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"Doc, I'm Going for a Walk": Liberalizing or Restricting the Movement of Hospitalized Patients-Ethical, Legal, and
David Alfandre1,2,3, Sara Stream4,5, Cynthia Geppert6,7
1VA National Center for Ethics in Health Care, US Department of Veterans Affairs, Washington, DC, USA. david.alfandre@va.gov.
Abstract:
When patients are admitted to the hospital, they are generally expected to remain in or within close proximity to their assigned rooms in order to promote their safety and appropriate medical care. Although there are circumstances when patients may safely leave their hospital room or floor, guidance within the medical literature for the management of patient movement within the hospital are lacking. Excessive restrictions on patient movement may be seen as overly paternalistic, while lax requirements may interfere with high quality care, patient safety and efficient hospital practice. As a result, guidance in the form of institutional policy is warranted. Such policy development should take into consideration the potential clinical, legal, and ethical concerns in balancing the competing values of patients' preferences and respect for autonomy, while ensuring high quality, safe, and efficacious medical care. This paper will provide a framework for hospitals to create institution-specific patient movement policies that are fair, systematic, and transparent.
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