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



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.


  1. Access Economics (2003). The dementia epidemic: economic impact and positive solutions for Australia. Access Economics Pty, CanberraGoogle Scholar
  2. Access Economics (2010). Caring places: planning for aged care and dementia 2010–2050. Access Economic Pty, Canberra, pp 1–117Google Scholar
  3. 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 1–55Google Scholar
  4. Alberta. (2009) Frequently Asked Questions: Adult Guardianship and Trusteeship Act. Accessed 15 Sept 2009
  5. 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, SydneyGoogle Scholar
  6. 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):795–824Google Scholar
  7. Beyer GW (2009) The Uniform Power of Attorney Act: New Solutions to Old Problems. Estate Planning Studies (April), pp 1–8Google Scholar
  8. Blankman K (1997) Guardianship models in the Netherlands and Western Europe. Int J Law Psychiatry 20(1):47–57CrossRefGoogle Scholar
  9. 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, AdelaideGoogle Scholar
  10. Burningham S (2009) Developments in Canadian adult guardianship and co-decision making law. Dalhous J Leg Stud 18:119–156Google Scholar
  11. Burns F (2002) Undue influence inter vivos and the elderly. Melbourne Univ Law Rev 26(3):499–536Google Scholar
  12. Burns F (2003) The elderly and undue influence inter vivos. Leg Stud 23(2):251–283CrossRefGoogle Scholar
  13. Butterwick SJ, Hommel PA, Keilitz II (2001) Evaluating mediation as a means of resolving adult guardianship cases. Center for Social Gerontology, Ann ArborGoogle Scholar
  14. Carney T (1982) Civil and social guardianship for intellectually handicapped people. Monash Univ Law Rev 8:199–232Google Scholar
  15. Carney T (1989) The limits and the social legacy of guardianship. Federal Law Rev 18:231–266Google Scholar
  16. Carney T (1995) Judging the competence of older people: an alternative? Ageing Soc 15:515–35CrossRefGoogle Scholar
  17. Carney T (1999) Abuse of enduring powers of attorney: lessons from the Australian tribunal experiment? New Zeal Univ Law Rev 18:481–508Google Scholar
  18. Carney T (2003) Challenges to the Australian guardianship & administration model? Elder Law Rev 2:1–13 (electronic)Google Scholar
  19. 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):255–278Google Scholar
  20. Carney T, Singer P (1986) Ethical and legal issues in guardianship options for intellectually disadvantaged people. A.G.P.S., CanberraGoogle Scholar
  21. Carney T, Tait D (1997) The adult guardianship experiment: tribunals and popular justice. Federation Press, SydneyGoogle Scholar
  22. Creyke R (1993) Focusing on individual needs: developing the law's mechanisms for mentally disabled and elderly people. Int Soc Secur Rev 46:79–96CrossRefGoogle Scholar
  23. Dhanda A (2008) Constructing a new Human Rights Lexicon: convention on the rights of persons with disabilities. SUR Int J Hum Right 8, npGoogle Scholar
  24. Dhanda A, Narayan T (2007) Mental health and human rights. Lancet 370(9594):1197–1198CrossRefGoogle Scholar
  25. 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, WashingtonGoogle Scholar
  26. Donnelly M (2008) From autonomy to dignity: treatment for mental disorders and the focus for patient rights. Law in Context 26(2):37–61Google Scholar
  27. 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):95–114Google Scholar
  28. Doron I (2002) Elder guardianship kaleidoscope: a comparative perspective. Int J Law Pol Fam 16(3):368–398CrossRefGoogle Scholar
  29. Doron I (2003) A multi-dimensional model of elder Law: an Israel example. Ageing Int 28(3):242–259CrossRefGoogle Scholar
  30. Doron I (2006) Elder law: current issues and future horizons. Eur J Ageing 6(1):60–66CrossRefGoogle Scholar
  31. 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):144–160CrossRefGoogle Scholar
  32. 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, 1–113Google Scholar
  33. 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 192–224Google Scholar
  34. Hancock L (2002) The care crunch: changing work, families and welfare in Australia. Crit Soc Pol 22(1):119–140CrossRefGoogle Scholar
  35. 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 301–326Google Scholar
  36. Kämpf A (2008) The disabilities convention and its consequences for mental health laws in Australia. Law in Context 26(2):10–36Google Scholar
  37. 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 467–479Google Scholar
  38. 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):113–117CrossRefGoogle Scholar
  39. Kohn NA (2006) Elder empowerment as a strategy for curbing the hidden abuses of durable powers of attorney. Rutgers Law Rev 59(1):1–53Google Scholar
  40. Kohn NA (2009) Outliving civil rights. Wash Univ Law Rev 86(5):1053–1115Google Scholar
  41. Lewis R (2004) Elder law in Australia. LexisNexis Butterworths, SydneyGoogle Scholar
  42. Marshall TH (1963) Sociology at the crossroads and other essays. Heinemann, LondonGoogle Scholar
  43. 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 151–177Google Scholar
  44. 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):283–342Google Scholar
  45. 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):425–436CrossRefGoogle Scholar
  46. Newberry AM, Pachet AK (2008) An innovative framework for psychosocial assessment in complex mental capacity evaluations. Psychol Health Med 13(4):438–449CrossRefGoogle Scholar
  47. NSW Legislative Council (2010) Substitute decision-making for people lacking capacity. NSW Legislative Council Standing Committee on Social Issues, SydneyGoogle Scholar
  48. Pascalev A, Vidalis T (2010) 'Vague Oviedo': autonomy, culture and the case of previously competent patients. Bioethics 24(3):145–152CrossRefGoogle Scholar
  49. 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):223–237CrossRefGoogle Scholar
  50. Productivity Commission (2011) Caring For Older Australians: Draft report. Accessed 21 Jan 2011
  51. QLRC (2008) Shaping Queensland's Guardianship Legislation: principles and capacity–discussion paper. Queensland Law Reform Commission, Brisbane, pp 1–169Google Scholar
  52. Ramesh M (2004) Review article: issues in globalisation and social welfare in Asia. Soc Pol Soc 3(3):321–327CrossRefGoogle Scholar
  53. 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:
  54. Sen A (2009) The idea of justice. Allen Lane, LondonGoogle Scholar
  55. Sweet V (2007) Thy will be done: think your living will takes care of everything? Maybe not. Health Aff 26(3):825–830CrossRefGoogle Scholar
  56. Takahashi M (2004) Beyond crisis and dissonance: the restructuring of the Japanese welfare state under globalism. Soc Pol Soc 3(3):283–290CrossRefGoogle Scholar
  57. 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 1–14Google Scholar
  58. 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, MelbourneGoogle Scholar
  59. Tilse C, Setterlund D, Wilson J, Rosenman L (2005) Minding the money: a growing responsibility for informal carers. Ageing Soc 25(02):215–227CrossRefGoogle Scholar
  60. VLRC (2011) Guardianship consultation paper. Victorian Law Reform Commission, Melbourne, pp 1–458Google Scholar
  61. 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):85–110Google Scholar
  62. Whitton L (2001) Finding the elder voice in legislation. Int J Law Psychiatry 24(2/3):149–165CrossRefGoogle Scholar
  63. Whitton L (2007) Durable powers as an alternative to guardianship: lessons we have learned. Stetson Law Rev 37(7):7–57Google Scholar
  64. Wood E (2005) History of guardianship. In: Quinn MJ (ed) Guardianship of adults: achieving justice autonomy and safety. Springer, New York, pp 17–48Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Faculty of LawUniversity of SydneySydneyAustralia

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