Abstract
A case is presented where the physician requests a video fluoroscopic evaluation of swallowing and was told that there would be approximately 12-month wait. The patient had Parkinson’s disease and was at significant risk of death from aspiration pneumonia. The physician was offered a “bedside” or clinical examination which the physician found unacceptable. The medical facts of the matter are reviewed particularly as it relates to the adequacy of the “bedside” or clinical examination of swallowing to rule out the significant risk of aspiration pneumonia. An ethical analysis is provided. Particularly the responsibility of the healthcare delivery system and the issue of a speech-language pathologist abetting the limitations of the healthcare delivery system are reviewed.
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