Ethical Challenges and Considerations in Dysphagia Management: A Scoping Review.

Area of Science:

• Healthcare Ethics
• Speech-Language Pathology

Background:

• Speech and language therapists (SLTs) in dysphagia care encounter frequent ethical dilemmas involving clinical risk, patient autonomy, and cultural factors.
• Existing literature lacks a consolidated overview of how ethical principles and reasoning have evolved in dysphagia management over time.

Purpose of the Study:

• To comprehensively synthesize ethical challenges in dysphagia management across different decades and contexts.
• To structure this synthesis using Rest's Four-Component Model of ethical behavior.

Main Methods:

• A scoping review adhering to PRISMA-ScR guidelines.
• Systematic database search from 1990-2024 identifying 22 peer-reviewed articles.
• Data analysis using descriptive statistics and thematic content analysis, classifying principles via Beauchamp and Childress and Rest's models.

Main Results:

• Analysis revealed evolving ethical priorities for SLTs, highlighting the significance of ethical decision-making and person-centered care.
• Key ethical considerations include patient autonomy, informed consent, moral judgment, and sensitivity.
• Telepractice introduces new ethical concerns regarding equity, privacy, and informed consent.

Conclusions:

• Dysphagia management presents a dynamic ethical landscape requiring cultural awareness, respect, shared decision-making, and evidence-based practice.
• SLTs need continuous education, interdisciplinary collaboration, and adaptable ethical frameworks.
• Rest's Four-Component Model aids in understanding ethical complexities, identifying gaps, and fostering genuine ethical conduct.