title: Complex discharges and undocumented patients: growing ethical concerns.
abstract: A growing number of discharges at acute-care hospitals involve patients who are undocumented and lack legal status. Because such patients are ineligible for public assistance, long-term care facilities will routinely deny them admission. These discharges become complex discharges because of such financial barriers. If local family support is unavailable, discharging such patients to a safe and suitable location becomes increasingly difficult. These complex discharges implicate a number of ethical principles. We describe such complex discharge cases, apply various ethical frameworks, and call for potential policy solutions to address this growing ethical concern.
authors.affiliation: Neiswanger Institute for Bioethics, Loyola University, Chicago Stritch School of Medicine, Maywood, Illinois, USA. kparsi@lumc.edu
authors.forename: Kayhan
authors.initials: K
authors.lastname: Parsi
authors.forename: Nina
authors.initials: N
authors.lastname: Hossa
mesh_terms: D000062:Accidents, Occupational; D026690:Ethics, Clinical; D004991:Ethics, Institutional; D017408:Guidelines as Topic; D006801:Humans; D019458:Insurance Coverage / Q000941:ethics*; D007348:Insurance, Health / Q000941:ethics*; D008134:Long-Term Care / Q000191:economics / Q000941:ethics; D008297:Male; D017057:Medically Uninsured; D028681:Moral Obligations; D019838:Neck Injuries / Q000150:complications / Q000209:etiology; D009735:Nursing Homes / Q000191:economics / Q000941:ethics; D010351:Patient Discharge / Q000592:standards; D011640:Public Policy; D011782:Quadriplegia / Q000209:etiology; D012121:Respiration, Artificial; D014171:Transients and Migrants; D014481:United States; D055815:Young Adult