ABSTRACT
Physical and mental impairments may hinder the normal dialogue which occurs between doctor and patient, thereby obstructing the usual consent process. The consent is an authorisation or refusal of an intervention offered to a particular individual, and unjustified attempts to exclude that individual from the process are likely to conflict with the principles of non-maleficence, beneficence and respect for autonomy. The notions of capacity and autonomy are closely related, and it has been demonstrated that decisions about whether an individual is autonomous can be troublesome, particularly where evidence in favour of autonomy is lacking. A way forward is to permit decisions by adults who have partial autonomy or who retain the characteristics of personhood. In addition, the moral validity of a consent process may be influenced by the values of health workers themselves, depending upon their particular conception of respect for autonomy or non-maleficence.
