Dysphagia, or difficulty swallowing, is a relatively common consequence fol
lowing stroke, with most sources quoting rates of around 40%. The percentag
e of stroke patients who require tube feeding for nutritional support varie
s quite widely, with studies quoting rates in the acute phase from 8.5% to
29%. Since stroke patients are likely to constitute a high percentage of pa
tients on a neurology or rehabilitation ward, neurologists and physiatrists
are likely to be confronted with the sometimes challenging decision of whe
ther and when to commence tube feeding and whether and when to discontinue
it after it has begun. This decision-making process is likely to involve me
dical, ethical and legal considerations and the main purpose of this paper
is to review these considerations and provide some practical recommendation
s.