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Guardianship, “Social” Citizenship and Theorising Substitute Decision-Making Law

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Beyond Elder Law

Abstract

This chapter reviews different approaches to management of declining cognitive and decision-making powers of aged citizens to determine whether the most appropriate contemporary balance points have been found between philosophical values of autonomy and paternalism, the respective roles of state and civil society, respect for cultural values and pluralism, and tolerance of reasonable degrees of individual risk. Particular attention is devoted to the implications of preferences for supported decisionmaking rather than substitute decisionmaking, as expressed in recent international conventions. It argues that the civil citizenship goal of maximal social participation by aged citizens retains its appeal, resonating with contemporary ‘capability‘ theories of justice. However countries must remain mindful of the need to craft laws, institutions and programs in light both of domestic cultural values and evidence-based assessments of competing legal or other policy instruments.

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Notes

  1. 1.

    Article 12(2) provides that “States Parties shall recognize that persons with disabilities enjoy legal capacity on an equal basis with others in all aspects of life” [emphasis added]. Article 12(4) however stipulates that “all measures that relate to the exercise of legal capacity” shall provide for “appropriate and effective safeguards to prevent abuse in accordance with international human rights law”, before going on to expressly refer to “respect[ing] the rights will and preferences of the person”, freedom from “conflict of interest and undue influence”, and being “proportional and tailored to the person’s circumstances, apply[ing] for the shortest time possible, and …subject to regular review…”.

  2. 2.

    For the US: 2011 Alzheimer’s Disease Facts and Figures: http://www.alz.org/downloads/Facts_Figures_2011.pdf. Accessed 7 July 2011.

  3. 3.

    The Convention entered into force on January 2009: http://www.hcch.net/index_en.php?act=conventions.text&cid=71. Accessed 7 July 2011. To date 13 countries have signed (Cyprus, Czech Republic, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Netherlands, Poland, Switzerland, United Kingdom) and 6 have ratified (Estonia, Finland, France, Germany, Switzerland, UK).

  4. 4.

    See http://www.international-guardianship.com/yokohama-declaration.htm. Accessed 7 July 2011. The declaration maintains a role for reformed adult guardianship, subject to taking “all practicable steps” to “help” a person to make a decision, “without success”: Article 3(2). In a similar vein, Article 4 opens by declaring that “every adult who lacks capacity to make a particular decision at a particular time, and is without any other means of support or representation in the decision-making process, is entitled to have a competent guardian”.

  5. 5.

    For a recent overview, see Kämpf (2008).

  6. 6.

    Article 12(4) ambiguously uses both language consistent with competence-based substitute decision making (adult guardianship) and language espousing “supported-decision making” (Dhanda and Narayan 2007, 1198; Dhanda 2008). See also Minkowitz (2010). While arguably charting the rhetorical direction for reform of mental health laws (such as greater use of enduring powers of attorney or advance directives), neither silence nor ambiguous drafting displaces prior explicit language in previous international instruments (Weller 2008, 87–90). Autonomy/capacity-based legislation rather short-changes mental health patients in practice (Donnelly 2008, esp 49–51).

  7. 7.

    Section 72(1)(a) of the NSW Trustee and Guardian Act 2009 (NSW) provides that the NSW trustee when exercising estate management powers in respect of a managed person “must determine whether the action is of such a nature that the person or a relative or relatives of the person should be consulted about the action”.

  8. 8.

    Section 66(1) of the Guardianship Act 1987 (NSW) provides that: “The Tribunal shall not make a decision in respect of an application made to it until it has brought, or used its best endeavours to bring, the parties to a settlement”. Subsection (1A) provides a dispensation where “the Tribunal considers that it is not possible, or appropriate, to attempt to bring the parties to a settlement”.

  9. 9.

    Personal Directives Act (Alberta) Ch P-6 RSA 2000 (as amended in 2006 and 2008 with effect from August and September 2009); Powers of Attorney Act (Alberta) Ch P-20 RSA 2000.

  10. 10.

    For a recent argument along these lines with regard to the over protectiveness, and diminution of privacy rights associated with US “elder protection” (and reporting) laws, see Kohn (2009).

  11. 11.

