Representation: Vulnerability Just Ahead?

The following is an excerpt from a recent email to a doctor explaining why Representation can be so crucial for higher-functioning individuals. Please pay particular attention to the last paragraph:

The legislation defines “capacity” as “the ability, with or without support, to

• understand information relevant to making a decision; and

• appreciate the reasonably foreseeable consequences of making or not making a decision including, for greater certainty, the reasonably foreseeable consequences of the decision to be made.

In my experience, it is often the second component that is the real sticking point. The simplest example is, perhaps, a child’s ball rolling across the road. Although the child can show his want/need to retrieve the ball at any cost, none of us would allow him to simply run into the road because we understand what the child cannot; namely, the very real risk (and potentially severe consequences) of being hit by a vehicle.

A more apropos example might be a challenged young adult meeting (and perhaps developing a form of relationship with) an individual in the community or elsewhere, who then asks our young adult to go somewhere or do something with them. Given that executive functioning deficits cut through every aspect of a person’s life, the issue becomes the young adult’s ability to think through the potential consequences of the decision he must now make. If, for example, the other individual is a stranger or you and I would see that what that person is proposing is illegal or potentially unwise or even dangerous, [unless a legal Representative has been appointed], no one would have the ability to intervene.

I see it much less as us imposing our value judgement as to what might constitute a “good" decision in the circumstances as recognizing that, whatever any one of us might ultimately decide, we at least have the ability to (if we choose) think forward as to potential consequences; whereas, adults in [this] situation simply do not (and likely will never) have this same ability.