Submission
No 30
SUPPORTED DECISION-MAKING IN NSW
Organisation: Multicultural Disability Advocacy Australia
Date Received: 13 March 2026
MDAA SUBMISSION TO THE INQUIRY INTO SUPPORTED DECISION-MAKING
MARCH 2026
ACKNOWLEDGEMENT OF COUNTRY
We respectfully acknowledge the traditional custodians of the land on which we live, work, and meet. We pay our respects to Elders past, present, and emerging.
We recognise their enduring connection to their land, waters, and skies and honour their rich cultural heritage and knowledge systems.
We commit to listening, learning, and standing in solidarity with Aboriginal and Torres Strait Islander peoples, walking alongside them in the ongoing journey towards justice and reconciliation.
Contact for this submission:
William Robin
redacted
Alicia Rodriguez
redacted
Multicultural Disability Advocacy Australia (MDAA) welcomes the opportunity to contribute to the Committee on Ageing and Disability’s inquiry into supported decision-making for adults with disability and older people in New South Wales. This submission draws on MDAA’s advocacy experience supporting people with disability from multicultural backgrounds to understand their rights and make decisions about services, supports and systems affecting their lives.
MDAA works directly with people navigating complex systems such as disability services, health services, housing and government programs. In many situations the issue is not whether a person wants to make their own decisions. The challenge lies in whether the surrounding systems allow meaningful participation in those decisions. Much of MDAA’s work involves helping people understand options, communicate preferences and engage with services which may otherwise feel difficult to navigate.
The inquiry examines the lived experience of people seeking support to make decisions for themselves and barriers to implementing supported decision-making across legal, financial, health, education, employment and care systems in New South Wales. It also considers the distinct experiences of Aboriginal people and people from multicultural backgrounds, the role and functions of the Ageing and Disability Commission in relation to supported decision-making, and possible changes to those functions. The inquiry further examines measures to ensure substitute decision-making remains an alternative approach used only in appropriate and limited circumstances.
Supported decision-making reflects how decisions occur in everyday life. Most people rely on others when making important choices. Family members, friends or professionals may help a person understand information, discuss options or consider consequences before a decision is made. In most circumstances this type of assistance is considered normal and helpful. When a person with disability receives similar support it can sometimes be interpreted as evidence of incapacity.
Historically many legal and service systems responded by relying on substitute decision-making arrangements such as guardianship or financial management. These frameworks transfer decision-making authority to another person once a person is assessed as lacking capacity. While intended as protection, they can remove control over major areas of life including housing, healthcare, finances and services.
Over the past decade sustained reform activity across Australia has examined how decision-making frameworks should evolve. Much of this work traces back to the Australian Law Reform Commission report Equality, Capacity and Disability in Commonwealth Laws (Report No. 124, 2014). This report examined how Commonwealth laws interact with decision-making capacity and recommended a shift toward supported decision-making models. It emphasised legal frameworks should recognise and support a person’s ability to exercise legal capacity wherever possible.
This reform direction aligns with international human rights developments, particularly the Convention on the Rights of Persons with Disabilities, adopted by the United Nations General Assembly in 2006. Article 12 of the Convention recognises the right of persons with disability to enjoy legal capacity on an equal basis with others and requires states to ensure access to the support people may need to exercise that capacity.
Following the 2014 ALRC report several major reviews continued examining decision-making frameworks. In 2017 the Australian Law Reform Commission released Elder Abuse: A National Legal Response (Report No. 131). This inquiry examined guardianship, powers of attorney and financial decision-making arrangements and reinforced the importance of supporting people to exercise legal capacity while ensuring substitute decision-making powers are carefully limited and monitored.
In New South Wales the NSW Law Reform Commission undertook a major review of the guardianship system in Review of the Guardianship Act 1987 (NSW) (Report No. 145, 2018). The Commission examined whether the existing guardianship framework reflected contemporary disability rights principles and considered reforms designed to support people to make their own decisions.
More recently the Royal Commission into Violence, Abuse, Neglect and Exploitation of People with Disability examined decision-making arrangements extensively. Its Final Report, particularly Volume 6: Enabling Autonomy and Access (2023), identified continuing concern that many systems still default to substitute decision-making rather than exploring ways to support individuals to exercise their own decision-making rights.
Taken together these reviews show a clear policy direction. Governments and law reform bodies recognise the need to move away from substitute decision-making toward systems which support individuals to exercise legal capacity. Implementation however remains uneven and many systems still operate largely through substitute decision-making approaches.
In practice professionals and institutions often begin by asking whether a person can make a decision independently. Less attention is given to identifying support which could enable participation in the decision. Professional judgement can strongly influence outcomes. Medical practitioners and other professionals who control access to services hold significant authority within decision environments. Individuals may feel pressure to accept advice from professionals perceived as gatekeepers to services.
