Restraints

A restraint is an intervention that limits a person’s movement or behaviour. The object alone does not determine whether it is a restraint. A physical or mechanical device, a locked environment, or a medication used primarily to control behaviour may be restrictive depending on its purpose and the circumstances. A medication given to treat pain, psychosis, or withdrawal is not automatically a chemical restraint simply because the patient becomes calmer. Restraint is not a routine fall-prevention measure, a response to refusal, a punishment, or a substitute for observation. It is considered only when all four conditions are met: 1. The intervention is necessary to prevent serious bodily harm to the patient or another person. 2. Less-restrictive alternatives have been attempted and have not worked. 3. The intervention offers greater freedom or quality of life than the realistic unrestrained alternative. 4. A documented plan of treatment authorizing the restraint has been obtained, with consent from the patient or appropriate substitute decision-maker unless an emergency exception applies. The third condition can sound contradictory: how can restricting movement provide greater freedom? Compare the...