Navigating ethical discharge planning: A case study in older adult rehabilitation


  • Evelyne Durocher MOT, OT Reg (Ont); Doctoral Student. Barbara E. Gibson PhD, PT; Assistant Professor.

Evelyne Durocher, Graduate Department of Rehabilitation Sciences, University of Toronto, 160-500 University Avenue, Toronto, ON M5G 1V7, Canada. Email:


Background:  Ethical issues are becoming more complex as individuals live longer with increased disability and medical needs. This article elucidates common ethical issues encountered in discharge planning with older adults.

Methods:  We conducted normative ethical analysis of a clinical case using methods of philosophical inquiry, including thick description, reflexivity, conceptual clarification and examination of competing arguments for internal consistency.

Results:  The analysis demonstrates how health-care teams struggle to balance protection from harm while honouring informed choices. We argue that ethical discharge planning requires judicious identification of client values, even if these conflict with team determinations of best interests.

Conclusion:  Dialogue is needed to identify risks, help clients determine their personal level of acceptable risk and determine provisions to minimise risks.