Abstract
This article explores the issue of aphasia and decision-making within the context
of clinical ethics and patient rights. The cases described illustrate the danger of
making assumptions about the inherent competence of people with aphasia and the life-altering
consequences if no attempt is made to “accommodate” or support communication when
competence may be masked by aphasia. Speech-language pathologists have a moral obligation
and a key role to play in providing communication support that may serve to reveal
a person's intact capacity to make specific decisions, as well as in supporting the
steps involved in the decision-making process. This role also extends to providing
guidance, education, and training for others involved in evaluating the decision-making
capacity of people with aphasia. Communication support strategies useful at each stage
of the decision-making process are detailed.
Keywords
aphasia - ethics - capacity - communication support - speech-language pathology