    In addition to stocking the legal toolkit with the currently missing options, this model carries the potential to estimate the “demand” for each, in the same way that the Tolkein ll “stepped care” model develops optimal mental health service targets for different kinds of conditions (though with greater elasticities given the combination of medical and legal factors in play: email, John Brayley Monday, October 26, 2009).

  12. 12.

    Indeed there are similar needs for assistance in navigating the increasing complexity of financial planning and aged care services, which guardianship or administration alone may not meet (Tilse et al. 2003, 2005).

  13. 13.

    Sen (2009, 410) calls this a focus on “assessment of social realizations, that is, on what actually happens (rather than mere appraisal of institutions and arrangements)”.

References

  • Access Economics (2003). The dementia epidemic: economic impact and positive solutions for Australia. Access Economics Pty, Canberra

    Google Scholar 

  • Access Economics (2010). Caring places: planning for aged care and dementia 2010–2050. Access Economic Pty, Canberra, pp 1–117

    Google Scholar 

  • Alberta (2007) Legislative Review of the Dependent Adults Act and the Personal Directives Act: Final Report and Recommendations. Calgary, Alberta, Government of Alberta, Legislative Review (Ms Cindy Ady, chair), pp 1–55

    Google Scholar 

  • Alberta. (2009) Frequently Asked Questions: Adult Guardianship and Trusteeship Act. http://www.justice.gov.ab.ca/public_trustee/default.aspx. Accessed 15 Sept 2009

  • Andrews G, Tolkien II Team (2006) Tolkien II – a needs-based, costed stepped-care model for mental health services. World Health Organization Collaborating Centre for Classification in Mental Health, Sydney

    Google Scholar 

  • Beaupert F, Carney T, Tait D, Topp V (2008) Property management orders in the mental health context: protection or empowerment? New South Wales Law J 31(3):795–824

    Google Scholar 

  • Beyer GW (2009) The Uniform Power of Attorney Act: New Solutions to Old Problems. Estate Planning Studies (April), pp 1–8

    Google Scholar 

  • Blankman K (1997) Guardianship models in the Netherlands and Western Europe. Int J Law Psychiatry 20(1):47–57

    Article  Google Scholar 

  • Brayley J (2009) Decisions about supported accommodation: advocacy and supported decisionmaking vs substitute decision making. Rights, Responsibilities and Rhetoric: Unpacking policy and practice issues in mental health law, guardianship & trusteeship, Adelaide

    Google Scholar 

  • Burningham S (2009) Developments in Canadian adult guardianship and co-decision making law. Dalhous J Leg Stud 18:119–156

    Google Scholar 

  • Burns F (2002) Undue influence inter vivos and the elderly. Melbourne Univ Law Rev 26(3):499–536

    Google Scholar 

  • Burns F (2003) The elderly and undue influence inter vivos. Leg Stud 23(2):251–283

    Article  Google Scholar 

  • Butterwick SJ, Hommel PA, Keilitz II (2001) Evaluating mediation as a means of resolving adult guardianship cases. Center for Social Gerontology, Ann Arbor

    Google Scholar 

  • Carney T (1982) Civil and social guardianship for intellectually handicapped people. Monash Univ Law Rev 8:199–232

    Google Scholar 

  • Carney T (1989) The limits and the social legacy of guardianship. Federal Law Rev 18:231–266

    Google Scholar 

  • Carney T (1995) Judging the competence of older people: an alternative? Ageing Soc 15:515–35

    Article  Google Scholar 

  • Carney T (1999) Abuse of enduring powers of attorney: lessons from the Australian tribunal experiment? New Zeal Univ Law Rev 18:481–508

    Google Scholar 

  • Carney T (2003) Challenges to the Australian guardianship & administration model? Elder Law Rev 2:1–13 (electronic)

    Google Scholar 

  • Carney T, Keyzer P (2007) Planning for the future: arrangements for the assistance of people planning for the future of people with impaired capacity. Queensland Univ Technol Law Justice J 7(2):255–278

    Google Scholar 

  • Carney T, Singer P (1986) Ethical and legal issues in guardianship options for intellectually disadvantaged people. A.G.P.S., Canberra

    Google Scholar 

  • Carney T, Tait D (1997) The adult guardianship experiment: tribunals and popular justice. Federation Press, Sydney

