Policies should explicitly support informed choice and patient autonomy (Teoli & Ghazzemzadeh, 2023).

State/Federal law should be upheld in all policies.

Legal counsel should be consulted in the creation of policies that support shared decision-making to ensure the process is legally valid.

Provide training regarding:

• informed consent

• dysphagia ethics

• patient rights

• risk communication

The Agency for Healthcare Research and Quality has free, pre-made training modules for healthcare leaders and professionals.

Use of templates will help improve consistency of informed consent implementation across providers and facilities.

Clearly document:

• risks and benefits

• alternatives discussed

• patient understanding

• patient preferences & choice

There are multiple options for templates available on this site.

The formats of these templates include an interactive form generator, blank printable forms, and a macro-enabled Microsoft Word form.

Use ethics committees or interdisciplinary discussions when conflict exists.

According to the AMA “[e]thics committees, or similar institutional mechanisms, offer assistance in addressing ethical issues that arise in patient care and facilitate sound decision making that respects participants’ values, concerns, and interests.”

The AMA Code of Medical Ethics section 10.7 on Ethics Committees in Health Care Institutions provides guidance on how to ensure that ethics committees are effective.

Encourage clinicians and staff to advocate for both safety and autonomy.

Hoffman & Strand (2024) found that over 70% of providers in their study reported decision-making conflict between providers and patients or their surrogates in long-term care (p. 157).

However, they stated that “only half of facilities hav[e] a formal policy that providers can utilize for dispute mediation” (Hoffman & Strand, 2024, p. 157).

Hoffman & Strand (2024) also found that there is a high level of staff utilization when clear policies and resources are provided (p. 157).