From biscuits to boyfriends: the ramifications of choice for people with learning disabilities

Accessible summary • Choosing can be easy, such as when deciding what biscuit to eat. • Sometimes it is hard to choose, such as deciding on who to have as a boyfriend or girlfriend. • Sometimes even choosing a biscuit can be hard if your doctor says it is not healthy for you. • There are lots of reasons why we choose to do things. • Everyone needs to think about these reasons to help people with learning disabilities make good choices. Summary Choice plays an important role in a person's quality of life. This paper looks at the issue of choice for people with learning disabilities. It considers the extent to which people with learning disabilities are able to choose and are provided with real choices. It also covers the extent to which true choice may or may not be advantageous for some people with learning disabilities. By concentrating particularly on the issue of choice about food and diet, this paper indicates how seemingly simplistic choices, such as decisions over food consumed, can cause major health problems for the decision-maker and hence be a more complex and vital decision than at times it is perceived to be. Additionally, this paper focuses on important factors surrounding choice for people with learning disabilities that previous research may have overlooked. One such factor is how past experience affects the decision-making process. Another, is the issue of the range of choice that is possible, relative to a person's cognitive ability to be fully aware of this range. In particular, this paper emphasizes the important role of the carer. It addresses the impact which the carer's own, perhaps unconscious personal choices, beliefs and ideologies may have on the ‘choices’ made by people with learning disabilities, and more worryingly, on the ‘choices’ offered to them. This paper highlights problems with current research into the area of choice for people with learning disabilities and provides suggestions for future study.