What Are The Options?
Option 1:
Support Shared Decision-Making
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Under this option:
Margaret receives education regarding risks, benefits, and uncertainties of all options
Informed refusal is documented
The interdisciplinary team collaborates on a patient-centered care plan
Margaret is allowed to choose thin liquids if that’s her preference
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Margaret’s autonomy and dignity are preserved
Her quality of life may improve
Trust between Margaret and her care team may strengthen
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Margaret’s aspiration risk remains present, but this risk is hard to quantify
Daniel’s staff may experience discomfort
Daniel’s anxiety regarding liability may continue
Option 2:
Enforce Diet Recommendations
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Sofia mandates that Margaret only have the safest documented diet
Sofia’s staff are instructed not to provide thin liquids
Safety remains the primary organizational priority
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Margaret’s aspiration risk may decrease, but this is hard to quantify.
Daniel’s staff may feel legally protected from adverse events
Organizational consistency is maintained
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Margaret’s federally protected autonomy may be diminished
Coercion may occur
Margaret’s quality of life may decline
Margaret’s trust with her care team may erode