Presenter: Amanda Warren, MS, CCC-SLP
– P.R., prior course participant
Ethics Committees in hospitals facilitate decision making and support clinical care, taking into consideration multiple values and perspectives. Members should represent diverse skills, experiences, and knowledge.
This course includes a case review of a man with dementia living in a long-term care facility. He is not communicative, sits in a wheelchair, has some swallowing difficulties, and is unable to feed himself. There are DNR, DNI, and DNH orders in his medical record.
His family has asked that a Heimlich maneuver not be performed if he were to choke. This presentation will reveal emerging ethical challenges in healthcare and explore the role of the SLP as an integral member of the ethics team, particularly when questions include communication and swallowing components.
This course is offered for 0.2 ASHA CEUs – 2 contact hours.
Course Overview – Run Time: 2:14:21
– A.N., prior course participant
The content of this online CE course does not focus exclusively on any specific proprietary product or service. Presenter financial and non-financial disclosures may be found in the Presenter & Disclosures area.
Video presentation with downloadable handout. Stop and re-start the course at any point. Learners retain access to course content after completion for ongoing reference and review.
"The case study was beneficial. Thoughtful, analytical, and compassionate." C.S. (Dec. 2023)
"Excellent presentation. This course was well organized, background reviewed, and then the case study presented." J.R. (Nov. 2023)
"The topic on redesigning the care pathway was helpful." D.D. (Nov. 2023)
"I liked the presenter's knowledge and clarity. Discussing the reasons why Heimlich would be added to patient's healthcare choice was beneficial." P.T. (Nov. 2023)
"The bioethical principles considered by an ethics committee and the analysis completed when making an ethical decision were beneficial to discuss. I enjoyed learning about the example case to understand better the principles and all that goes into an ethics committee and their decision." B.M. (Nov. 2023)
"I enjoyed the enthusiasm and knowledge of this presenter! I found the discussion comparing nonmaleficence and beneficence to be the most beneficial because it detailed how to contrast and compare 2 opposing methods of thought. This will help me better explain to a patient/family members why certain decisions are made." B.M. (Nov. 2023)
"I liked the openness of the speaker to address the complexities of DNR and other proxy decisions. Discussing the ethics of practice as related to the Heimlich being performed was beneficial." M.K. (Nov. 2023)
"This case analysis really helped me think about more than one aspect of decision-making." H.H. (Oct. 2023)
"The presenter was very informative and easy to listen to. The issue of letting a person choke if they have decided not to have any medical intervention at that time was interesting." M.M. (Oct. 2023)
"I liked the instructor's use of a real life ethical dilemma. And considerations for forming a hospital ethics committee were helpful." L.G. (Oct. 2023)
"Learning contributions of the SLP to an ethics committee. Great discussion regarding the ethics committee in this type of situation. This course also gave me thoughtful considerations for my own family as well as myself." S.H. (Oct. 2023)
"I liked this case study. And the ease of registration and viewing this course." J.O. (Oct. 2023)
"Discussing the importance of informed consent prior to treatment was beneficial. The case study was very interesting and informative. I liked that the presenter went through all the considerations discussed by the ethics teams in this case." R.P. (Oct. 2023)
"Discussion of the case study was beneficial, looking at different interventions vs aggressive measures. I liked the speaker and the idea of increased role of SLP in ethics committees." E.N. (Sep. 2023)
"I liked this case study. Discussion of pt choice and not our own comfort." R.M. (Sep. 2023)
"Wonderful presenter!" N.M. (Sep. 2023)
"Ethics in relation to dysphagia management. I found Amanda's presentation to be very interesting." L.M. (Aug. 2023)
"Excellent presenter and discussion of actual Ethics Committee decision-making process and examples." B.P. (Jul. 2023)
"The presenter was so thorough! I liked the process of ethics and ethical cases relating to eating/drinking." M.P. (Jul. 2023)
