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.
Reply by Aroskar to Wightman on "Administrative Ethics: Perspectives on Patients..."
May 04, 1999