Ethical Issues Involving the Right Hemisphere Stroke Patient: To Treat or Not to Treat?

Abstract

The management of patients with right hemisphere damage (RHD) presents a challenge to the allied health clinician. In addition to impairments in specific cognitive areas, some patients may not be aware of the presence or extent of their deficits or the impact of these deficits on everyday activities. This article briefly describes two related models of awareness/unawareness that may help guide the assessment and treatment process in patients with neurological damage including RHD. Then, some clinical care decisions regarding patients with decreased awareness are presented together with a framework for organizing and evaluating the various factors associated with a case.

Keywords:

• anosognosia
• awareness
• clinical decision making
• right hemisphere stroke
• treatment