"Fascinating discussion of the case study regarding Heimlich maneuver. I will try to better consider patient and families' thought processes when guiding patients with decisions about care and treatment. I liked the in depth look at a particular case that appeared one way and turned out to have many facets." D.B. (Jun. 2023)
"I liked the case scenario and seeing the process that was used to get to a resolution / plan for this patient." J.W. (Jun. 2023)
"This course was informative and interesting. The discussion about the need for SLPs to be a member of the Ethics committee was beneficial. I liked the content and the way in which it was presented." C.S. (Jun. 2023)
"Seeing the importance the SLP can bring to an ethics committee." K.F. (Jun. 2023)
"This is very helpful to share with other healthcare providers. It was beneficial to discuss that to assist in comfort isn't doing nothing, it's doing something different." A.J. (Jun. 2023)
"Presenter was easy to listen to and relevant to my work setting - acute care hospital. I liked the topic on the importance of having interdisciplinary team members on an Ethics committee - and benefit of SLP participation." L.D. (Jun. 2023)
"The 4 box analysis system was beneficial. I liked the case presentation of Mr. Z." T.S. (Jun. 2023)
"The presenter explained everything well. I liked the discussion of whether or not it is ethical for the Heimlich to be used on a patient who is choking if they have certain orders in place such as DNR." K.A. (May 2023)
"The inner dialogue in clinical ethical decision-making was beneficial. I liked the accessibility of course." E.G. (May 2023)
"The speaker was positive and easy to learn from. I liked the idea that SLPs should be considered as a participant in an ethics committee." K.F. (Apr. 2023)
"I liked this specific example of the circumstances around dysphagia and choking." M.C. (Apr. 2023)
"Great review to use in my clinical practice. I liked the ethical considerations discussed." M.K. (Mar. 2023)
"Consideration of varied principles of ethics in decision making. I liked the online accessibility." C.W. (Mar. 2023)
"I found the whole discussion most beneficial to my daily practice! The presenter was clear, concise, and articulate!" D.H. (Mar. 2023)
"I liked the application and relevance to my daily practice." E.G. (Mar. 2023)
"The consensus and four-box analysis models were beneficial. The case study was very helpful, and all of the information was appreciated!" S.L. (Mar. 2023)
"Evidence-based and useful in my day-to-day practice. The speaker was engaging and expressive and held my attention. What's included in the continuum of care and what could be declined was a useful perspective. Time-wise, she gave appropriate time to the topics she covered." R.B. (Mar. 2023)
"The case study was a real-life scenario that clinicians may encounter. Discussion on personal beliefs vs. patient rights was beneficial." B.A. (Mar. 2023)
"Great topic related to ethics for SLPs. The presenter was engaging, relatable, and interesting. I liked the case presentation and processes by which a plan was developed. Also, the statement that comfort care doesn’t mean doing nothing, it just means doing something different…..this is excellent for education!" B.K. (Mar. 2023)
"Relevant to my daily practice." E.G. (Mar. 2023)
"I found the entire presentation to be excellent. The presenter was knowledgeable, articulate, and presented the course in a very organized way." W.F. (Feb. 2023)
"She was an excellent speaker. I liked the entire presentation." G.B. (Feb. 2023)
"I liked Amanda Warren's positive core values regarding a very difficult topic. And team with varied beliefs coming to a consensus." M.B. (Feb. 2023)
"Enjoyed the case scenario. Liked how it pertained to a specific ST case." J.W. (Jan. 2023)
"Thought provoking and relevant information." A.P. (Jan. 2023)
"Discussion of ethics committee in general and explanation re: why DNPH could be an option for patients was beneficial." K.H. (Jan. 2023)
"This course was wonderful and educational. The topics of dementia in the aging population and how it will affect patients making the decision of wanting or not wanting the Heimlich was interesting." T.R. (Jan. 2023)
"The presentation was excellent. Good layout and discussion of ethics." S.M. (Jan. 2023)
"The case study was well chosen and discussed. I liked the ease of course access." R.J. (Jan. 2023)
"The presenter was really easy to listen to and provided a nice balance between clinical experience and evidence. I have never worked in a facility where SLPs were part of the ethical committee. This was very eye-opening to the benefits." E.L. (Dec. 2022)
