Navigating ethical discharge planning: A case study in older adult rehabilitation.
BACKGROUND
Ethical issues are becoming more complex as individuals live longer with increased disability and medical needs. This article elucidates common ethical issues encountered in discharge planning with older adults.


METHODS
We conducted normative ethical analysis of a clinical case using methods of philosophical inquiry, including thick description, reflexivity, conceptual clarification and examination of competing arguments for internal consistency.


RESULTS
The analysis demonstrates how health-care teams struggle to balance protection from harm while honouring informed choices. We argue that ethical discharge planning requires judicious identification of client values, even if these conflict with team determinations of best interests.


CONCLUSIONS
Dialogue is needed to identify risks, help clients determine their personal level of acceptable risk and determine provisions to minimise risks.
Durocher
Evelyne
E
Graduate Department of Rehabilitation Sciences, Collaborative Program in Bioethics, University of Toronto, Toronto, Ontario, Canada. evelyne.durocher@utoronto.ca
Gibson
Barbara E
BE
D000369:Aged, 80 and over; D026686:Beneficence; D002170:Canada; D003657:Decision Making; D026689:Ethical Analysis; D006801:Humans; D008297:Male; D016743:Mental Competency / Q000592:standards*; D010351:Patient Discharge / Q000592:standards*; D057240:Patient Preference; D026684:Personal Autonomy; D011788:Quality of Life; D012047:Rehabilitation Centers / Q000941:ethics* / Q000458:organization & administration; D012449:Safety; D012944:Social Support