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Y​‌‍‍‍‌‍‌‍‍‍‌‌‌‍‌‌‌‌‌‌​ou are a social worker employed in a geriatric care unit

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Y​‌‍‍‍‌‍‌‍‍‍‌‌‌‍‌‌‌‌‌‌​ou are a social worker employed in a geriatric care unit of a local hospital. Several times during the past year, the hospital admitted Arnold S., a retired taxi driver, for a number of medical problems including end-stage renal disease, for which he receives kidney dialysis three times each week. Because of his complicated medical condition, he is on multiple medications that he frequently confuses or does not take. Arnold’s partner and caretaker died a year ago. He has no other family and lives alone in a basement apartment. His frequent hospitalizations are a direct result of his inability to take his medications correctly and to care for himself properly, despite efforts to provide him with in-home care. The issue is not financial; the 2010 Affordable Care Act (ACA) now covers many of the services he requires (Gorin & Moniz, 2019). The hospital is under increasing pressure to limit its in-patient population. Not only is such care more expensive, but under the ACA, the hospital’s readmission rates and measures​‌‍‍‍‌‍‌‍‍‍‌‌‌‍‌‌‌‌‌‌​ of patient outcomes affect its overall funding. The recent pandemic has strained the hospital’s resources to the breaking point. There is considerable interest, therefore, in finding alternative ways to address Arnold’s problems, although neither the ACA nor the NASW Code of Ethics provide specific ethical guidelines in this regard (Graber & O’Brien, 2019; McCoy, 2018; Vecchione, 2012). During his last hospitalization, Arnold confides in you and several of your colleagues that he enjoys being in the hospital because it provides him with what he needs most: people who care for him and about him. You get the distinct impression that Arnold’s failure to take his medications correctly may be, at least in part, deliberate in order to require readmission to the hospital. How would you respond to Mr. S.? On what ethical principles would you base your response? What are the conflicting ethical duties in this situation? What approach would you use to decide a course of action? What personal values influence y​‌‍‍‍‌‍‌‍‍‍‌‌‌‍‌‌‌‌‌‌​our response?

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