障害者介助における意思の尊重と推察のあわい

抄録

Although professional ethics requires caregivers to obey their disabled clients, it can be difficult for disabled people to give firm instructions. Some earlier studies have suggested that caregivers may set their own standards of care, which is risky considering that there is a discrepancy between what caregivers think and what their clients want. To understand the management of this risk, the author observed interactions between caregivers and their physically disabled clients. A qualitative analysis showed that even when caregivers misinterpret clients' messages, they do not think that there is a serious problem because clients can point out errors, and caregivers can try again. Sometimes, however, caregivers hesitate to act without directions because of the issue of the privacy of the clients' family. Even though clients consent to caregivers acting without explicit directions, their actions can be modified if the caregiver deems it necessary according to their clinical judgment.