title: Clinical ethics in the context of language and cognitive impairment: rights and protections.
abstract: 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.
authors.affiliation: Spaulding Rehabilitation Hospital, Boston, Massachusetts 02114, USA. Lbradywagner@partners.org
authors.forename: Lynne C
authors.initials: LC
authors.lastname: Brady Wagner
mesh_terms: D016223:Advance Directives / Q000941:ethics / Q000331:legislation & jurisprudence; D000368:Aged; D032781:Codes of Ethics; D003072:Cognition Disorders / Q000503:physiopathology / Q000523:psychology; D003657:Decision Making; D026690:Ethics, Clinical; D005260:Female; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000331:legislation & jurisprudence; D007806:Language Disorders / Q000503:physiopathology / Q000523:psychology; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D010344:Patient Advocacy; D010358:Patient Participation / Q000331:legislation & jurisprudence; D028701:Patient Rights / Q000941:ethics* / Q000331:legislation & jurisprudence; D026684:Personal Autonomy; D014481:United States