Discharging to the Street: When Patients Refuse Medically Safer Options.
J Clin Ethics
; 33(2): 92-100, 2022.
Article
en En
| MEDLINE
| ID: mdl-35731813
ABSTRACT
The ethical obligation to provide a reasonably safe discharge option from the inpatient setting is often confounded by the context of homelessness. Living without the security of stable housing is a known determinant of poor health, often complicating the safety of discharge and causing unnecessary readmission. But clinicians do not have significant control over unjust distributions of resources or inadequate societal investment in social services. While physicians may stretch inpatient stays beyond acute care need in the interest of their patients who are experiencing homelessness, they must also consider the implications of using an inpatient hospital bed for someone without the attendant level of medical need. Caring for patients in an inpatient setting when they no longer require acute care means fewer beds for acute care patients. And when a patient who is experiencing homelessness declines a medically safer option such as a skilled nursing facility, then clinicians may be faced with the sole option of discharge to the street, which raises troubling questions of nonmaleficence and social justice. Here we investigate the different forms of injustice that play out when patients are discharged to the street, and offer a map of the interwoven ethical responsibilities of clinicians, hospitals, and skilled nursing facilities.
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Bases de datos:
MEDLINE
Asunto principal:
Alta del Paciente
/
Instituciones de Cuidados Especializados de Enfermería
Tipo de estudio:
Observational_studies
Límite:
Humans
Idioma:
En
Revista:
J Clin Ethics
Asunto de la revista:
ETICA
Año:
2022
Tipo del documento:
Article