    Google Scholar 

  • Creyke R (1993) Focusing on individual needs: developing the law's mechanisms for mentally disabled and elderly people. Int Soc Secur Rev 46:79–96

    Article  Google Scholar 

  • Dhanda A (2008) Constructing a new Human Rights Lexicon: convention on the rights of persons with disabilities. SUR Int J Hum Right 8, np

    Google Scholar 

  • Dhanda A, Narayan T (2007) Mental health and human rights. Lancet 370(9594):1197–1198

    Article  Google Scholar 

  • US DoH&HServices (2007) Advance directives and advance care planning: legal and policy issues. U.S. Department of Health and Human Services, Office of Disability, Aging and Long-Term Care Policy, Washington

    Google Scholar 

  • Donnelly M (2008) From autonomy to dignity: treatment for mental disorders and the focus for patient rights. Law in Context 26(2):37–61

    Google Scholar 

  • Doron I (1999) From lunacy to incapacity and beyond—guardianship of the elderly and Ontario’s experience in defining “legal incapacity”. Health Law Can 19(4):95–114

    Google Scholar 

  • Doron I (2002) Elder guardianship kaleidoscope: a comparative perspective. Int J Law Pol Fam 16(3):368–398

    Article  Google Scholar 

  • Doron I (2003) A multi-dimensional model of elder Law: an Israel example. Ageing Int 28(3):242–259

    Article  Google Scholar 

  • Doron I (2006) Elder law: current issues and future horizons. Eur J Ageing 6(1):60–66

    Article  Google Scholar 

  • Dunn M, Clare C, Holland A (2010) Living ‘A Life Like Ours’: support workers’ accounts of substitute decision-making in residential care homes for adults with intellectual disabilities. J Intellect Disabil Res 54(2):144–160

    Article  Google Scholar 

  • Fisher KR, Gleeson R, Edwards R, Purcal C, et al (2010) Effectiveness of individual funding approaches for disability support. Occasional Paper No 29. Department of Families, Housing, Community Services and Indigenous Affairs, Canberra, 29: i–viii, 1–113

    Google Scholar 

  • Goodman R, Peng I (1996) The East Asian Welfare States: peripatetic learning, adaptive change, and nation-building. In: Esping-Andersen G (ed) Welfare states in transition. Sage, London, pp 192–224

    Google Scholar 

  • Hancock L (2002) The care crunch: changing work, families and welfare in Australia. Crit Soc Pol 22(1):119–140

    Article  Google Scholar 

  • Howe A (1997) The aged care reform strategy: a decade of changing momentum and margins for reform. In: Borowski A, Encel S, Ozanne E (eds) Ageing and social policy in Australia. CUP, Sydney, pp 301–326

    Google Scholar 

  • Kämpf A (2008) The disabilities convention and its consequences for mental health laws in Australia. Law in Context 26(2):10–36

    Google Scholar 

  • Kapp M (1996) Aging and the law. In: Binstock R, George L (eds) Handbook of aging and the social sciences, Academic Press, San Diego, pp 467–479

    Google Scholar 

  • Kim S, Hahm K-H, Park HW, Kang HH et al (2010) A Korean perspective on developing a global policy for advance directives. Bioethics 24(3):113–117

    Article  Google Scholar 

  • Kohn NA (2006) Elder empowerment as a strategy for curbing the hidden abuses of durable powers of attorney. Rutgers Law Rev 59(1):1–53

    Google Scholar 

  • Kohn NA (2009) Outliving civil rights. Wash Univ Law Rev 86(5):1053–1115

    Google Scholar 

  • Lewis R (2004) Elder law in Australia. LexisNexis Butterworths, Sydney

    Google Scholar 

  • Marshall TH (1963) Sociology at the crossroads and other essays. Heinemann, London

    Google Scholar 

  • Minkowitz T (2010) Abolishing mental health laws to comply with the convention on the rights of persons with disabilities. In: McSherry B, Weller P (eds) Rethinking rights-based mental health laws. Hart Publishing, Oxford, pp 151–177

    Google Scholar 

  • Morris G (2009) ‘Let’s Do the Time Warp Again': assessing the competence of counsel in mental health conservatorship proceedings. San Diego Law Rev 46(2):283–342

    Google Scholar 

  • Moye J, Wood E, Edelstein B, Wood S et al (2007) Statutory reform is associated with improved court practice: results of a tri-state comparison. Behav Sci Law 25(3):425–436

