Ethical and Legal Issues Related to Restraints in Psychiatric-Mental Health Practice for Children/Adolescents and Adults.
The four articles above address ethical and legal issues related to the use of restraints (pharmacological and physical) on adults, children, or adolescents in mental health practices, with the primary considerations being safety, dignity, autonomy, and the possibility of abuse. According to the author Oh (2021), rather than prioritizing one over the other, it is crucial to establish a balance between the patients’ “autonomy and dignity” and “health and safety,” as these are significant aspects of their fundamental human rights and require ethical preservation.
In ethical considerations, children or adolescents might not fully comprehend or agree to the usage of restrictions; hence, moral concerns regarding autonomy and the requirement to consult parents or guardians before making decisions are essential. For kids and teenagers, the concept of beneficence is of benefit to the patient, and non-maleficence (avoidance of harm) is especially important. If possible, restraint use should only occur with the least restrictive techniques when required. It is imperative from an ethical and justice perspective that minors receive an equal amount of care and protection and are not unreasonably confined. For minors, obtaining informed permission can be challenging. Hence, involvement from parents or guardians is required, and consent from the child is also essential when feasible. Considerations that have impacted the choice to restrain a child include the need to continue the process, its nature, the child’s safety, their level of agitation, their age, the parent’s perspective, the security of the healthcare team, and the ability to get the child’s agreement (Lombart et al., 2019).
The ability for autonomy is higher in adults. Patients experience a violation of their autonomy when placed on restraints against their will; therefore, it is critical to demonstrate the immediate and apparent hazards associated with such measures. Like children or adolescents, the same guidelines apply to adults as well. However, adults frequently focus more on determining the immediate risk of injury rather than the possible psychological effects of applying restraints. In beneficence and non-maleficence, the same guidelines apply to children, adolescents, and adults; however, evaluating the present risk of injury rather than the possible psychological effects of applying restraints is frequently given more weight. According to Jang et al. (2024), ethical behavior is more challenging when one is providing care for someone with limited cognitive ability; therefore, educating health professionals (improving their knowledge and attitudes) on human rights and the guidelines surrounding the usage of physical restraints could put a stop to the improper use of physical restraints.
In the areas of legal considerations, laws frequently include extra protections for minors, such as obligatory debriefings, frequent reviews of the use of restraints by impartial organizations, and the engagement of child advocacy agencies. Adults also have the legal right to information regarding their care, the right to challenge the application of restraints, and the right to legal counsel if they believe there is an infringement on their rights. Every incidence of using restraints in healthcare requires appropriate and thorough documentation, including the reason(s), length of the incident, and steps taken to defuse the situation. These requirements apply to both adults and children or adolescents.
The Applic
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