Strength in compromise.

Abstract

This article describes Mark (age 26) who has severe dysarthria following a head injury. He accepted AAC (SpeechViewer) as a short-term measure, but was keen to use technology (the electropalatograph) he saw promoted in the media to improve his oral skills. His speech and language therapists feel that this will not help him. The ethical issues involved in the case are discussed and illustrated by the use of Seedhouse's ethical grid. These include the levels of practicality, the general level of outcome to be achieved, the level of duties expected, and the principles behind health work. Issues which impact on Mark's expectations of the speech and language therapy service and which remain unresolved are the gaps in NHS provision for young head injured individuals as their circumstances change, and the tendency of the media to overstate the benefits of new approaches to disability.