Determining Decision-Making Capacity in Individuals with Severe Communication Impairments After Stroke: The Role of Augmentative-Alternative Communication (AAC)

2004 ◽  
Vol 11 (1) ◽  
pp. 84-88 ◽  
Author(s):  
Bethany L. Diener ◽  
Janet A. Bischof-Rosario
Keyword(s):  
Decision Making ◽  
Alternative Communication ◽  
Augmentative Alternative Communication ◽  
Decision Making Capacity ◽  
Communication Impairments

scholarly journals “I would prefer not to”: Assessing competence to consent in a case of refusal of cancer treatment

2019 ◽  
Vol 14 (1) ◽  
pp. 42-45
Author(s):  
Gustavo B Castellana ◽  
Lilia B Schraiber ◽  
Talita R de Oliveira ◽  
Daniel M de Barros
Keyword(s):  
Decision Making ◽  
Forensic Psychiatry ◽  
Patient Relationship ◽  
Ethical Conflict ◽  
Actual Case ◽  
Clinical Issue ◽  
Case Presentation ◽  
Decision Making Capacity ◽  
Forensic Psychiatric

Background Based on an actual case in which a psychiatrist was called in to assess a patient’s capacity to refuse treatment, the aim of this study is to discuss how to manage this ethical and clinical issue and the dilemmas faced by the medical team. Case presentation: The case involved a 45-year-old female patient diagnosed with breast cancer who refused treatment. Since the mastology team had doubts about the patient’s mental state and given that she refused to consent to surgery, a forensic psychiatric consult was requested. Conclusion The forensic psychiatry team concluded that the patient’s decision-making capacity was preserved. The team suggested some actions to help the specialists deal with the ethical conflict. A reflection is proposed about the role of psychiatrists when an ethical dilemma involving decision-making capacity emerges in clinical situations, elucidating their work not only as physicians who determine diagnoses and conducts, but also as agents of transformation in the doctor–patient relationship.

scholarly journals Promote Assistive and AAC technologies during Covid-19

2021 ◽  
Vol 21 (3) ◽  
pp. 215-229
Author(s):  
Michela Galdieri ◽  
Michele Domenico Todino
Keyword(s):  
Physical Space ◽  
Assistive Technologies ◽  
Alternative Communication ◽  
Remote Communication ◽  
Augmentative Alternative Communication ◽  
Training Systems ◽  
Communication Needs ◽  
Teaching Learning ◽  
Physical Spaces

The Covid-19 health emergency has produced a rethinking of education and training systems based on open and flexible physical spaces and remote communication channels; however, socialization processes and virtual relational exchanges are still possible and at the same time authentic. Moreover, the use of telecommunication technologies augment efforts to find a new way to organize educational spaces when it is not possible to share physical space and virtual spaces must be used. Starting from the role of assistive technologies in European policies, this work presents a case study about the inclusive perspective of corporeality and action in teaching-learning process and described an experience done in a third grade class of a primary school in Rome where a teacher used an eye communicator with GRID3 software and tools of Augmentative Alternative Communication with a student with complex communication needs, main goal of this activity was to create an inclusive and sharing path for each scholar done in distance education.   Promuovere le tecnologie assistive e la CAA al tempo del Covid-19.   L’emergenza sanitaria da Covid-19 ha sollecitato un ripensamento dei sistemi educativi e formativi quali dimensioni aperte e flessibili in cui formarsi, spazi nei quali i canali di comunicazione a distanza hanno reso possibile processi di socializzazione e scambi relazionali virtuali ma non per questo meno autentici, luoghi della didattica in cui favorire gli apprendimenti mediante l’uso di tecnologie che hanno consentito di raggiungere risultati anche in assenza di condivisione di uno spazio fisico. Il lavoro presenta una riflessione sul ruolo delle tecnologie assistive nelle politiche europee, sul potenziale inclusivo della corporeità e dell’azione nei percorsi di insegnamento-apprendimento e propone la descrizione di un’esperienza svoltasi nella classe terza di una scuola primaria romana dove, in presenza di un’alunna con gravi difficoltà comunicative, la didattica ha previsto l’uso del comunicatore oculare con software GRID3 coniugato alle pratiche e agli strumenti propri della Comunicazione Aumentativa Alternativa, con l’obiettivo di creare un percorso inclusivo e partecipativo per ciascun alunno, seppure a distanza.

