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Artificial Nutrition and Hydration

Denise Dougherty, SLP

July 29, 2013

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Question

Does a physician have the final word on artificial nutrition and hydration for a patient?

Answer

In my experience, surveyors have explained to administrators waivers do not hold up in court and the power of attorney should not be making those decisions either. This was kind of a surprise to me.  They said as long as the doctor discontinued the order for the modified diet and the thickened liquids that is all they needed.  They did not need the waiver.  Again I would be very clear about the decision in your education note, so the patient and the family cannot come back and say they did not know.  Be very clear about that informed education session, and that it is informed refusal of whatever recommendations we made based on the instrumental assessments and/or the bedside evaluation.

Denise Dougherty is a solo practitioner in Pennsylvania and consults for The Arijah Children's Foundation in Anguilla, BWI, providing evaluations and therapy for special needs children. Denise serves as the President of the American Academy of Private Practice in Speech Pathology and Audiology (AAPPSPA), and is the AAPPSPA liaison for ASHA Health Care Economics Committee. Ms. Dougherty is a member of the Technical Experts Panel for Quality of Insights of Pennsylvania, working on initiating quality measures for CMS to improve effectiveness, efficiency, economy and quality of services delivered to Medicare beneficiaries.


denise dougherty

Denise Dougherty, SLP

Denise Dougherty is a solo practitioner in Pennsylvania and consults for The Arijah Children's Foundation in Anguilla, BWI, providing evaluations and therapy for special needs children. Denise serves as the President of the American Academy of Private Practice in Speech Pathology and Audiology (AAPPSPA), and is the AAPPSPA liaison for ASHA Health Care Economics Committee. Ms. Dougherty is a member of the Technical Experts Panel for Quality of Insights of Pennsylvania, working on initiating quality measures for CMS to improve effectiveness, efficiency, economy and quality of services delivered to Medicare beneficiaries. She received her bachelor's degree in communication disorders from Marywood University in Scranton, Pennsylvania; a master's degree in communication disorders from St. Louis University; and has completed postgraduate courses at Johns Hopkins University and the University of Phoenix. She is a member of the Business and Professional Women's Association, Pennsylvania Speech and Hearing Association, American Speech and Hearing Association and has received numerous ASHA ACE Awards. She is an instructor for Cross Country Education, CIAO Seminars and SpeechPathology.com and has been invited to present several seminars in 2013 in Santiago, Chile on dysphagia.  


Related Courses

Decision Making for Alternate Nutrition and Hydration - Part 1
Presented by Denise Dougherty, MA, SLP
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  'Great discussions of ethics and resources'   Read Reviews
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