Harvard T.H. Chan School of Public Health, USA.
St Christopher's Hospice, UK.
Nurs Ethics. 2020 Aug;27(5):1355-1363. doi: 10.1177/0969733020912518. Epub 2020 May 5.
Discharging a homeless patient from hospital raises ethical issues which are compounded when the patient is from outside the United Kingdom. This article begins with an extended case study of a 30-year-old homeless man from Lithuania describing his complex medical and social needs. It is best practice for all homeless patients to have their housing needs planned for prior to discharge, but this is made more difficult by the United Kingdom's 'hostile environment' policy which creates a subclass of homeless people who are not eligible for support. This means healthcare professionals discharge patients back to homelessness, even when this is likely to adversely affect their health and dignity both directly and indirectly through impairing access to care for chronic conditions. Policies in health and social care which compel professionals to treat some patients with second-class care undermine the ethics of healthcare professions.
将无家可归的患者从医院出院会引发伦理问题，而当患者来自英国境外时，这些问题会更加复杂。本文首先通过对一名来自立陶宛的 30 岁无家可归男子的详细案例研究，描述了他复杂的医疗和社会需求。最好的做法是，所有无家可归的患者在出院前都要为他们的住房需求做好计划，但英国的“敌对环境”政策使这变得更加困难，该政策创造了一类无家可归者，他们没有资格获得支持。这意味着医疗保健专业人员将患者送回无家可归的状态，即使这可能直接或间接地通过损害他们获得慢性疾病护理的机会，对他们的健康和尊严产生不利影响。迫使专业人员对某些患者进行二等护理的卫生和社会保健政策破坏了医疗保健专业的伦理规范。
