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Ethical Challenges and Considerations in Dysphagia Management: A Scoping Review

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Title: Ethical Challenges and Considerations in Dysphagia Management: A Scoping Review
Language: English
Authors: Alida Naudé (ORCID 0000-0002-3618-6551), Amisha Kanji (ORCID 0000-0002-9577-4935)
Source: International Journal of Language & Communication Disorders. 2026 61(2).
Availability: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
Peer Reviewed: Y
Page Count: 15
Publication Date: 2026
Document Type: Journal Articles
Information Analyses
Reports - Research
Descriptors: Physical Disabilities, Eating Disorders, Ethics, Risk, Personal Autonomy, Patients, Cultural Influences, Allied Health Personnel, Speech Language Pathology, Intervention, Cultural Awareness, Participative Decision Making, Evidence Based Practice, Interdisciplinary Approach, Professional Development
DOI: 10.1111/1460-6984.70214
ISSN: 1368-2822
1460-6984
Abstract: Background: Speech and language therapists (SLTs) working in dysphagia care regularly navigate complex ethical dilemmas involving clinical risk, patient autonomy and cultural considerations. While ethical principles are well-recognized in the field, consolidated evidence mapping how these principles and ethical reasoning components have been represented in the literature over time remains limited. This review offers a comprehensive synthesis of ethical challenges in dysphagia management across decades and contexts, uniquely structured using Rest's Four-Component Model of ethical behaviour. Method: This scoping review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. A systematic search of databases from 1990 to 2024 identified 22 peer-reviewed articles. Data were analysed using descriptive statistics and thematic content analysis, with ethical principles and components classified according to Beauchamp and Childress and Rest's Four-Component Model. Main Contributions: Analysis revealed evolving ethical priorities within interdisciplinary roles and responsibilities of SLTs. These ethical priorities suggest the importance of ethical decision- making and person-centred care in dysphagia management, specifically foregrounded by the focus on the principles of autonomy and informed consent and the components of moral judgement and sensitivity. Conclusion: The findings underscore the dynamic and complex ethical landscape of dysphagia management, emphasizing the need for cultural awareness and respect, shared decision-making and evidence-based practice. To navigate these challenges, SLTs require continuous education, interdisciplinary collaboration and adaptable ethical frameworks. This review provides a comprehensive synthesis of ethical challenges and considerations through longitudinal, theory-informed analyses using Rest's Four Component model. This model is useful in breaking down complexity into understandable psychological steps, identifying gaps, guiding education and culture by fostering genuine ethical conduct beyond intellectual understanding across decades, geographic regions and professional roles in SLT.
Abstractor: As Provided
Entry Date: 2026
Accession Number: EJ1500610
Database: ERIC
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  Data: Ethical Challenges and Considerations in Dysphagia Management: A Scoping Review
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  Data: <searchLink fieldCode="AR" term="%22Alida+Naudé%22">Alida Naudé</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-3618-6551">0000-0002-3618-6551</externalLink>)<br /><searchLink fieldCode="AR" term="%22Amisha+Kanji%22">Amisha Kanji</searchLink> (ORCID <externalLink term="https://orcid.org/0000-0002-9577-4935">0000-0002-9577-4935</externalLink>)
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  Data: <searchLink fieldCode="SO" term="%22International+Journal+of+Language+%26+Communication+Disorders%22"><i>International Journal of Language & Communication Disorders</i></searchLink>. 2026 61(2).
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  Data: Wiley. Available from: John Wiley & Sons, Inc. 111 River Street, Hoboken, NJ 07030. Tel: 800-835-6770; e-mail: cs-journals@wiley.com; Web site: https://www.wiley.com/en-us
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  Data: 10.1111/1460-6984.70214
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  Data: 1368-2822<br />1460-6984
– Name: Abstract
  Label: Abstract
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  Data: Background: Speech and language therapists (SLTs) working in dysphagia care regularly navigate complex ethical dilemmas involving clinical risk, patient autonomy and cultural considerations. While ethical principles are well-recognized in the field, consolidated evidence mapping how these principles and ethical reasoning components have been represented in the literature over time remains limited. This review offers a comprehensive synthesis of ethical challenges in dysphagia management across decades and contexts, uniquely structured using Rest's Four-Component Model of ethical behaviour. Method: This scoping review was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist. A systematic search of databases from 1990 to 2024 identified 22 peer-reviewed articles. Data were analysed using descriptive statistics and thematic content analysis, with ethical principles and components classified according to Beauchamp and Childress and Rest's Four-Component Model. Main Contributions: Analysis revealed evolving ethical priorities within interdisciplinary roles and responsibilities of SLTs. These ethical priorities suggest the importance of ethical decision- making and person-centred care in dysphagia management, specifically foregrounded by the focus on the principles of autonomy and informed consent and the components of moral judgement and sensitivity. Conclusion: The findings underscore the dynamic and complex ethical landscape of dysphagia management, emphasizing the need for cultural awareness and respect, shared decision-making and evidence-based practice. To navigate these challenges, SLTs require continuous education, interdisciplinary collaboration and adaptable ethical frameworks. This review provides a comprehensive synthesis of ethical challenges and considerations through longitudinal, theory-informed analyses using Rest's Four Component model. This model is useful in breaking down complexity into understandable psychological steps, identifying gaps, guiding education and culture by fostering genuine ethical conduct beyond intellectual understanding across decades, geographic regions and professional roles in SLT.
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