All individuals have a fundamental right to be free from unreasonable bodily restraint. At times, however, health conditions may result in behavior that puts patients at risk of harming themselves. In such situations, it may be ethically justifiable for physicians to order the use of chemical or physical restraint to protect the patient.
Except in emergencies, patients should be restrained only on a physician’s explicit order. Patients should never be restrained punitively, for convenience, or as an alternate to reasonable staffing.
Physicians who order chemical or physical restraints should:
- Use best professional judgment to determine whether restraint is clinically indicated for the individual patient.
- Obtain the patient’s informed consent to the use of restraint, or the consent of the patient’s surrogate when the patient lacks decision-making capacity. Physicians should explain to the patient or surrogate:
- Why restraint is recommended
- What type of restraint will be used
- Length of time for which restraint is intended to be used
- Regularly review the need for restraint and document the review and resulting decision in the patient’s medical record.
In certain limited situations, when a patient poses a significant danger to self or others, it may be appropriate to restrain the patient involuntarily. In such situations, the least restrictive restraint reasonable should be implemented and the restraint should be removed promptly when no longer needed.
AMA Principles of Medical Ethics: I, IV
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