Article

To address the risks of aspiration pneumonia, patients with dysphagia may be
prescribed a modified diet. The goal of diet modification is to decrease the risk
of patients aspirating food due to their diminished swallowing reflex. Some
patients may not accept diet modification or may not adhere to the treatments
identified by the interdisciplinary team. Such scenarios may result in important
moral uncertainty and concern for clinicians. As a result of several ethics
consultations related to this issue, a working group of the Clinical Ethics
Committee at the Jewish Rehabilitation Hospital in Laval, Quebec, Canada,
developed a framework for responding to situations when patients do not adhere to
recommended diet modification. The goal of this tool is to facilitate discussion
and collaboration between clinicians and patients, to clarify assumed versus real
risk, and to promote shared decision-making in dysphagia care. In this article we
examine the clinical context of diet modification for patients with dysphagia in
rehabilitation hospitals, explore ethical aspects of this topic, present the
clinical algorithm, and discuss our experience with developing and piloting this
tool.

Langue : ANGLAIS