    Article  Google Scholar 

  • Newberry AM, Pachet AK (2008) An innovative framework for psychosocial assessment in complex mental capacity evaluations. Psychol Health Med 13(4):438–449

    Article  Google Scholar 

  • NSW Legislative Council (2010) Substitute decision-making for people lacking capacity. NSW Legislative Council Standing Committee on Social Issues, Sydney

    Google Scholar 

  • Pascalev A, Vidalis T (2010) 'Vague Oviedo': autonomy, culture and the case of previously competent patients. Bioethics 24(3):145–152

    Article  Google Scholar 

  • Polivka L, Moody H (2001) A debate on the ethics of aging: does the concept of autonomy provide a sufficient framework for aging policy? J Aging Ident 6(4):223–237

    Article  Google Scholar 

  • Productivity Commission (2011) Caring For Older Australians: Draft report. http://www.pc.gov.au/projects/inquiry/aged-care/draft. Accessed 21 Jan 2011

  • QLRC (2008) Shaping Queensland's Guardianship Legislation: principles and capacity–discussion paper. Queensland Law Reform Commission, Brisbane, pp 1–169

    Google Scholar 

  • Ramesh M (2004) Review article: issues in globalisation and social welfare in Asia. Soc Pol Soc 3(3):321–327

    Article  Google Scholar 

  • Salzman L (2010) Rethinking Guardianship (Again): Substituted Decision Making as a Violation of the Integration Mandate of Title II of the Americans with Disabilities Act. Univ Colorado Law Rev 81(1):158–245. Available at SSRN: http://ssrn.com/abstract=1523387

  • Sen A (2009) The idea of justice. Allen Lane, London

    Google Scholar 

  • Sweet V (2007) Thy will be done: think your living will takes care of everything? Maybe not. Health Aff 26(3):825–830

    Article  Google Scholar 

  • Takahashi M (2004) Beyond crisis and dissonance: the restructuring of the Japanese welfare state under globalism. Soc Pol Soc 3(3):283–290

    Article  Google Scholar 

  • Thane P (2001) Changing paradigms of ageing and being older: an historical perspective. In: Weisstub D, Thomasma D, Gauthier S, Tomossy G (eds) Aging: culture, health, and social change, vol 10. Kluwer, The Hague, pp 1–14

    Google Scholar 

  • Tilse C, Wilson J, Setterlund D, Robinson G (2003) Families, asset management and care giving: developing issues in policy, research and practice. 8th Australian Institute of Family Studies Conference, Melbourne

    Google Scholar 

  • Tilse C, Setterlund D, Wilson J, Rosenman L (2005) Minding the money: a growing responsibility for informal carers. Ageing Soc 25(02):215–227

    Article  Google Scholar 

  • VLRC (2011) Guardianship consultation paper. Victorian Law Reform Commission, Melbourne, pp 1–458

    Google Scholar 

  • Weller P (2008) Supported decision-making and the achievement of non-discrimination: the promise and paradox of the disabilities convention. Law in Context 26(2):85–110

    Google Scholar 

  • Whitton L (2001) Finding the elder voice in legislation. Int J Law Psychiatry 24(2/3):149–165

    Article  Google Scholar 

  • Whitton L (2007) Durable powers as an alternative to guardianship: lessons we have learned. Stetson Law Rev 37(7):7–57

    Google Scholar 

  • Wood E (2005) History of guardianship. In: Quinn MJ (ed) Guardianship of adults: achieving justice autonomy and safety. Springer, New York, pp 17–48

    Google Scholar 

Download references

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  1. Faculty of Law, University of Sydney, Sydney, NSW, Australia

    Terry Carney

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  1. Terry Carney
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Correspondence to Terry Carney .

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  1. Dept. Gerontology, University of Haifa, Mount Carmel, Haifa, 31 905, Israel

    Israel Doron

  2. Policy and Aging, National Institute of Law,, Metcalfe 1155, Montreal, H3B 2V6, Canada

    Ann M. Soden

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Carney, T. (2012). Guardianship, “Social” Citizenship and Theorising Substitute Decision-Making Law. In: Doron, I., Soden, A. (eds) Beyond Elder Law. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-25972-2_1

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