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Clinical Rehabilitation, Vol. 12, No. 1, 3-10 (1998)
DOI: 10.1191/026921598670782549

Respect for autonomy: issues in neurological rehabilitation

Julius Sim

Department of Physiotherapy Studies, Keele University, Keele, UK

Objective: To examine the ethical principle of respect for autonomy within the context of neurological rehabilitation.

Discussion: The nature of the principle of respect for autonomy is examined, and specific difficulties to which it may give rise in this area of practice are identified. These concern difficulties of communication with neurologically impaired patients, issues of competence related to patient decision-making, problems of consensus between patient and professional, and the role of the patient's family in the rehabilitation process.

Conclusion: A number of strategies, based on a client-centred model of practice, are suggested which may counteract these difficulties and assist in respecting the patient's autonomy to the appropriate degree, while seeking to attain high-quality clinical outcomes.


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