Ethics dying at home

Death at home has become Increasingly common. End of life care at home creates ethical challenges that are very different from those encountered in the hospital or nursing home. Geographic disparities in rates of death at home raise ethical issues related to access 10 care. Home health agencies and communities make decisions, possibly ethically based, regarding investments in home-based end of life care and hospice versus other types of care. In the home setting, clinicians can be ethically challenged by the degree to which patients and families control care. Home care providers face refusal of care, limited control over use of opioid analgesics, and suicide. This article describes these ethical issues and principles that can help address them.