To Feed or Not to Feed Advancements in evaluation and treatment of dysphagia would seem to make treatment decisions more clearcut. However, the decision process is complicated by factors brought to the clinical setting by both clinician and patient. Lack of appreciation for these factors or unwillingness to address them can limit the evaluation and result ... Viewpoint
Viewpoint  |   February 01, 1995
To Feed or Not to Feed
 
Author Affiliations & Notes
  • Holly A. Segel
    University of Colorado Health Sciences Center
  • Martin L. Smith
    Cleveland Clinic Foundation
  • Contact author: Holly A. Segel, MA, 4467 Buena Vista Court, Castle Rock, CO 80104
Article Information
Viewpoints
Viewpoint   |   February 01, 1995
To Feed or Not to Feed
American Journal of Speech-Language Pathology, February 1995, Vol. 4, 11-14. doi:10.1044/1058-0360.0401.11
History: Received September 9, 1992 , Accepted March 22, 1994
 
American Journal of Speech-Language Pathology, February 1995, Vol. 4, 11-14. doi:10.1044/1058-0360.0401.11
History: Received September 9, 1992; Accepted March 22, 1994
Advancements in evaluation and treatment of dysphagia would seem to make treatment decisions more clearcut. However, the decision process is complicated by factors brought to the clinical setting by both clinician and patient. Lack of appreciation for these factors or unwillingness to address them can limit the evaluation and result in services inconsistent with the patient’s wishes and values. These factors include: (a) the cultural and social significance of eating; (b) medical judgments about patient mental status, treatment burdens, prognosis, and risk of aspiration; and (c) patient directives, treatment refusals, and definitions of quality of life. Each set of factors must be considered in treating individuals with swallowing disorders. A discussion of these factors and practical recommendations for addressing them have been developed jointly by a speech-language pathologist and a bioethicist.
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