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关怀与选择架构:亲属在支持性决策过程中对成年智障者的支持

Care and choice architecture: Relatives' support for adults with intellectual disabilities in supported decision-making processes.

作者信息

Demic Sadeta, van den Breemer Rosemarie, Hanisch Halvor, Lid Inger Marie

机构信息

VID Specialized University, Norway.

Inland School of Business and Social Sciences, Norway.

出版信息

J Intellect Disabil. 2025 Sep;29(3):651-666. doi: 10.1177/17446295241297184. Epub 2024 Oct 30.

Abstract

The UN Convention on the Rights of Persons with Disabilities (CRPD) describes supported decision making as a fundamental human right. This study explores relatives' experiences, dilemmas, as well as key factors in supported decision-making processes with adults with intellectual disabilities living in municipal housing. The study draws on qualitative, in-depth interviews with relatives. Findings suggest that we can learn about supported decision making by using choice architecture and care theories, demonstrating that: (a) supported decision-making sometimes requires careful facilitation with a focus on the person's preferences/perspective; this careful facilitation can be understood in terms of choice architecture, (b) choice architecture in the context of intellectual disability requires an intentionality of care and a focus on the person's preferences/perspective, (c) relatives are concerned, not only with support in the moment, but also the effect of the decision in the long term, and (d) relatives' care is a significant factor in meeting choice architecture in systemic conditions.

摘要

联合国《残疾人权利公约》(CRPD)将辅助性决策描述为一项基本人权。本研究探讨了亲属的经历、困境,以及与居住在市政住房中的成年智障人士进行辅助性决策过程中的关键因素。该研究基于对亲属的定性深入访谈。研究结果表明,我们可以通过运用选择架构和照护理论来了解辅助性决策,这表明:(a)辅助性决策有时需要精心引导,重点关注个人的偏好/观点;这种精心引导可以从选择架构的角度来理解,(b)智障背景下的选择架构需要照护的意向性,并关注个人的偏好/观点,(c)亲属不仅关心当下的支持,还关心决策的长期影响,(d)亲属的照护是在系统条件下满足选择架构的一个重要因素。

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