Sometimes a difficult decision to swallow: Ethical dilemmas when patients with dysphagia who lack capacity want to eat.

Abstract

Mr. J is an 82-year-old retired farmer with a preexisting diagnosis of moderate vascular dementia who recently suffered a stroke resulting in a new diagnosis of dysphagia and a loss of complex decision-making capacity. He is admitted to a hospital rehabilitation unit for a course of speech, physical and occupational therapy. His wife, Mrs. J, is his surrogate and has made clear that the couple's shared goals of care are for him to regain as much function as possible so he can return to his own home.