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Opinion 8.17 - Use of Restraints

All individuals have a fundamental right to be free from unreasonable bodily restraint. Physical and chemical restraints should therefore be used only in the best interest of the patient and in accordance with the following guidelines:

(1) The use of restraints, except in emergencies, may be implemented only upon the explicit order of a physician, in conformance with reasonable professional judgment.

(2) Judgment should be exercised in issuing pro re nata (PRN) orders for the use of physical or chemical restraints, and the implementation of such orders should be frequently reviewed and documented by the physician.

(3) The use of restraints should not be punitive, nor should they be used for convenience or as an alternative to reasonable staffing.

(4) Restraints should be used only in accordance with appropriate clinical indications.

(5) As with all therapeutic interventions, informed consent by the patient or surrogate decision maker is a key element in the application of physical and chemical restraints, and should be incorporated into institutional policy.

(6) In certain limited situations, it may be appropriate to restrain a patient involuntarily. For example, restraints may be needed for the safety of the patient or others in the area. When restraints are used involuntarily, the restraints should be removed when they are no longer needed. (I, IV)

Issued March 1992 based on the report "Guidelines for the Use of Restraints in Long Term Care Facilities," adopted June 1989.