Difficult Discharge

It is Thursday afternoon.  You receive a call from one of the hospital Discharge Planners, Zahra.  Zahra requests your assistance with decision making about a patient named Mr. Roberts. She provides you with a summary of what has happened since Mr. Roberts was admitted to the hospital six weeks ago. Zahra explains that Mr. Roberts is an 83 year old who police brought to the hospital six weeks ago. The police had received a call about an elderly man walking back and forth on the same street over the course of two hours during a snowstorm, without a winter coat or boots.  The police told the Emergency Department staff that Mr. Roberts was unable to tell them his address, and that he appeared disoriented and confused. Mr. Roberts was admitted to hospital with a urinary tract infection (UTI), delirium, and ‘failure to thrive.’ Dr. Suleman identifies and contacts Mr. Roberts’ substitute decision makerDr. Suleman was Mr. Roberts’ physician on admission to the...
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Money, Money, Money

The ethics committee has received a request to review a donation proposed by a local oil company. The proposed donation is substantial, and your organization would be able to use the money to improve access to primary care providers, which meets a significant need in the community. The organizational values for your organization are respect, stewardship, excellence, person-centered care, and trust. A key strategic direction is responding to primary health needs in communities. The oil company would like its name on a new primary care clinic and is willing to set up an endowment to support hiring health care providers to staff the clinic. In this case, there are concerns about accountability, which center on the motivation behind the donation and what the oil company hopes to gain by making it. Some feel strongly that the organization’s integrity is significantly diminished by accepting the money, and believe that it is too high a price to pay. Others acknowledge concerns about transparency, but focus on how...
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