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Sinai Health Bioethics Grand Rounds: An Approach to Working with At-Risk Patients Expressing a Desire for Discharge | Virtual
November 9, 2023 @ 12:00 pm - 1:00 pm
Speakers:
Jordan Pelc, MD, MSc, CCFP
Jesstina McFadden, BKin, LLB (JD)
Omar Ghaffar, MD, MSc, FRCPC
Rosanna Macri, MHSc, AccIM, Q.Med, CHE
Abstract:
There is literature on patients leaving against medical advice (AMA). The topic for this session is distinct. We will focus on situations where clinical teams identify “risky discharges,” i.e., for patients who are medically stable but still have care needs that are challenging to meet perfectly on discharge. Many of these patients have some degree of cognitive impairment. These situations can involve legal and ethical issues. Across Canada, there is a lack of guidance for clinicians when at-risk patients seek premature discharge before their inpatient treatment is complete and necessary community supports are in place.
Objectives:
· To describe legal and ethical challenges with cognitively-impaired patients expressing a desire to leave hospital
· To provide a decision support tool that can facilitate decision making in accordance with legal and ethical principles
· To demonstrate the use of the tool in a clinical case scenario
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