Background
In 2016, the Knesset passed an amendment to the Capacity and Guardianship Law, 5722-1962, which recognizes supported decision making (SDM) as an alternative to guardianship. Following the Amendment, the Administrator General in the Ministry of Justice appointed an SDM officer, as part of the National Department for Supervision of Guardians and Alternatives for Guardianship.
According to the law, provisions with regard to the roles and authorities of decision-making supporters are to be provided by the government and approved by the Knesset. At the time of this report (December 2021) these regulations have not yet been completed. In the meantime the Administrator General published an interim procedure regulating the process of appointing decision-making supporters and their roles[1].
The research presented here was conducted in 2020-21 on behalf of the National Department for Supervision of Guardians and Alternatives to Guardianship at the Administrator General at the Ministry of Justice and by the JDC-Israel Unlimited. It was preceded by an international review of supported decision-making arrangements in select countries and several pilot programs worldwide.[2]
Objectives
Assist the Administrator General at the Ministry of Justice in improving SDM procedures and practices in Israel. The study has four secondary objectives:
- Examine the implementation of the interim provisions by the Administrator General regulating the appointment of a decision-making supporter and provide recommendations for its final regulations.
- Examine the actual practice of SDM arrangements.
- Define best practice in SDM.
- Suggest appropriate mechanisms of safeguards and supervision of SDM arrangements.
Method
- Seventeen semi-structured interviews with professionals who are involved in SDM in Israel: officials from the Ministry of Justice, Ministry of Welfare and Social Affairs, welfare officers, social workers and representatives of NGOs.
- Fifteen SDM case studies. Case studies consisted of an interview with the decision maker, the supporter, and a third person familiar with both of them and with the actual SDM practice (such as a social worker, an attorney or a family member). In nine cases, all three were interviewed; in two cases, the decision maker and supporter were interviewed; and in four cases only the supporter was interviewed. A total of 35 semi-structured individual interviews were held as part of the case studies.
Outline of this Report
The report is divided into four sections. The first deals with systemic aspects of supported decision making: the appointment process and recommendations for its improvement; documenting and monitoring the appointments and the role of the Department for Supervision of Guardians and Alternatives for Guardianship. The second section addresses best practice in SDM. The third section deals with mechanisms and practices of safeguards and supervision of SDM arrangements. The fourth section addresses fundamental and ethical questions related to the application and practices of SDM. Finally, the appendix presents selected case studies.
Summary and Recommendations
SDM is a relatively new legal arrangement in Israel and throughout the world. It is still evolving and is still implemented on a limited basis. This study reported on the experience and knowledge accumulated on SDM as it is currently applied in Israel, and the insights derived from them as a basis for continuing to shape SDM policy, implementation, and practice.
The findings highlight the importance of the information meetings provided by the
Department of SDM before the appointment of the SDM supporter, and of the instruction meetings held after the appointment. These meetings were found to help decision makers and their potential supporters in the various stages of the appointment process and have the potential of making the process more efficient. Nevertheless, best practices for these meetings should be designed, relevant professionals should be trained accordingly, and meetings should be continuously offered in various areas around the country to ensure their accessibility to a variety of audiences.
The research further indicates the need to develop a range of mechanisms for safeguards and supervision of SDM arrangements, based on the practical experience of SDM arrangements in Israel as detailed herein, and on practical experience accumulated worldwide. Supervision should be designed to uniquely address SDM, and it should include guidance, proactive supervision, and a complaint mechanism accessible to both decision makers and others.
SDM work is complex and involves fundamental and ethical questions for supporters. Accordingly, mechanisms should be made available for providing instruction, support, and guidance for supporters; forums should be established for continued development of knowledge on SDM, particularly the definition of the decision supporter role; ethical frameworks should be established for the SDM work; and professional and peer forums should be made available for addressing fundamental and ethical questions.
Finally, knowledge on the practice of SDM arrangements should be continually developed. This knowledge will be used for training and guiding supporters and for professional development of paid professionals as well as volunteer supporters, as well as for continuing to shape the policy and practice of SDM and developing safeguards and supervision mechanisms.
[1] Administrator General and Official Receiver, Ministry of Justice (June 26, 2018). Procedure Regarding the Appointment of a Decision Supporter by the Court [Hebrew]; Administrator General and Official Receiver, Ministry of Justice (October 27, 2019). Procedure Regarding the Appointment of a Decision Supporter by the Court – Clarifications Made on October 10, 2019 [Hebrew].
[2] Rimon-Greenspan, H., Yabo, M., Namer-Furstenberg, R., & Rivkin, D. (2020). Supported Decision Making: Applied Aspects, Supervision and Defining Optimal Support – International Review. RR-20-845. Myers-JDC-Brookdale Institute.
Citing suggestion: Rimon-Greenspan, H. (2021). Supported Decision Making in Israel: Policy, Practice, and Ethics. RR-889-21. Myers-JDC-Brookdale Institute. (Hebrew)