A model for organizing an ethical analysis of the discharge planning process

This paper presents a model for identifying, clarifying and analyzing the ethical dilemmas inherent in the discharge planning process of the chronically impaired older person from an acute care hospital to the community or an institution. From the myriad of moral quandaries that patients, families and service providers face in the process, this paper will address two categories of questions. The first concerns the conflict between provider paternalism and client autonomy. The second question involves distributive justice and the allocation of scarce resources. Two cases at different stages of the identification, assessment and disposition process will be examined in order to identify the morally relevant facts and persons, possible alternatives and competing values and ethical principles.