"All topics were beneficial in achieving a broader understanding. I liked the course organization - explanations to enhance understanding and learning - integration of questions & answers as the presentation was presented." D.D. (Dec. 2022)
"Beneficence vs. Maleficence. The instructor was well prepared, well spoken, and knowledgeable." A.G. (Dec. 2022)
"The speaker was very easy to listen to. The idea of considering the patient's wishes and plans of care over that of our traditional training to prolong life." J.P. (Dec. 2022)
"Learning function and purpose of an ethics committee in an acute hospital setting. Questions answered as they came up - kept it relevant to the topic being discussed in that moment." A.F. (Dec. 2022)
"Speaker was very good - liked discussion of ethics amongst dysphagia population." K.D. (Dec. 2022)
"The case study was very helpful for application of the principles." K.C. (Dec. 2022)
"Excellent presenter. Good explanations. Learning how ethics committees work." R.S. (Dec. 2022)
"I really enjoyed the case study. It was incredibly thought-provoking and interesting to break down the decision-making that goes into a comfort-based approach and why. This is definitely becoming a more relevant topic of discussion as the population ages and the prevalence of dementia and dysphagia increases. The framework behind the decision-making process was well broken down and clearly applied to the case study." A.N. (Dec. 2022)
"The case study that allowed me to see the process of the ethics that the committee put into practice and the ongoing discussion with questions throughout the course were all incredible." E.C. (Nov. 2022)
"I liked the speaker's enthusiasm and knowledge regarding the subject." L.H. (Nov. 2022)
"Speaker was very knowledgeable and clear. I liked the way ethics principles were used to guide the decision in the case presentation." C.G. (Nov. 2022)
"Addressing staff or bystander concerns during choking incident when intervention is prevented was really helpful. This course had good pace of information and anecdotal stories." S.M. (Nov. 2022)
"Everything covered was beneficial! I really needed to hear all of this! The instructor was impeccable! I will seek more courses from her! Thanks! Love her style, format, content, and delivery!" K.K. (Nov. 2022)
"The Ethics Consultation process was very informative. I appreciated the opportunity for team members to consider their personal reactions/beliefs specific to this case study patient. The framework for identifying key questions and concerns seems very helpful in terms of gleaning the most information possible for decision-making. I loved the split-screen format! Being able to view the presenter and the slides simultaneously really personalized the instruction and made me feel part of a class!!" J.K. (Nov. 2022)
"The case discussion of Mr Z was a perfect example of how to navigate through a difficult situation. I initially had a visceral reaction to the dilemma of providing treatment or not to provide. The instructor did a masterful job of laying out the process that led to the final decision. Wonderful approach! Excellent instructor. Very knowledgeable and approachable. She has a passion for this area." L.H. (Nov. 2022)
"The graphics and handouts were good." M.M. (Nov. 2022)
"Good example of a tricky scenario - and advocating for the role of SLPs on ethics committees or to be involved with relevant consults." E.R. (Nov. 2022)
"It was very informative." C.J. (Nov. 2022)
"Excellent presentation on a very difficult topic. Learning that the HCP can make the decision to include refusing the Heimlich as part of the DNR, DNI, DNH." I.H. (Nov. 2022)
"I enjoyed this entire course! Excellent presentation!" J.S. (Oct. 2022)
"I liked the simplistic presentation." T.T. (Oct. 2022)
"Excellent presenter!" A.C. (Oct. 2022)
"I liked the entire course and the way it was presented." B.B. (Oct. 2022)
"I like the speaker's knowledge and the real life examples provided. And learning more about how an Ethics Committee functions." S.B. (Oct. 2022)
"The complex consideration of comfort care, emergency care, and consistency in care for DNR, DNI, DNPH were good." T.E. (Sept. 2022)
"I thought the case study was the most helpful because I could apply it to a typical work situation. I liked the examples and information about the Ethics committee and the typical things they look into in the hospital setting." J.S. (Sept. 2022)
