Interacting with People who have Severe Communication Problems: ethical considerations

ABSTRACT People who have severe speech and communication problems have difficulties making themselves heard both in everyday communications and society at large. In spite of the positive results which have followed the development of non-vocal intervention strategies, this group of people is at risk for being left out of the social common and being alienated. It is important to realise that one cannot do in the technical what one cannot do in the ethical. Unless both social interaction and intervention with people who have severe communication impairments are based on ethical reflection, the moral standards that are applied to this group may be lower than for other people. True communicative interaction depends on the acceptance that the other partner has something of value to communicate, even if the means for expressive communication are limited and the messages are vague and difficult to understand. A moral requirement for autonomy, that is, an equal footing or right to expression, places an ethical imperative on the more competent communication partner to strive to overcome the asymmetrical relationship and help the disabled person create authentic messages. Ethics is awareness based on the reflection on moral phenomena, grounded in the norms and values of the society and typically the result of discourse and co-constructive reflection, in the form of everyday discussions as well as of public philosophical scrutiny. Communication is a vehicle of reflection and discourse may be regarded as joined reflection. Thus, time for discourse in professional work may be a prerequisite for ethical practice.