ABSTRACT
This chapter focuses on the following areas: definitions of ethical values, ethical decision-making, living wills and advanced directives, the effects of dehydration and starvation on the client who is dying, alternative feeding as a treatment and guidelines for gastrostomy tube placement. Autonomy is a commitment to respect an individual's independent actions and choices; it includes the client's dignity, worth and rights. Beneficence is the obligation to act in the best interest of the client's welfare. Professional responsibility is an obligation to observe the rules of professional conduct with clients, colleagues and the community as a whole. Rice suggests there is an opportunity for speech and language therapists to facilitate clients' autonomy where they have communication impairments. The focus of intervention then moves to controlling distressing symptoms and keeping the client comfortable. Artificial nutrition and hydration in terminally ill clients may increase pain, oedema, respiratory congestion, nausea and vomiting.