"The presenter is super interesting and easy to listen to. You can hear her passion and that makes it easier to watch and listen." A.S. (Sept. 2022)
"EXCELLENT COURSE! I will be referring my speech friends and colleagues." M.B. (Sept. 2022)
"The explanation of the process of how the committee came to their conclusion regarding the case study was beneficial. I liked the video of presenter along with slides. Made it feel more like an in-person CEU course." L.G. (Sept. 2022)
"Easy to follow and quick. I liked the discussion of ethics regarding the heimlich maneuver." A.S. (Aug. 2022)
"Specific examples of an ethics case - I liked the education and counseling with patients and family." L.M. (Aug. 2022)
"This benefited my practice by: 1. Bioethical principals to be considered by ethics teams. 2. The benefits of having an SLP on the ethics committee. 3. How to assure staff that they are still providing care in comfort care situations." V.M. (Aug. 2022)
"I liked the ability to go back and repeat parts of the lecture. Working at my own pace - flexibility it provides." V.M. (Aug. 2022)
"I appreciated the case history highlighting a very real scenario that I could find myself in while working in acute care and making me think about how consequences of dysphagia may impact the other staff caring for a patient. I felt like the presenter was very knowledgeable and passionate about her involvement in Ethics committee/discussion and overall palliative care/end-of-life input especially regarding dysphagia and that made me want to soak up everything she said and keep listening." E.E. (July 2022)
"I would not have chosen it based on title, but it exceeded my expectations for frank discussion of structure ethical decision making." M.K. (July 2022)
"Great discussion of the role of an ethics committee. I liked all of the course content." A.J. (June 2022)
"All of it was fantastic information – the breakdown of the Ethics Committee and the analysis in which this case study was reviewed. The organization and explanation of the information as well as the analysis and implementation in relation to pt care was good." W.R. (June 2022)
"It was all very informative. Course was easy to understand and follow." D.P. (May 2022)
"Course was easy to follow. I liked how it integrated ethics into multiple environments with case examples." T.M. (May 2022)
"The course was concise. I liked how it went over a specific pt example and what the family wanted." C.L. (May 2022)
"I liked the presenter. Very interesting case involving the ethical decision around using the heimlich." M.C. (May 2022)
"I liked how the case example really illustrated the process of ethical decision making in an ethics consult scenario." J.O. (Apr. 2022)
"The presenter was excellent, concise, and provided an important tool many SLPs may need to incorporate into their practice, especially in LTC facilities." T.W. (Mar. 2022)
"Very informative. I liked the discussion regarding educating staff members on how to proceed with allowing a patient to aspirate with intake." G.G. (Mar. 2022)
"I liked the incorporation of the SLP on an ethics committee, and the functional case study." J.B. (Mar. 2022)
"It explored a unique topic which does come up and haven't seen this type of topic discussed before." K.D. (Jan. 2022)
"I found the idea of knowing if there is an ethics committee in your facility and how to engage them to be eye opening. I was keenly aware of them when I was in a larger acute care rehabilitation center but not in the individual SNFs I frequently work PRN in. I think that some issues that we frequently address on the floor (e.g., carrying out the SLP recommendations by staff members etc.) could be assisted by an ethics committee review so that it becomes an institutional discussion rather than a tug of war on the floor." L.M. (Dec. 2021)
"I really enjoyed the different insight of dysphagia and how SLP can get involved." N.K. (Dec. 2021)
"Amanda was a great speaker and it was very informative. I also liked that I could play this in the car on a trip - as my husband was driving. I listened with headphones and took notes the powerpoint slides. Thank you for truly making your videos mobile!" E.D. (Nov. 2021)
"Consideration for ethical choices with sensitive topics was beneficial for my daily practice. The speaker was engaging and dynamic." D.P. (Oct. 2021)
"Appreciate the case study as a tie in to principals of ethics. . . . and case not dissimilar to those faced at end of life settings (LTC, HH) routinely" M.C. (Sept. 2021)
