Ethical Decision Making Regarding a Common Home Care Issue: Homebound Status

Abstract

Medicare’s homebound regulation continues to present ethical dilemmas for clinicians faced with the limitations it imposes for clients in need of health care services. This article applies ethical theory and the principles of veracity, beneficence, nonmaleficence, justice, autonomy, and fidelity to the issue. A variety of strategies home care agencies can use to address ethicalissues are discussed. The use of an ethicaldecision-making modelto assist clinicians in reaching appropriate decisions is described and applied to a case study. The importance of addressing deficits in the home care system, as opposed to manipulation of the regulation to meet individual patient need, is recommended.