Restraints Legal and Ethical Issues

The protection and safety of the user of the service is of paramount importance and includes: legal considerations on professional diligence and consent; political issues of advocacy and power; Human rights; and ethical principles. Restraint can be used physically, through medication, or through more subtle means. A person`s attempt to detain another person is legally justified in limited situations, such as to prevent a person from committing a crime. In other circumstances, deference cannot be justified. From a legal and moral perspective, it is important to ensure that nursing practice is not associated with unjustified restrictions. This article focuses on restraint in a care setting for the elderly, highlighting the complexity of situations where restraint may be necessary and the ethics that govern its use. Physicians prescribing chemical or physical chains should: Everyone has the fundamental right to be free from unreasonable physical restraint. However, health problems can sometimes lead to behaviors in which patients are at risk of harming themselves. In such situations, it may be ethical for physicians to order the use of chemical or physical restraints to protect the patient. The use of chains in intensive care represents an extreme end to the continuum of behavioural management. Limitations increase a person`s vulnerability to neglect, harm and exploitation, and are associated with significant physical harm and devastating psychological consequences. The core values of respecting people, preventing harm and promoting positive outcomes often conflict when physical chains are used. This article explores the ethical issues faced by critical care nurses when balancing the potential harms associated with limitations with the primary obligation to patient health and safety.

The challenge for critical care nurses is to establish more humane and dignified forms of care for critically ill patients. Ethics requires a moral approach that “does no harm first” by applying useful practices that serve to protect the best interests of service users and build public trust. In some limited situations, when a patient poses a significant danger to themselves or others, it may be appropriate to unintentionally control them. In such situations, the least restrictive restriction should be implemented and the restriction should be lifted immediately when it is no longer necessary. The primary purpose of physical restraint in the treatment of mental disabilities is to prevent injury or harm to the service user or others, but research shows that it can cause trauma and injury. Physical restraint is a controversial issue, and it is important for caregivers to keep abreast of clinical governance strategies, regulations, and policy developments. In recent years, there have been discussions about the application and abuse of the restrictive practice of physical restraint, particularly in care facilities where vulnerable clients live. In developmental services, nurses face difficult decisions when caring for clients when dealing with challenging behaviour. Layla Hughes and Paula Lane describe the effects of restraint practices in practice for intellectual disability in Ireland and how policy changes affect nurses. Except in emergencies, patients should only be controlled by express order of a physician.

Patients should never be held for punitive reasons, convenience or as an alternative to adequate staff.