RUNNING HEAD: Ethics and the use of restraints
The Ethical Uses of Mechanical and Chemical Restraint in
Psychiatric and Long-term Care Facilities
Abstract
Restraint usage in the hospital setting is on the rise especially in long-term facilities that provide services for geriatric populations. Often staff will use restraints as a form of retaliation for unruly patients. This paper examines literature that pertains to the usage, laws, prevalence, and ethics that surround this controversial topic. In many cases it is advisable to obtain informed consent from either the patient or his or her family prior to the use of restraint procedures. Laws affecting the use of these techniques vary from state to date however, the statistics are quite telling of situation that needs to be guided. Outlined in this article are various ethical dilemmas pertaining to restraint usage, legal implications of misuse, and proper interventions that utilize the patient’s current treatment goals.
Introduction
There has been, in recent years, an increased overall sensitivity to the potential for the abuse of long-term care patients by medical staff. These abuses primarily surround the use of physical restraint through mechanical manipulation, seclusion, and pharmaceutical means. Additionally, the criterion for the involuntary admission to a psychiatric or long-term hospital has changed. What once use to be called a “treatment model” paradigm for hospitals has converted to a “dangerousness model.” To add responsibility to this shift, from 1970 to 1994, the amount of psychiatric admissions more than doubled as the number of available inpatient occupancy was cut by half (Allen, 1999). Deprivation of liberty, the classic concern with psychiatric hospitals, is now the exception as the lack of access to services may now be more of a rights issue. Furthermore, hospitals have become increasingly dangerous places...