Describe an ethical approach to ending a therapeutic relationship with a patient (discharge) when safety concerns exist.

• A. Discharge immediately without explanation.
• B. Discharge and abandon care.
• C. Terminate the relationship when safe; no further action.
• D. Communicate clearly, ensure continuity of care, protect patient privacy, document rationale, and involve ethics or legal guidance if needed.

Answer: (D)

Ending a therapeutic relationship when safety concerns exist requires a planned, patient-centered approach that protects the patient and ensures a safe transition to ongoing care. The best approach is to terminate the relationship in a deliberate way: communicate clearly about the reasons for discharge, arrange for continuity of care with another qualified clinician or appropriate services, protect the patient’s privacy during the transition, document the rationale and all actions taken, and involve ethics or legal guidance if needed. This aligns with professional duties to prevent harm, respect autonomy, and promote safety, while avoiding abandonment or abrupt endings. Discharging without explanation, abandoning care, or ending the relationship without a plan would undermine safety and trust, whereas a thoughtful, well-documented process with proper referrals and safeguards serves the patient best.