Supported Decision-Making: Non-Domination Rather than Mental Prosthesis

Recently, bioethicists and the UNCRPD have advocated for supported medical decision-making on behalf of patients with intellectual disabilities. But what does really entail? One compelling framework is Anita Silvers Leslie Francis’ mental prosthesis account, which envisions as a process in trustees act mere appendages patient’s will; trustee provides cognitive tools patient requires to realize her conception own good. We argue that would be better understood collaborative process, giving disabilities opportunity make decisions respectful relationship trusted others. offer an alternative account where primary constraint protect from domination by trustee. This advantageous its preservation prospects genuine collaboration, approach ultimately reinforces problematic ideal isolated self-determination.