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Ethics, Informed Consent, and Decisions About Nonoral Feeding for Patients With Dysphagia

Sharp, Helen M. PhD, CCC-SLP; Wagner, Lynne Brady MA, CCC-SLP

doi: 10.1097/01.TGR.0000284768.32334.96

Alternative methods for sustaining or artificial nutrition and hydration (ANH) may be recommended when a person is at risk for malnutrition, dehydration, or aspiration due to oropharyngeal dysphagia. Patients and their families may have existing preferences not to accept ANH. Contemporary ethical principles and practices require that clinicians engage patients (or their surrogate) in a process of shared decision making so they can make fully informed choices. This article provides a comprehensive review of the requirements for informed consent associated with ANH, and offers practical solutions to ethical issues that arise for clinicians who work with patients with dysphagia in rehabilitation settings.

From the Department of Speech Pathology and Audiology, Western Michigan University, Kalamazoo (Dr Sharp); and the MGH Institute of Health Professions Ethics Initiative, Spaulding Rehabilitation Hospital, Boston, Mass (Ms Brady Wagner).

Corresponding author: Helen M. Sharp, PhD, 1903 W Michigan Ave, Mail Stop 5355, Western Michigan University, Kalamazoo, MI 49008 (e-mail:

© 2007 Lippincott Williams & Wilkins, Inc.