End-of-Life Decision Making, Quality of Life, Enteral Feeding, and the Speech-Language Pathologist A speech-language pathologist assessing swallowing function may determine that an individual is no longer able to meet his or her nutritional needs safely through oral feeding alone. The choice to initiate, withhold, or discontinue artificial nutrition and hydration (ANH) should be made by a fully informed decision maker, be ... Article
Article  |   October 01, 2005
End-of-Life Decision Making, Quality of Life, Enteral Feeding, and the Speech-Language Pathologist
Author Affiliations & Notes
  • Elizabeth Hanna
    Bridgepoint Hospital, Toronto, Canada
  • Aviva Joel
    Bridgepoint Hospital, Toronto, Canada
Article Information
Swallowing, Dysphagia & Feeding Disorders / Attention, Memory & Executive Functions / Articles
Article   |   October 01, 2005
End-of-Life Decision Making, Quality of Life, Enteral Feeding, and the Speech-Language Pathologist
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), October 2005, Vol. 14, 13-18. doi:10.1044/sasd14.3.13
SIG 13 Perspectives on Swallowing and Swallowing Disorders (Dysphagia), October 2005, Vol. 14, 13-18. doi:10.1044/sasd14.3.13
A speech-language pathologist assessing swallowing function may determine that an individual is no longer able to meet his or her nutritional needs safely through oral feeding alone. The choice to initiate, withhold, or discontinue artificial nutrition and hydration (ANH) should be made by a fully informed decision maker, be it the patient or his or her substitute decision maker (SDM). As health-care professionals with specific knowledge of the issues leading up to the decision, speech-language pathologists have a crucial role in providing information and support. The Terry Schiavo case reminded us how emotional, challenging, and divisive these choices can be. Supporting patients and families through this process requires not only a solid grounding in dysphagia, but also a wide range of knowledge relating to the law, ethics, risk benefit analyses, and one's own values and beliefs. This knowledge must be balanced with compassion, courage, and sensitivity. The objective of this article is to present possible roles of the speech-language pathologist in these discussions.
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