Supporting the contraceptive decision-making of adults with intellectual disabilities: A socio-legal examination

Historically, people with intellectual disabilities have been denied the right to make decisions about their own lives. Today, debates continue regarding how to conceptualise decision-making rights and how people with cognitive or psychosocial disabilities should be supported to exercise them. However, relatively little socio-legal research that draws upon empirical data has been conducted in this domain. In this thesis, the contraceptive decision-making of adults with intellectual disabilities is used as an empirical context for examining support for decision-making under the Mental Capacity Act (England and Wales) 2005 (MCA). This is achieved through a mixed methods approach comprising three elements: an analysis of relevant Court of Protection judgments, an online survey of 166 professionals and family members involved in the lives of adults with intellectual disabilities, and 13 interviews with adults with intellectual disabilities themselves. The findings are integrated with the relevant legal literature to argue that, under the MCA, there is an over-emphasis on the role of information in decision-making support, which has limiting and even harmful implications for practice. It is proposed that international law, namely the United Nations’ Convention on the Rights of Persons with Disabilities (2006), offers a broader approach to supporting decision-making, which is likely to better meet the support needs of individuals with disabilities. Nonetheless, complex challenges regarding implementation remain. The thesis concludes by identifying legal and practical implications for supporting people with intellectual disabilities with contraceptive decision-making, as well as in other decision-making contexts.

Name dc:type.qualificationname

Doctor of Philosophy (PhD)

Level dc:type.qualificationlevel

Doctoral

Grantor dc:publisher.institution

University of Cambridge

Year dc:date.issued

2024

Author dc:creator

• Rawles, Jodie

Advisors dc:contributor.advisor

• Clare, Isabel
• Craigie, Jillian

• contraception
• decision-making
• intellectual disabilities
• learning disabilities
• supported decision-making

Licence

• https://www.repository.cam.ac.uk/bitstreams/6ba80fe8-889c-402a-9ac5-26fa382ab3fe/download
• https://www.rioxx.net/licenses/all-rights-reserved/

Language dc:language

eng

DOI dc:identifier.doi

https://doi.org/10.17863/CAM.111059

OAI identifier oai:identifier

oai:www.repository.cam.ac.uk:1810/372157