Human rights and intellectual disabilities in an era of 'choice'.
Choice-only service plans can shut people out unless you also protect safety, teach how to decide, and track real inclusion.
01Research in Context
What this study did
McGeown et al. (2013) wrote a theory paper. They asked: do ‘choice’ models really help people with intellectual disability?
They looked at human-rights laws and everyday service rules. They argued that too much talk about ‘free choice’ can leave clients out.
What they found
The authors say choice-only services can harm. If staff just wait for the person to choose, support may vanish.
They call for a wider view of rights: safety, belonging, and respect, not just picking options.
How this fits with other research
Cooper et al. (1990) warned the opposite: don’t over-protect. Clients have the right to eat too many doughnuts or nap. The two papers seem to clash, but they don’t. J et al. focus on daily fun choices; R et al. target big service design.
Vassos et al. (2016) later reviewed Person-Centred Planning. They found small gains in community time, not life changes. Their data back R et al.’s point: choice alone is thin.
Armas Junco et al. (2025) went further. They tracked adults who moved to community homes. More choice moments raised self-determination. Their study extends R et al. by showing choice still matters—when paired with real supports.
Why it matters
You write choice goals every day. This paper tells you to check the balance. Add safety nets, teach decision steps, and measure belonging, not just ‘client picked option A.’ Monday session: ask, ‘Does this choice come with the support the learner needs to succeed?’
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02At a glance
03Original abstract
BACKGROUND: Efforts to uphold and promote the human rights of people with intellectual disabilities (ID) are being affected by the increasing emphasis on 'choice' in the delivery of social care services. While rights presume subjects or selves to whom they apply, there is a disconnect between the subjects presumed within human rights frameworks and the variable capacities of a heterogeneous ID population. This disconnect is amplified by choice discourses which characterise current service provision based upon neoliberal ideologies. METHOD: Conceptual assumptions and theoretical positions associated with human rights in relation to people with ID are critically examined. RESULTS: The analysis results in an argument that current conceptualisations of personhood in relation to human rights exclude people with ID. The adverse effects of this exclusion are exacerbated within services which emphasise the permissive rights associated with a neoliberal agenda of 'choice' over protective rights. CONCLUSIONS: In order to ensure that the human rights of people with ID are upheld, neoliberal emphases on choice need to be tempered and a more nuanced and inclusive notion of personhood in relation to universal human rights needs to be adopted.
Journal of intellectual disability research : JIDR, 2013 · doi:10.1111/j.1365-2788.2012.01641.x