10 - Ethical use of restraints

Summary

Restraint therapy is instituted to prevent injuries to patients or others by restricting a patient's movement. Used appropriately, restraint therapy reduces patient risk and improves outcome. Otherwise, restraint can cause accidental injury or even death. Physicians are ethically obliged to limit the use of restraints to clinically and adequately justified situations so that associated risks can be reduced. Physicians should consider whether the benefits of restraint therapy are worth the harms. This chapter presents two case studies on the appropriate use of restraint therapy. In the first case, the desire for the restraints may have been misguided. The second case exhibits the effects of restraint therapy on the family. The ethical principles of respect for patient self-determination (including informed consent obtained from surrogate decision-makers), beneficence and non-maleficence should weigh heavily in the decision to employ restraint as a mode of treatment.