"The information was very applicable to my work environment." L.G. (Sept. 2021)
"It helped clarify a lot of questions pertaining to ethical issues like in Mr. Z's case." M.D. (Sept. 2021)
"I have seen several children with feeding issues. Some had tubes and others did not. Some with tubes did not appear to need them any longer and other children who were eating very little for a variety of sensory and/or anatomical and/or oral motor reasons and were not evaluated for a tube. This webinar brought up many of the questions I had concerning when to tube and when not to tube a child. The power point presentation was easy to follow. I liked the fact that the presenter did state that watching a person choke to death would be difficult for others to watch." C.D. (Aug. 2021)
"This was truly eye-opening for me. The instructor grabbed my attention from start to finish." P.R. (Aug. 2021)
"The ethical analysis and application to particular case will be beneficial for my daily practice." J.T. (Aug. 2021)
"Great presenter! Engaging, concise but relaxed, not dependent upon slides or handouts for the bulk of the info but as tools for clarification instead." – T.E. (Jun 2021)
"The style of the presentation, by the speaker, was interesting and made it easy to listen to and understand the complex topics discussed."– D.F. (Jun 2021)
"The clarity, organization and relatability of the presenter. Her presentation has encouraged me to think differently about perceived ethical challenges." – R.B. (Jun 2021)
"The entire course was well presented and provided areas for further evaluation/study. The case study was a perfect example for the application of the principles." – C.H. (Jun 2021)
"The case study format with a walk through of the process was really helpful for providing a framework I could utilize at my workplace." – K.M. (Jun 2021)
"It helped me further understand the ethical considerations when dealing with patients who have dysphagia and taking into account their personal autonomy." – B.D. (Jun 2021)
"I found it fascinating to hear how the ethics team worked through the questions and problems and came to their decisions. Having an actual example of such a complex question was extremely helpful." – M.F. (Jun 2021)
Amanda Warren, MS, CCC-SLP, is a medical Speech-Language Pathologist practicing in the city of Boston, MA. She has extensive experience in outpatient, acute care, rehabilitative care, skilled nursing, and home care environments. Amanda teaches at the undergraduate and graduate level in Speech-Language Pathology. She has a special interest in palliative dysphagia management, augmentative communication at the end of life, and patient-family advocacy and education.
Financial — Amanda Warren is presenter online CE courses sponsored by Northern Speech Services; receives royalties.
Nonfinancial — Amanda Warren has no relevant nonfinancial relationships to disclose.
This program is offered for 0.2 ASHA CEUs (Intermediate Level; Professional Area).
ASHA CEUs: NSS online courses are registered with ASHA and are offered for ASHA CEUs. The number of ASHA CEUs is noted above. Note that 0.1 ASHA CEU = 1 contact hour = equals 1 CEE.
ASHA CE Registry: During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.
ASHA CEUs: Attendees must meet at least one of the following conditions in order to be eligible to earn ASHA CEUs:
If an attendee is not an ASHA member or CCC holder but meets any of the above criteria, they may inform the ASHA CE Registry of their eligibility by visiting this site.
Licensing Boards: Most state licensing boards DO accept CEUs earned online (usually classified as home-study credits). Some state boards do, however, place a limit to the number of credits that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any credit limits related to home-study courses prior to registering for this course.
Additional accrediting agencies by which Northern Speech is an approved CE provider:
Course Completion Timeframe:
You have unlimited time to complete our online courses. You may log off and log on as often as you’d like to in order to complete all sections of a course.
However, completion dates are based on Eastern Standard Time. Therefore, if you need your CEUs by a certain date, be sure to complete the course test before 11:59pm EST on that date. For example, if you need CEUs before January 1st, you will need to complete the course test before 11:59pm EST on December 31st.
