Self-Determination Across the Life Span

Across their lifespan, all human beings aim to achieve a certain level of independence concerning their self-image and place in the community. Self-determination includes both the developmental aspect of the individual as well as the social context in which they place themselves. For people with intellectual disabilities or ID, self-determination is the building block of assimilation into the community. For individuals suffering from intellectual disabilities, the need for self-determination begins in early life but gets more potent with adolescence and continues into adulthood. 

What is meant by self-determination?

Self-determination is an inherent process where a person establishes their own sense of self through independent choices. It is in close relation to the concept of free will and refers to individuals determining the course of their life and health by exercising their right to choose for themselves. One key component of self-determination is that an individual's choice is free from any outside influence. It allows complete freedom to the individual irrespective of their health status. Self-determination is closely related to an individual's autonomy that may be restricted because of their physical condition. It also considers the ecological or environmental aspect that corresponds to the practical and developmental part of decision-making.

What are the five principles of self-determination?

Self-determination can be explained by five core principles that allow individuals to achieve independence in their lives for all their choices fully. These are as follows:

  • Freedom: Each adult with disabilities can take the liberty to exercise their own choice irrespective of their health condition. Their freedom is in no way less than that of people without disabilities. The right to choose is the same for all citizens.
  • Authority: The authority to make decisions on your behalf should not be in someone else's hands. The individual gets to make all the decisions related to the services offered to them and the medical or social support they require. 
  • Support: Each individual can choose the kind of support they expect from healthcare professionals or their community. Individuals can pick their support system as they become contributing members of the community. Rather than requiring supervision, they ask for help as and when needed.
  • Responsibility: As an individual with their own choices, they also get to choose their role in the community. Adults with disabilities also get to be responsible for their own decisions on how they are willing to spend money. Financial responsibility is an essential part of self-determination.
  • Confirmation: Confirmation reinforces the values mentioned above so that an individual's decision does not happen under any unwarranted influence. It makes the decisions final based on all the factors provided when choosing the type of services or support one wants.

What does self-determination mean in aged care?

Older adults find it challenging to maintain their autonomy with deteriorating health and reduced authority compared to their caregivers. However, self-determination gives them enough knowledge about their own life to make informed decisions about all aspects of their lives, from social to medical and economic. Aged care involves the ability of older individuals to choose the method of care and the authority to select the support and services they want to engage with. It not only gives complete autonomy to older adults but also allows them to exercise their legal right to make decisions. They also have a moral right to be informed about their condition to decide on the type of care they prefer.

Why is self-determination important in healthcare?

Self-determination is essential in healthcare because medical professionals are bound to respect an individual's authority when making decisions about their own body. As long as individuals are mentally competent to choose for themselves, they have legal and ethical rights to pick their medical treatment. Choosing the course of treatment following the diagnosis helps the patients cope with their conditions better and also helps reinforce positive health patterns. 

If the choices of an adult are out of free will, they are more likely to persist with healthy behaviors with greater dedication and engagement. The Self-Determination Theory or SDT is applied to healthcare because an individual's autonomy positively impacts their psychological health. It would eventually help individuals to keep persisting with renewed motivation towards maintaining their physical health through positive behaviors.


Self-determination is a process that begins in childhood and gains momentum in adolescence. Adults require autonomy, especially when making important life decisions, from healthcare to finances. Self-determination allows adults of all ages to exercise their authority for the kind of support they require. Individuals have the freedom to be responsible for their decisions. They also have the legal right to choose the medical treatment they want, which would help them continue healthy behavioral patterns in the long run.