Ethical Issues- Caregivers & Ethics: The Discharge Plan

Panelists:

Casey Kohler, MD,FACS

The MetroHealth System

Marcie Lambrix, MA, HEC-C
Case Western Reserve University

Hospital discharge is often viewed as a patient-centered decision, but the ethical impact on family caregivers is frequently overlooked. When patients choose to return home, caregivers may assume complex medical, emotional, administrative, and financial responsibilities, often without fully understanding what that role entails or freely consenting to it. This presentation explores the ethical challenges of discharge planning through a critical lens that focuses on the four pillar principles: autonomy, beneficence, non-maleficence, and justice. It examines how caregiver well-being is directly linked to patient outcomes, highlighting the “triple burden” of caregiving, including moral stress, administrative responsibility, and financial impacts. Using case studies, this session explores whether current discharge practices adequately support informed caregiver participation, and proposes practical strategies to better integrate caregivers early in the hospitalization process in order to create safer, more sustainable, and ethically sound discharge plans.

By the end of this session, participants will be able to:

1. Describe the ethical tensions that arise when patient discharge preferences conflict with caregiver capacity, safety, and well-being.

2. Examine how caregiver burden and relational autonomy challenge traditional approaches to informed consent in discharge planning.

3. Apply evidence-based discharge strategies, including Project RED, to support ethically sustainable transitions of care.