Brady Wagner Lynne C
Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114, USA.
Semin Speech Lang. 2003 Nov;24(4):275-84. doi: 10.1055/s-2004-815581.
Ethical dilemmas are particularly complex when a patient has a communication disorder. Questionable decision-making capacity can affect an individual's ability to participate in the informed consent process. When other cognitive impairments as well as language deficits are present, the risk of losing one's right to autonomy is greatly increased. Alternatively, the protection afforded those who are clearly incompetent may be limited if a person appears to have decision-making capacity but is unable to adequately process information. These challenges are illustrated in this article by use of clinical case descriptions. They also serve to demonstrate ways in which speech-language pathologists can provide the expertise needed to assist patients and medical teams in addressing these particular issues and ensuring patient autonomy.
当患者存在沟通障碍时，伦理困境会变得尤为复杂。可疑的决策能力会影响个体参与知情同意过程的能力。当同时存在其他认知障碍以及语言缺陷时，丧失自主权利的风险会大大增加。相反，如果一个人看似有决策能力但无法充分处理信息，那么给予那些明显无行为能力者的保护可能会受到限制。本文通过临床病例描述来说明这些挑战。它们还展示了言语语言病理学家可以提供专业知识的方式，以协助患者和医疗团队解决这些特殊问题并确保患者的自主权。
