Capacity, Choice and Advance Directives 

Case scenario

Mrs. Kate ,in her final stage of dementia, so she planned ahead, she was determined not to die slow, lonely, frightful death, so she  wrote a living will eight years ago,  one that clearly stated that, when her time came, she did not want heroic measures taken to keep her alive, she clearly stated that her caregiver should  not give her any nourishment or liquids Her family was in agreement with her.

Today she is 90 years old with advance dementia in a semi vegetable state and she is been fed with 3 times a day, with pureed food, and she opens her mouth and the food is pushed in most often with difficulties, the family believes she is doing this by reflex and not her will, and the health acre argues that it is a demonstration of the will to live.

This has causes an ethical dilemma and you as a speech language pathologist is brought to the ethical committee, what can you bring to the table, assuming you are supporting Mrs. kate in this case scenario, that her living will should be respected, what is the role of a speech language pathologist, how can you prove that she is eating and swallowing the pureed food that she is been fed with as a reflex and not her will……

• Debate clearly using an ethical decision-making framework to organize debate.  All steps should be included.
• based on ethical theories and principles.  Accurate use of a wide variety of theories and principles clearly highlights the multi dimensional aspects of the dilemma. Evidence of a high level of critical thinking.
• Clear, comprehensive and accurate use of relevant nursing codes and standards.  All legal issues clearly discussed.  Use of a wide variety of scholarly nursing research to support discussions
• Clear decision about action to be taken stated. Conclusions and actions well supported by theories, principles, nursing standards and laws. Clear statement of why recommended action was chosen.