{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T21:19:54Z","timestamp":1777929594017,"version":"3.51.4"},"reference-count":30,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T00:00:00Z","timestamp":1588636800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Nurs Ethics"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:p>Discharging a homeless patient from hospital raises ethical issues which are compounded when the patient is from outside the United Kingdom. This article begins with an extended case study of a 30-year-old homeless man from Lithuania describing his complex medical and social needs. It is best practice for all homeless patients to have their housing needs planned for prior to discharge, but this is made more difficult by the United Kingdom\u2019s \u2018hostile environment\u2019 policy which creates a subclass of homeless people who are not eligible for support. This means healthcare professionals discharge patients back to homelessness, even when this is likely to adversely affect their health and dignity both directly and indirectly through impairing access to care for chronic conditions. Policies in health and social care which compel professionals to treat some patients with second-class care undermine the ethics of healthcare professions.<\/jats:p>","DOI":"10.1177\/0969733020912518","type":"journal-article","created":{"date-parts":[[2020,5,5]],"date-time":"2020-05-05T07:59:01Z","timestamp":1588665541000},"page":"1355-1363","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Discharge policies for homeless people and immigrants: Compromising professional ethics"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6022-2260","authenticated-orcid":false,"given":"Nathan","family":"Hodson","sequence":"first","affiliation":[{"name":"Harvard T.H. Chan School of Public Health, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rose","family":"Glennerster","sequence":"additional","affiliation":[{"name":"St Christopher\u2019s Hospice, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2020,5,5]]},"reference":[{"key":"bibr1-0969733020912518","unstructured":"National Health Service (Charges to Overseas Visitors) Regulations 2015."},{"key":"bibr2-0969733020912518","unstructured":"Medical Act 1983."},{"key":"bibr3-0969733020912518","unstructured":"The Code\n                      . Nursing and Midwifery Council, 29 January 2015, https:\/\/www.nmc.org.uk\/globalassets\/sitedocuments\/nmc-publications\/nmc-code.pdf"},{"key":"bibr4-0969733020912518","unstructured":"Good medical practice. General Medical Council, 25 March 2013, p. 65, https:\/\/www.gmc-uk.org\/-\/media\/documents\/good-medical-practice-english-20200128_pdf-51527435.pdf?la=en&hash=DA1263358CCA88F298785FE2BD7610EB4EE9A530"},{"key":"bibr5-0969733020912518","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61132-6"},{"key":"bibr6-0969733020912518","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31869-X"},{"key":"bibr7-0969733020912518","first-page":"382","volume":"93","author":"Story A","year":"2013","journal-title":"Lancet"},{"key":"bibr8-0969733020912518","unstructured":"Deloitte. Healthcare for the homeless: homelessness is bad for your health, pp. 1\u201332. https:\/\/www2.deloitte.com\/uk\/en\/pages\/life-sciences-and-healthcare\/articles\/healthcare-for-the-homeless.html"},{"key":"bibr9-0969733020912518","unstructured":"Office of the Chief Analyst. Healthcare for single homeless people. Department of Health, London, March 2010, p. 44."},{"key":"bibr10-0969733020912518","unstructured":"Homeless Link. Support for homeless people in England: annual review 2015, 2015, https:\/\/www.homeless.org.uk\/sites\/default\/files\/site-attachments\/Full%20report%20-%20Single%20homelessness%20support%20in%20England%202015.pdf"},{"key":"bibr11-0969733020912518","unstructured":"Improving hospital admission and discharge for people who are homeless, 2011, https:\/\/www.homeless.org.uk\/sites\/default\/files\/site-attachments\/hospital_admission_and_discharge._reportdoc.pdf"},{"key":"bibr12-0969733020912518","unstructured":"Homeless Link. Evaluation of the homeless Hospital discharge fund, January 2015, https:\/\/www.homeless.org.uk\/sites\/default\/files\/site-attachments\/Evaluation%20of%20the%20Homeless%20Hospital%20Discharge%20Fund%20FINAL.pdf"},{"key":"bibr13-0969733020912518","unstructured":"Homelessness Reduction Act 2017."