This House Believes in instrumental assessment
Author: Samantha Procaccini & Paula Leslie
Magazine issue: Summer 10
Page numbers: 16-18
Date: 31 May 2010
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This is the sixth in our series of articles set out like a debate, with the Proposition required to prove its case and the Opposition aiming to show why the Proposition is wrong. The Proposition case is that clinicians should complete an instrumental examination – videofluoroscopy or fibreoptic endoscopy – on all acute care patients referred for swallow evaluation. They argue this would provide the external evidence needed to achieve the highest quality patient care. The Opposition points out that the clinical swallow evaluation serves a wider range of purposes than detecting aspiration, and one of its aims is to establish whether there is a need to conduct an instrumental examination. Universal use would be a pure act of paternalism and violation of the ethical principles of autonomy and informed consent. The authors Samantha Procaccini and Paula Leslie conclude that, while instrumental assessment has an integral role, it must not be over-used and that the clinical swallowing evaluation should be comprehensive and followed up with instrumental assessment if required.
