New ACP position paper addresses ethics in long-term care

A new paper from the College sheds light on the ethical challenges and systemic flaws in long-term care in the United States, urging a fundamental shift toward patient-centered, equitable, and accountable care. “Optimizing Ethical Care, Quality, and Safety in Long-Term Services and Supports: A Position Paper from the American College of Physicians,” was published May 6 by Annals of Internal Medicine.

The paper notes that long-term care, including nursing homes, assisted living facilities, home-based services, and hospice, are essential for individuals who are unable to care for themselves due to chronic conditions, cognitive decline, or functional limitations. Despite its importance, the system suffers from inadequate staffing, inconsistent oversight, and unsustainable business models that often prioritize profits over patient well-being, ACP said.

The paper emphasizes that systemic problems have been exacerbated by the COVID-19 pandemic, which revealed significant weaknesses in infection control, transparency, and oversight across care facilities.

To address this, the paper calls for ethical, evidence-based use of resources, respect for patient dignity and autonomy, advancement of health equity, and greater transparency and accountability in long-term care.