Ethical Issues in Mobile Psychiatric Treatment with Homebound Elderly Patients: The Psychogeriatric Assessment and Treatment in City Housing Experience

Authors: Blass, David M.; Rye, Rebecca M.¹; Robbins, Beatrice M.²; Miner, Mary M.²; Handel, Sharon³; Carroll, John L.²; Rabins, Peter V.

Source: Journal of the American Geriatrics Society, Volume 54, Number 5, May 2006 , pp. 843-848(6)

Publisher: Wiley-Blackwell

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Abstract:

Unique and challenging ethical difficulties arise during mobile psychiatric treatment of elderly patients. This article outlines and analyzes five of these challenges that have been encountered during nearly 20 years of experience with the Psychogeriatric Assessment and Treatment in City Housing Program in Baltimore, Maryland. The ethical challenges reviewed are: establishing the treatment contract versus the right to refuse treatment, protecting confidentiality versus patient protection, protecting autonomy versus asserting beneficence, treatment termination versus open-ended treatment, and cost versus benefit of care. Ethical challenges with homebound elderly patients are unique because of patient characteristics as well as features of the treatment environment.

Keywords: psychiatric home care; ethics; mobile treatment; geriatric psychiatry

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1532-5415.2006.00706.x

Affiliations: 1: Johns Hopkins Hospital, 2: Johns Hopkins Bayview Medical Center, and Departments of 3: Department of Psychiatry and Behavioral Sciences,

Publication date: 2006-05-01