Meat Acquisition Skill and Male Reproductive Success in Guinea Baboons.

In rural hospitals, decisions regarding the care of older adults with cognitive decline can involve navigating complex medicolegal decisions within the reality of resource‐constrained service environments. Cognitive decline is defined as a spectrum of neurocognitive disorders (i.e., dementia) that can eventually lead to impairments in multiple social and functional domains [, ]. In aged care literature, cognitive decline is increasingly recognised not only as a diagnostic category, but as a lived experience intersecting with frailty, complex discourse around attributable rights and social vulnerability []. For this commentary, we use the term ‘cognitive decline’ with a broader formulation in mind, that encompasses the fluctuating impairments in cognitive and physical functioning that can impact the individual's ability to understand, retain and use relevant information and communicate a choice in a specific context []. This demographic, in particular, frequently requires complex decisions regarding accommodation, treatment and discharge planning, and where there is a loss of capacity, enacting substitute decision‐making processes. Substitute decision‐making includes ‘guardianship or conservatorship agreements’ [, p. 3], whereby an individual is nominated to make decisions for an adult person []. In New South Wales (NSW), provides a statutory structure for appointment of substitute decision‐makers, who can be made responsible for personal and/or financial matters [, , ]. This can occur in the form of an Enduring Guardian (i.e., legally nominated individual, commonly a family member or trusted associate chosen previously by the individual) or as a guardian appointed by the NSW Civil and Administrative Tribunal (NCAT), when an individual is observed to not have capacity to further advocate for their care in a manner that is consistent with ensuring their safety and wellbeing [, ]. In principle, these frameworks are intended to ensure that decisions around a person's care and medical treatment align with their values and best interests. In contrast, supported decision‐making refers to processes that assist individuals to make their own decisions to the greatest extent possible, with emphasis on their will and preferences []. Whilst this has become increasingly influential in policy and human‐rights discourse, particularly following the United Nations Convention on Rights of Persons with Disabilities (CRPD), substitute decision‐making remains embedded in most state‐based guardianship legislation, including NSW [, , ]. By contrast, Victoria's more explicitly embeds supported decision‐making principles, including attention to the person's will and preferences []. Queensland and Tasmania's and respectively requires decision‐makers to act in a way that is least restrictive and with consideration of the person's preferences []. South Australia and Western Australia's and respectively, the Australian Capital Territory's , and Northern Territory's and retain more traditional guardianship structures, although each contains varying duties to consider the person's wishes or least restrictive alternatives []. This uneven legislative landscape means that nationally consistent approaches to supported or substitute decision‐making are lacking, which contends with Commonwealth aged‐care reforms that place a greater emphasis on the former [].