All persons over the age of 18 are deemed to have legal capacity unless and until a Guardian has been appointed for them by a court, so healthcare professionals should honor and respect the choices of all adults, including those who may have intellectual or developmental disabilities.

Supported decision-making agreements (SDMAs) are contracts entered into by persons with intellectual disabilities after a facilitation process, designating individuals to support them in various ways and in various domains. Although SDMAs do not yet have legal status in New York, healthcare professionals should accept and rely upon SDMAs as contracts made by persons with legal capacity, and allow named supporters to assist the client/patient in the ways provided for in the SDMA.

Where otherwise appropriate, healthcare proxies executed by persons with intellectual disabilities should also be honored.