Supporting decision making in reproductive and sexual health for people with disability

A tool to assist clinicians in supporting the decision making of clients with intellectual disability

Who should use the tool?

Clinicians providing reproductive and sexual health consultations to people with intellectual disability.

When should the tool be used?

When a person with intellectual disability requires support to make a decision about their reproductive and sexual health.

Why is the tool needed?

To ensure people with intellectual disability receive approproate support to make their own decisions.

How is the tool used?

The tool provides clinicians with easy-to-use guidelines for supporting the clience around six common reproductive and sexual health decisions.

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Download the tool here.

Everyone has the right to make their own decisions about their reproductive and sexual health. However, people with intellectual disability are often incorrectly assumed to lack capacity to make their own decisions and other people, including clinicians, unnecessarily make decisions for them.

About supporting decision making

Since the United Nations Convention on the Rights of Persons with Disabilities was adopted in 2006, there has been a growing shift towards seeing people with disability as people with rights.

Supporting decision making is a way to uphold a person's rights. It is a process of assisting a person (notably those with complex cognitive and/or communication support needs) to understand, consider and communicate their choices. This choice ultimately remains the decision of the person with disability.

The role of the clinician

Clinicians have a responsibility to assist clients to make decisions, not to make decisions for them. This requires the clinician to discuss the decision making factors with the client including weighing up the benefits and risks and considering other factors that may influence a decision. Health information required to make a decision needs to be provided in accessible formats including easy-to-read resources. Above all, the clinician needs to acknowledge that the client is in control. Sometimes the clinician may not agree with the decision that is made but they need to respect the person's ability to make that decision whenever possible.

About this tool

Family Planning NSW has developed a tool for clinicians to provide guidelines for supporting people with intellectual disability to make their own decisions relating to hteir reproductive and sexual health. There may be many issues to consider and it is not always easy for the clinican to think about the important decision making factors during the consultation. The tool can guide clinicians when supporting a client to make their own decision in a specific situation.

Essential to supporting decision making is establishing good communication with the client. The tool includes tips for providing effective communication and includes links to easy-to-understand resources suitable for using with people with intellectual disability. The tool also provides scenarios around six reproductive and sexual health decisions in the clinical setting, including:

  1. Whether to have sexual intercourse
  2. Whether to have STI testing today
  3. What type of contraception to use
  4. Whether to become a mother
  5. What to do about an unintended pregnancy

For more information about the tool or to provide feedback, contact

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