Testamentary capacity and aphasia: A descriptive case report with implications for clinical practice

Background: Testamentary capacity (the capacity to make a will) is recognised in the literature as an important issue for speech-language pathologists' assessment of people with aphasia, but current guidelines for clinical practice lack an empirical base. Aims: The research aimed to suggest some guidelines for clinical practice based on information considered relevant for the court in determining testamentary capacity. Methods & Procedures: A recent legal case involving a challenge to the will of a woman with severe aphasia was critically examined with reference to current guidelines in the literature regarding assessment of testamentary capacity. Outcomes & Results: Examination of the information available on the case indicated that the judge gave priority to accounts of the everyday communication of the person with aphasia (including reported discourse samples) over the information provided by expert medical witnesses. The extent to which communication effectiveness could be maximised was found to be a matter of key significance to the determination of capacity. Conclusions: This study has implications for speech-language pathologists' assessment practices and reports, as well as for scope of practice with regard to legal decision making of people with aphasia. These issues are discussed in relation to the World Health Organisation's ICF framework of functioning for social participation.

Democracry and the Individual

The main question informing this paper is whether it is possible to extend democracy beyond its liberal forms. The paper reflects upon this question with regard to its implications for the individual. For the radicalization of democracy implies a need for self-transformation, if the everyday egoism of contemporary citizens is not to thwart reasonable discussion and participation. Theorists such as Richard Rorty argue that the philosophical resources required to guide such self-transformation can be made available only by sacrificing the political freedom and cultural diversity liberalism has been able to precariously establish. Other theorists insist that the thresholds of pluralism and tolerance that existing liberal democracies are struggling to maintain actually require an extension of democracy. The paper evaluates two different theoretical strategies that aim to identify potentials for democratization without falling prey to the dilemma identified by Rorty: a ‘ deliberative’ strategy explicated with reference to Jürgen Habermas and an ‘existential’ approach represented here by William Connolly.