},{"key":"bibr14-0969733020912518","unstructured":"White J, Maguire E. Rough sleeping statistics Autumn 2018, England (revised). Ministry of Housing, Communities and Local Government, 25 February 2019, https:\/\/assets.publishing.service.gov.uk\/government\/uploads\/system\/uploads\/attachment_data\/file\/781567\/Rough_Sleeping_Statistics_2018_release.pdf"},{"key":"bibr15-0969733020912518","unstructured":"Shelter Legal. Persons ineligible for assistance, https:\/\/england.shelter.org.uk\/legal\/homelessness_applications\/eligibility_eeaeu_nationals\/Persons_ineligible_for_assistance"},{"key":"bibr16-0969733020912518","unstructured":"Garvie D. Homelessness Reduction Act 2017 policy and practice briefing. Shelter, April 2018, https:\/\/england.shelter.org.uk\/__data\/assets\/pdf_file\/0007\/1494871\/Homelessness_HRA17_Implementation_Briefing_FINAL.pdf"},{"key":"bibr17-0969733020912518","doi-asserted-by":"crossref","unstructured":"Immigration Act 2014, s38 and s39.","DOI":"10.1016\/j.niox.2014.03.126"},{"key":"bibr18-0969733020912518","unstructured":"Immigration Act 2014, 2015 amendments."},{"key":"bibr19-0969733020912518","unstructured":"The Immigration (European Economic Area) Regulations 2016."},{"key":"bibr20-0969733020912518","unstructured":"The Allocation of Housing and Homelessness (Eligibility) (England) (Amendment) Regulations 2014 s6b(i)."},{"key":"bibr21-0969733020912518","unstructured":"Harrison H. Charities call on government to fix \u00a31bn hole in homelessness services. Homeless Link, 24 April 2019, https:\/\/www.homeless.org.uk\/connect\/news\/2019\/apr\/24\/charities-call-on-government-to-fix-%C2%A31bn-hole-in-homelessness-services"},{"key":"bibr22-0969733020912518","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp19X705581"},{"key":"bibr23-0969733020912518","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2019-105634"},{"key":"bibr24-0969733020912518","unstructured":"Social Care Institute for Excellence. SCIE guide 15: dignity in care, May 2013, scie.org.uk\/publications\/guides\/guide15\/"},{"key":"bibr25-0969733020912518","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2524.2000.00270.x"},{"key":"bibr26-0969733020912518","unstructured":"Office of National Statistics. Deaths of homeless people in England and Wales: 2013 to 2017, https:\/\/www.ons.gov.uk\/peoplepopulationandcommunity\/birthsdeathsandmarriages\/deaths\/bulletins\/deathsofhomelesspeopleinenglandandwales\/2013to2017"},{"key":"bibr27-0969733020912518","unstructured":"The Equality Act 2010."},{"key":"bibr28-0969733020912518","doi-asserted-by":"publisher","DOI":"10.1002\/bs.3830010402"},{"key":"bibr29-0969733020912518","unstructured":"Parker J. Moral injury and burnout are not the same. BMJ Opinion, 6 June 2019, https:\/\/blogs.bmj.com\/bmj\/2019\/06\/06\/joshua-parker-moral-injury-and-burnout-are-not-the-same\/"},{"key":"bibr30-0969733020912518","doi-asserted-by":"crossref","unstructured":"Festinger L. A theory of cognitive dissonance. Stanford, CA: Stanford University Press, 1957, pp. 1\u20134.","DOI":"10.1515\/9781503620766"}],"container-title":["Nursing Ethics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0969733020912518","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/0969733020912518","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/0969733020912518","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T23:42:27Z","timestamp":1777678947000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/0969733020912518"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,5]]},"references-count":30,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["10.1177\/0969733020912518"],"URL":"https:\/\/doi.org\/10.1177\/0969733020912518","relation":{},"ISSN":["0969-7330","1477-0989"],"issn-type":[{"value":"0969-7330","type":"print"},{"value":"1477-0989","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,5]]}}}