These dynamics can become more complex for people with disability from multicultural backgrounds. Trust in government institutions and service systems is not always strong within many communities. Migration experiences, unfamiliarity with Australian legal systems and previous experiences of discrimination shape how individuals engage with institutions and authority figures.
Language barriers also play a role. Many people rely on others to interpret information or communicate with services. Without accessible and culturally safe communication individuals may struggle to fully understand options or express preferences.
Cultural expectations also shape how decisions are approached. In some communities questioning professionals such as doctors, lawyers or government officials may be seen as inappropriate. Individuals may defer to advice even where it does not reflect their own wishes.
Family dynamics also influence decisions. In collectivist cultures decision-making often connects to family responsibilities and shared interests. MDAA advocates regularly encounter individuals who feel obligated to prioritise decisions benefiting the household or wider family.
Collective approaches to decision-making represent legitimate cultural practices. Supported decision-making must still ensure the will and preferences of the individual remain central. Advocates often work with families to ensure the person with disability has space and support to express their own wishes.
Another principle underpinning supported decision-making is dignity of risk. Like anyone else people with disability should have the opportunity to make decisions involving uncertainty or risk. Experiences of trial, error and learning form part of independence and personal development. Systems which prioritise protection above all else can unintentionally restrict autonomy and limit opportunities to develop decision-making confidence.
MDAA regularly supports people with disability to make practical decisions about services. One example involves assisting a person to choose a service provider.
The process begins with a conversation about what matters most to the person. This may include language preferences, cultural understanding, gender of support workers, service location, interpreter availability or cost considerations. Based on these priorities the advocate works with the individual to develop questions for potential providers.
Depending on the person’s preference the advocate may support direct contact with providers or gather information on the person’s behalf. Each provider receives the same questions so responses can be compared. Responses are then presented to the individual in a clear format. The advocate does not make the decision. The advocate ensures the person understands the information and can compare options based on their own priorities. The individual remains the decision-maker throughout the process.
For some people this process builds confidence. Many individuals MDAA supports have not previously been encouraged to make decisions about their own supports. Identifying priorities, gathering information and comparing options can gradually build decision-making skills.
Role of the Ageing and Disability Commission
The Ageing and Disability Commissioner Act 2019 (NSW) establishes the Ageing and Disability Commission as a body responsible for protecting and promoting the rights of adults with disability and older adults. The Act states one object is to protect and promote the rights of adults with disability and older adults and to protect them from abuse, neglect and exploitation. It also recognises dignity, choice and control and respect for cultural and linguistic diversity.
The Commission plays an important safeguarding role. Its functions include raising awareness of abuse, providing advice and referrals and examining systemic issues affecting adults with disability and older people.
However the legislation does not establish a comprehensive supported decision-making framework. The Commission’s role focuses primarily on protection and systemic oversight rather than enabling supported decision-making across service systems.
The NSW Law Reform Commission in Review of the Guardianship Act 1987 (NSW) (Report No. 145, 2018) recommended the creation of a Public Advocate as part of a broader assisted decision-making framework. The proposed role included systemic advocacy promoting the rights of people who require decision-making support, advice and assistance to help individuals access supported decision-making arrangements, training and guidance for professionals and the community, investigative powers where abuse or misuse of decision-making authority may occur, and the ability to intervene in tribunal or court proceedings involving decision-making rights.
These proposed functions recognise supported decision-making requires both oversight and practical support.
Independent advocacy organisations already perform many of these functions in practice. Advocates regularly assist individuals to understand information, exercise decision-making rights, identify systemic barriers and support people through legal or tribunal processes.
Advocates also provide education to service providers and communities about decision-making rights and dignity of risk. In some situations advocates identify cases where misuse of decision-making authority may be occurring and assist individuals to seek remedies.
One of our strengths and a key focus of our work is promoting and strengthening culturally safe practice wherever we can. For people from multicultural backgrounds we often try to provide culturally safe support where systems may otherwise fall short. Language skills and cultural knowledge can assist in this work, but culturally safe practice does not depend on knowing every culture. It requires reflection, awareness of power imbalances and avoiding assumptions about a person’s beliefs, family roles or decision-making practices. With proper training and understanding of cultural safety principles we try to take time with decision-making conversations and ensure the right steps are taken to support decisions in a culturally safe way. This approach helps individuals express their own will and preferences rather than having decisions shaped by assumptions made by services.
Our Recommendations
Recommendation 1
Supported decision-making frameworks should recognise independent advocacy as a core mechanism enabling people with disability to exercise legal capacity.
Recommendation 2
Supported decision-making systems should take a culturally safe approach, allowing time and ensuring the proper steps are taken to support decision-making in line with these principles.
Recommendation 3
Policy and practice frameworks should explicitly recognise that seeking assistance with a decision does not mean a person lacks the ability to make that decision. Supported decision-making systems must uphold dignity of risk and ensure the will and preferences of the individual remain central to all decisions. Assistance with understanding information, considering options or communicating choices should be recognised as a normal part of decision-making rather than evidence of incapacity.