A 30-year-old female patient was admitted to the mental health unit of your hospital. She was brought in as a social admission, requiring minimal acute medical care. She has a rare genetic disorder and borderline personality disorder (she is dually diagnosed). As a result of these conditions, she is physically and verbally abusive to staff and has many no-contact orders with the nurses who work on the floor. In order to keep the staff safe, this patient is placed in a secluded room, where only certain staff members can provide care. Additionally, she has community mental health workers come in for 4 hours per day. She is not permitted to leave the room to go outside, or to walk around the floor.

The patient is irritated, and her conditions are getting worse, presumably because of the seclusion. Many staff are experiencing distress, labelling this environment as a restraint, and are asking questions about whether this patient should continue to be "housed" at the hospital.

Because of the complaints, her physicians medically cleared her, and have instructed the social workers to begin discharge planning. However, this patient does not have a permanent home, and many of the group homes will not take her. She has no good place to go.

In addition to this concern, hospital management has gotten involved, wondering about the 'least restraints' policy and whether it should apply to these types of situations.

What kind of ethical decision-making framework should be developed and how do we go about solving this problem for the patient, and for other similar ones going forward?