Access to course materials and content does not expire, even after completing the post test. You may continue to review course material by logging into your NSS account, clicking the My Online Courses tab, and then viewing your desired course.
Certificate of Completion:
On successful completion of the post test (80%), a certificate will be immediately available for download and/or printing. This certificate will include your name, date of completion (based on Eastern Time Zone, USA/Canada), and number of contact hours (CEUs / CEEs). Please note that CEUs are awarded on the date of successful test completion, not the date of course enrollment. Please ensure that you successfully complete the post test prior to any licensure renewal dates.
ASHA CE Registry Submission:
During the enrollment process, if you select to receive ASHA credit for this course and if you provide your ASHA number, NSS will automatically submit your CEU information to the ASHA CE Registry after successful course completion (80% on post test). This submission happens once per month, during the first week of the month. For example, if you complete your course on November 7th, NSS will submit all November online course CEUs to ASHA during the first week of December. When ASHA inputs the information into their database, they will mark the course as completed on the last day of the month in which it was completed, so November 30th using this example. The certificate of completion available for you to print immediately, however, will reflect the actual completion date, November 7th in this example. Due to ASHA processing procedures please allow 2-3 weeks, from the submission date, for the course to appear on your ASHA transcript.
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What is an Online Course?
Our Online Courses consist of video, audio, and/or text content and are offered for ASHA CEUs. Unlike a webinar, which requires participants to be logged on and at a computer at specific times, our Online Courses are available to you at any time, from any device, via your NorthernSpeech.com online account. You may work at your own pace and start and stop your course as you wish. Your course will conclude with a short post test. On successful completion of the post test (>80%), a printable certificate of completion is presented to you.
Northern Speech is an ASHA CE Provider and our online courses are registered with ASHA and offered for ASHA CEUs. Please note that successful completion of the online post test is required prior to the awarding of CEUs. Please contact your state licensing board for acceptance policies related to CEUs earned online. Please note that courses offered for university students are not applicable for CEUs.
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You may browse all online courses by clicking the Continuing Education tab above, then Online Courses. Once you find a course, click Enroll Now, and you will be asked to either log into your existing Northern Speech account or create a new online account. Once you’ve entered your account information and provided your credit card payment, your course will be immediately available to you.
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You will be able to access your online course by logging into your Northern Speech account and then clicking the My Online Courses tab on your profile screen. Click the course you would like to start or to resume. From there, proceed through the course sections until you are ready to complete the post test. You do not have to complete your course all at once. You may log on and off as you wish.
Each online course concludes with a post test consisting of multiple choice or true & false questions. Scores of 80% or greater are required for successful course completion and awarding of CEUs. You may revisit course materials and retest as needed to achieve a passing score.
Number of CEUs offered:
We offer courses from 1 to 21 contact hours. Each course will note the number of CEUs offered. Please note that 0.1 CEU = 1 contact hour = 1 CEE.
State licensing boards and online CEUs:
NSS is an ASHA CE Provider and most state licensing boards DO accept ASHA CEUs earned online (usually classified as home-study credits). Some boards do, however, place a limit to the number of CEUs that can be earned via home study/online courses. For the most current information, we suggest that you contact your licensing board or agency to verify acceptance policies and/or any CEU limits related to home-study courses prior to enrolling in an online course.
Our course formats include: text, audio, video, and PowerPoint with author narration. Each course will note the format on the course description page. Most courses include closed captioning.
Most of our online courses provide a link to download the accompanying handout as a PDF file.
Groups of 3 or more are eligible for a 20% discount on each registration on most of our online courses. To receive this discount, registrations need to be processed together via the "Group Rates" tab on the Online Course of your choice.
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Course Cancellation Policy:
A purchased online course can be exchanged, refunded, or transferred to another individual if contact is made with NSS (via phone or email) within 30 days of purchase and the course materials have not been viewed or downloaded.
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