The Changing World of Adult Guardianship Dr. Robert M. Gordon, Professor and Director: School of Criminology, Simon Fraser University. Distinguished Fellow: Canadian Centre for Elder Law, University of British Columbia, Vancouver, Canada rgordon@sfu.ca The Changing World Some key global developments in the field of adult guardianship and substitute decisionmaking. The growing interest in and implications of Shari’ah. The impact of the growth of the cyber-world and the emergence of “e-justice.” What has changed? Early 19th Century, beginning of process of organized exclusion of the “mad” but also improvement in the conditions of confinement Robert Gordon, M.P. “Gordon’s Bills” - 1828 Madhouse and County Asylums Act 1832 Metropolitan Commissioners in Lunacy (system of licensing and visiting) Regulation of private madhouses; provision of care for pauper lunatics. Led to the Imperial Lunacy Act, 1890 Key Global Developments since 1970 First Wave Reforms: early 1970s, Alberta, etc., Dependent Adults Act, triggered by the UN Declaration of the Rights of Mentally Retarded Persons (1969) Second Wave Reforms: 1980s/early 1990s comprehensive adult guardianship and substitute decision making, etc. legislation in key Commonwealth jurisdictions (in Canada & Australia) Third Wave Reforms: European Convention on Human Rights affecting the expanded European Union; UN Convention on the Rights of Persons with Disabilities (2006). Growth of idea of supported decision-making The Main Drivers Changing nature of institutional care and treatment (from exclusion to inclusion). Demands of rapid population aging (costs of care, abuse and neglect, etc.). Advances in health care, etc., (e.g., better understanding of incapacity). Adoption of various human rights instruments. Growing criticisms of system of adult guardianship on part of key interest groups. Common Presumptions and Principles Old presumptions and new principles, gradually extending to Common Law and Civil Code jurisdictions. Presumption of capability, regardless of method of communication. Right to autonomy and self determination if/when capable. Right to the least restrictive/intrusive but most effective forms of support and assistance if incapable and in need. Court/tribunal proceedings to be used only as an absolute last resort…develop alternatives. Address Needs in the Least Restrictive/ Intrusive but Most Effective Way How to develop least restrictive, etc., options, especially avoiding courts/tribunals? What triggers “guardianship”, are there alternative/ better ways of addressing adults’ needs in the late 20th/early 21st Century? Clusters of needs (the “bumps”) – Financial (and legal) decisions and daily management of financial affairs – Health care decisions – Personal care decisions (including residential care) Main constituencies Establish options for different constituencies, levels of capability/incapability, and fluctuations within the constituencies One size does not fit all – People with degenerative diseases of aging – People with developmental disabilities – People with psychiatric disorders – People with brain injuries – People with other degenerative disorders and diseases affecting capacity (Aids, Huntingtons disease, etc.) Least restrictive, etc. options Development of planned alternatives to guardianship: enduring powers of attorney, advance (proxy) directives, inter vivos trusts, plus easy access to planned alternatives. Health care and personal care substitute decision-making by relatives and friends, and/or instructional directives, with last resort option. Development of supported decision-making. Alternative dispute resolution/mediation to avoid hearings and allow for consent orders. Temporary, statutory property guardianship by guardian/trustee. Adult protection legislation (abuse/neglect) and public guardian/advocate/trustee services as a safety net. Issues and Challenges Assessments of incapability (new tools and techniques) Provision of infrastructure to support alternatives and protective measures (NGOs and public guardian/ advocate/trustee services) Professional (gatekeeper) education about the alternatives (e.g., through professional Colleges) Growing interest in reforms by “non-Western” nations, sparked by UN Convention U.N. Convention (2006) Triggered global interest in adult guardianship reform especially supported decision-making. Goal is progressive realization of the Convention’s provisions. Interface with Islamic Sacred Law – Shari’ah. Two main issues: – Reforms within Muslim countries – Application in non-Muslim countries