Assessing Decision-Making Capacity in Patients with Communication Impairments

Cambridge Quarterly of Healthcare Ethics 25 (4):691-699 (2016)
  Copy   BIBTEX


Abstract:The ethical principle of autonomy requires physicians to respect patient autonomy when present, and to protect the patient who lacks autonomy. Fulfilling this ethical obligation when a patient has a communication impairment presents considerable challenges. Standard methods for evaluating decision-making capacity require a semistructured interview. Some patients with communication impairments are unable to engage in a semistructured interview and are at risk of the wrongful loss of autonomy. In this article, we present a general strategy for assessing decision-making capacity in patients with communication impairments. We derive this strategy by reflecting on a particular case. The strategy involves three steps: (1) determining the reliability of communication, (2) widening the bandwidth of communication, and (3) using compensatory measures of decision-making capacity. We argue that this strategy may be useful for assessing decision-making capacity and preserving autonomy in some patients with communication impairments.



    Upload a copy of this work     Papers currently archived: 94,726

External links

Setup an account with your affiliations in order to access resources via your University's proxy server

Through your library

Similar books and articles


Added to PP

30 (#533,137)

6 months
9 (#454,577)

Historical graph of downloads
How can I increase my downloads?

Author Profiles

Charles Weijer
University of Western Ontario
Andrew H. Peterson
George Mason University