- is a written statement that sets down a person’s preferences, wishes, beliefs and values regarding future care. Advance statements can either be made in writing or verbally. They are not legally binding, but must be taken into account when decisions are made on behalf of a person who cannot make the decisions for themselves. They are a good way of enabling someone to express their wishes for the future, including both what they do and don't want.


For more information go to:

NHS Bedfordshire Clinical Commissioning Group

Lasting and Enduring Powers of Attorney forms: gov.uk

Planning ahead, end of life care: NHS Choices

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