Mental Disorders and Decision-Making Capacity: What Is the Role of Law?

2015 ◽  
Vol 22 (1) ◽  
pp. 75-82 ◽  
Author(s):  
Claire Rommelaere
Keyword(s):  
Decision Making ◽  
Capacity Assessment ◽  
Complex Task ◽  
Decision Making Capacity ◽  
Patient’S Rights ◽  
Surrogate Decision ◽  
Definition Of ◽  
Point Of Departure ◽  
Legal Consequences

AbstractWhen a patient appears to have a mental disorder, doubts may arise about his or her decision-making capacity. Health professionals must then assess the patient’s capacity in order to make sure of the validity of his or her consent or refusal. Incapacity has indeed legal consequences, as law provides for the appointment of a surrogate decision-maker in case of incapacity. With Belgian law as a point of departure, this contribution is aiming at identifying the role of law in capacity assessment itself, prior to the decision about (in)capacity. In order to protect the patient’s rights and to support the task of those carrying out the assessment, law should provide for a global definition of decision-making capacity and for a frame-procedure guiding this assessment. In my opinion, it is possible for law to contribute to the complex task of capacity assessment without interfering embarrassingly with healthcare practice.

Dealing with advance directives for critically ill adolescents

1992 ◽  
Vol 12 (5) ◽  
pp. 31-37 ◽  
Author(s):  
CH Rushton ◽  
ME Lynch
Keyword(s):  
Public Policy ◽  
Decision Making ◽  
Critical Care ◽  
Advance Directives ◽  
Nursing Practice ◽  
Critical Care Nurses ◽  
Essential Dimension ◽  
Decision Making Capacity ◽  
Improved Methods

Respecting the values and preferences of adolescents regarding treatment is an essential dimension of nursing practice. As public policy and societal thinking about the role of minors in healthcare decisions evolves, critical care nurses are in a pivotal position to provide leadership and guidance. Critical care nurses who care for adolescents should embrace the opportunity created by the PSDA to implement creative strategies for involving minors in decision making, seek improved methods of assessing decision-making capacity, and document the values and preferences of minors.

scholarly journals A ‘second youth’ for the EU Speakers’ Conference? A critical appraisal of its ‘quasi-constitutional’ role

2018 ◽  
Vol 10 (3) ◽  
pp. 83-106
Author(s):  
Cristina Fasone
Keyword(s):  
Decision Making ◽  
Critical Appraisal ◽  
Ex Post ◽  
Decision Making Capacity ◽  
Rules Of Procedure ◽  
Constitutional Constraints ◽  
The Many ◽  
Rule Making ◽  
The Eu

Abstract The EU Speakers’ Conference has experienced a ‘second youth’ after the entry into force of the Treaty of Lisbon by playing a ‘quasi-constitutional’ role in inter-parliamentary cooperation, and in particular by trying to exercise a rule-making function over the many inter-parliamentary venues of the EU’s system of government. The fulfilment of such a function has certainly not been made any easier as a consequence of the constitutional constraints surrounding the positions of the Speakers and Presidents of the European and Member States’ (MS) Parliaments, with a considerable variety in terms of powers and decision-making capacity among the MS and the EU. Despite these limitations, the ‘quasi-constitutional’ role of the EU Speakers’ Conference has mainly consisted of approving guidelines, if not directly rules of procedure, for other inter-parliamentary venues. It has also been argued that the coordinating function of the EU Speakers’ Conference can be much more effective when looking at its ‘quasi-constitutional’ role, and also in its function of joint parliamentary scrutiny in the EU, if it is aimed at enhancing the rational organisation of inter-parliamentary activities in terms of timing, agendas and ex-post supervision of the results, in the absence of any other possible alternative to the Speakers’ leadership.

Assessing Decision-Making Capacity in Patients with Communication Impairments

2016 ◽  
Vol 25 (4) ◽  
pp. 691-699 ◽  
Author(s):  
MOLLY CAIRNCROSS ◽  
ANDREW PETERSON ◽  
ANDREA LAZOSKY ◽  
TENEILLE GOFTON ◽  
CHARLES WEIJER
Keyword(s):  
Decision Making ◽  
Patient Autonomy ◽  
Ethical Principle ◽  
General Strategy ◽  
Semistructured Interview ◽  
Standard Methods ◽  
Communication Impairment ◽  
Decision Making Capacity ◽  
Loss Of Autonomy ◽  
Communication Impairments

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.

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