Supporting Autonomy for Patients with Intellectual Disability: Principles for Care Providers

Individuals experiencing intellectual disabilities (ID) often experience restricted autonomy. The prima facie core ethical principle of autonomy provides the fundamental basis for assuring self-determination for all persons, regardless of disability. This is affirmed by article 12 of the United Nations Convention on the Rights of Persons with Disabilities. However, ethical challenges arise from tension between prima facie principles, in this circumstance, between the mandate for autonomy and goal of nonmaleficence. This commentary reviews these concepts and recent research exploring intrinsic and extrinsic factors that enhance autonomy in persons with ID. Practical recommendations are provided to assist care providers in being intentional in anticipating challenges and in guiding their patients with ID and their families toward optimal degrees of autonomy.