with Muslim populations Shari’ah 1: Introduction of reforms within Muslim countries Range of orthodoxy (cf. Malaysia/Egypt with Iran/Saudi Arabia). Most likely in combined jurisdictions (e.g., Malaysia) 2: Application in non-Muslim countries containing large and growing Muslim populations (e.g., Britain, France and Canada) Driven by Constitutional guarantees of religious freedom; and, multi-cultural immigration policies. Countered by fear of violations of fundamental human rights and widespread islamophobia. Shari’ah Law derived from readings and interpretations of the Qur’an, the Sunnah, & the Hadith, by Imams, and issuance of fiqh & fatwa. Regulates daily life of Muslims, moral and physical Defines and regulates domestic and commercial relationships Resolution of disputes/ conflicts – Family law (divorce, maintenance, custody, etc.) – Property and inheritance, including trusts – Commercial law Accommodations in Non-Muslim Countries Offered on a voluntary basis only (religious choice). Use in non-binding settlements or consent orders. Parallel “adjudication” (advisory) similar to restorative/aboriginal justice circle remedies. Extensions of the community court concept. Faith-based arbitration (Ontario Arbitration Act) using religious principles to settle disputes (halted in 2005). More formal, enforceable decisions by alternative dispute resolution tribunals within dominant legal system (Muslim Arbitration Tribunals in Britain, 2007). www.matribunal.com Shari’ah and “guardianship” No specific interpretations or initiatives, yet. Patriarchal principles would extend to all aspects of existing systems of substitute decision-making: – Selecting the guardian/substitute decision-maker; – Health care and personal care decisions according to Muslim principles and based upon pre-expressed wishes or values and beliefs (substituted judgment); – Best interests decisions per relevant fatwa and decisions of paternal lineage; – Management of financial affairs (control and distribution of assets). The impact of the growth of the cyber-world Real life and cyber life…the growing phenomenon of virtual existence, the e-generation and the e-niverse. New forms of exploitation and victimization, some target vulnerable seniors; And new forms of dispute creation (Second Life); And new forms of (popular) justice and retribution: lasting global condemnation via the internet. Cyber exploitation and victimization of vulnerable adults Emotional abuse – Counselling suicide, on-line predatory behaviour, harassment, e-stalking, defamation, unwanted sexting. Financial abuse – Phishing (identity theft), fraud (bogus requests for financial aid, money transfer scams, etc.) Second Life New, organized aspect of virtual reality (Linden Corporation) Virtual existence leading to first (real) world conflicts (divorce, stalking, sexual abuse, sexual exploitation of children) e-Justice New forms of popular e-justice: shaming and retribution via social network and other internet sites (e.g., YouTube). Vancouver hockey riot and citizen surveillance Implications for guardianship Vindictive internet attacks on those involved with administering the guardianship system (beyond anonymous blogging) Vindictive internet attacks on family members in disputes with other family members Invasions of privacy of vulnerable adults (e.g., self neglect cases) to trigger interventions Conclusions “Adult Guardianship” very different to the 19th Century conception, in theory and in practice but threads remain. Importance declining in the face of less restrictive, more effective (and cheaper) alternatives. Form and content of the alternatives being driven by a range of factors affecting the main constituencies. Changes now occurring on a global basis with uncertain outcomes. Cyber-world becoming a force to be reckoned with as the e-generation ages (be prepared but watch for opportunities). Questions? MATCHING NEEDS AND INTERVENTIONS: ALZHEIMER DISEASE INCAPABILITY NONE SOME EXTENSIVE l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l NONE [PLANNING STAGE] [USE OF PLANNING TOOLS->.……………] [USE OF SUPPORT ………………………………………………………] INTERVENTION MATCHING NEEDS AND INTERVENTIONS: BRAIN TRAUMA INCAPABILITY NONE SOME EXTENSIVE l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l NONE SUPPORTED D’MKG-------LIMITED G’SHIP-----FULL G’SHIP INTERVENTION MATCHING NEEDS AND INTERVENTIONS: DEVELOPMENTAL DISABILITY INCAPABILITY NONE SOME EXTENSIVE l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l……l NONE INTERVENTION (SUPPORTED D’MKING -> …………) (SUBSTITUTE D’MKING ->…)