Opinion | Ethics Consult: Allow Co-Ed Hospital Room?

Welcome to Ethics Consult — an opportunity to discuss, debate (respectfully), and learn together. We select an ethical dilemma from a true, but anonymized, patient care case. You vote on your decision in the case and, next week, we’ll reveal how you all made the call. Bioethicist Jacob M. Appel, MD, JD, will also weigh in with an ethical framework to help you learn and prepare.

The following case is adapted from Appel’s 2019 book, Who Says You’re Dead? Medical & Ethical Dilemmas for the Curious & Concerned.

St. Dymphna’s Hospital is a small 120-bed hospital serving a predominantly rural population. Phil brings his elderly aunt Jenny to the emergency room after she suffers shortness of breath. She is diagnosed with pneumonia and told she will be admitted to the hospital as soon as a bed becomes available. Forty-eight hours later, on Sunday night, she is still waiting in the crowded emergency room, because the hospital is reportedly full.

Phil is a vigilant observer, and he notes that his aunt has been waiting longer than any other patient. He overhears one of the senior nurse managers, Ms. Rached, on the phone discussing the “bed situation.” She says: “They’re telling me we have an open bed for a male patient, but none for any female patients until someone is discharged.” Phil approaches the nurse manager and says, “My aunt is 92 years old and very ill. I don’t care if she’s in a room with a man or a woman. We’ll just draw the curtain. I want the first bed available.” The nearest other hospital with available beds is more than 6 hours away by ambulance.

No law prevents Ms. Rached from admitting a female patient to a double room already occupied by a male patient. However, in practice, the hospital has never allowed “co-ed” hospital rooms before, and, since it is Sunday night, Ms. Rached is the highest-ranking administrator on-site. She calls upstairs and learns that the male patient in the room with the available bed is a 91-year-old double amputee in a coma. No family is involved in his care.

Jacob M. Appel, MD, JD, is director of ethics education in psychiatry and a member of the institutional review board at the Icahn School of Medicine at Mount Sinai in New York City. He holds an MD from Columbia University, a JD from Harvard Law School, and a bioethics MA from Albany Medical College.

Check out some of our past Ethics Consult cases:

Let Patient Pray Pneumonia Away?

Perform Involuntary C-Section on Model?

Allow Ineligible Medicaid Recipient to Receive Novel Drug?