Implementing supported decision making in clinical research

Key points Current practice relies on surrogates to make research decisions for adults who have cognitive or intellectual disabilities. A number of commentators argue that this practice should be replaced with ‘supported’ decision‐making. The present manuscript considers three way to implement supported decision‐making in the context of clinical research. We argue that using supported decision‐making to enhance authenticity has the greatest potential to respect and protect adults who have cognitive and intellectual disabilities.