May 4, 1999
Reply by Author to on by Mila Ann Aroskar (Dec. 31, 1998)
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.
