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Reply by Aroskar to Wightman on "Administrative Ethics: Perspectives on Patients..."

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May 4, 1999

Reply by Author to letter to the editor by Wightman on Administrative Ethics: Perspectives on Patients and Community-Based Care by Mila Ann Aroskar (Dec. 31, 1998)

Dr. Aroskar's response:

Thanks for your response. You bring up the important problem of the "revolving door" that affects patient population groups in different ways and for different reasons, e.g., respect for patient/family autonomy and decision making, short in-patient stays based more on consideration of financial costs than patient needs. In response to the letter writer's proposal, I suggest the development of forums in senior centers, adult day care, nursing home residents' councils, and assisted living settings with patients/residents, family members, and staff for the purpose of discussion and suggestions about how to handle this issue - practice of "preventive ethics". This is a broader issue of organizational ethics, including institutional and public policies about healthcare funding and service delivery in which a hospital ethics committee could be involved.

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