Tough Choices in Home-based Care
Discussions of bioethics typically focus on care in the hospital, while ethical conflicts occur in all settings. For families and community-based organizations, there are frequent ethical conflicts in home-based health care. These include: whether a frail or disabled person can return or remain at home, whether driving or other activities should be permitted and who is responsible for providing needed care.
This presentation offered some basic principles and approaches to ethical issues in home care. Those attending were asked to discuss a number of actual cases. This seminar was designed for families providing elder care and health care professionals in all settings.
Edward Ratner, MD, Associate Professor of Medicine, Division of General Internal Medicine, University of Minnesota; Affiliate Faculty, Center for Bioethics, University of Minnesota | Dr. Ratner received his undergraduate degree from Carleton College. Medical school and residency training in Internal Medicine were at University of Chicago and affiliate hospitals. Post-residency training in Geriatric Medicine has included the Harvard's Geriatric Education Center, the Home Medicine Program at Boston University, and the University of Minnesota's Internal Medicine Geriatric Fellowship. His clinical practice currently focuses on care in the home, on behalf of the Spinal Cord Injury and Disorders Program of the Minneapolis VA Medical Center. He serves on the Graduate faculty in three programs: Bioethics, Gerontology and Health Informatics. Research and teaching interests include bioethics, home care, interprofessional education, end of life care, and ALS. His current projects include an AHRQ funded study of decision aids in advance care planning, development of a statewide POLST form and creation of service learning opportunities for medical and other graduate students.