Mechanical Restraints In Psychiatry

Treatment administered in food or drink should never be given to patients who are clearly refusing to accept treatment and have capacity to consent according to Mental Health Act 1983 whereas treatment for those who lack capacity may be prescribed in their best interests under the common law doctrine of necessity, and thus necessary to save life or

Within contemporary society, the legal process of placing an individual into a detention or psychatric treatment facility is called "civil commitment." Typically, this is reserved for the mentally ill, or those people who have satisfied the Court's rule that they are a danger to others, or to themselves. Society realizes that, at times, an individual may pose a danger to themselves or to society and be unable to make rational decisions. In fact, in most jurisdictions in the modern world, involuntary commitment procedures are specifically applied to individuals who have manifested some form of serious mental illness that acts to impair their reasoning to such extent that they are unable to make cogent and logical decisions. Therefore, at these times the state (the Court system) must intercede to find ways to make the appropriate decisions under a legal template. Involuntary commitment may have, in the past, been used in certain situations, inappropriately, but the statutory criteria that indicates one is a danger to self or others usually acts as a legal axiom (Korba, 2008).

Ultimately, involuntary commitment remains a complicated medically and ethically debated topic; one that creates a conflict and clear divide, between individuals who content that involuntary commitment results in vulnerable individuals with psychiatric illnesses being subjective to coercion and civil rights infringement, and those who believe, based on the principle of utility, that involuntary commitment is essential and integral to the safety of the those with psychiatric illnesses, as well as to society as a whole. Both sides offer empirical evidence, as well as moral support for why they believe involuntary commitment is either legally and morally acceptable, or ethically unacceptable, and thereby should be illegal. Regardless, infringing

To begin with the person is the centre of the plan, to be consulted with and their views must always come first: It should include all aspects of their care, and every professional should work together to provide it. (Leathard 2000) Autonomy refers to an individuals’ ability to come to his or her own decisions and requires nurses to respect the choices patients make concerning their own lives (Hendrick 2000).However Gillon Argues that the principle respect for autonomy may need some restriction, otherwise we may be morally obliged to respect an autonomous course of action with unthinkable consequences.( Gillon 1986) Every human being has an intrinsic value, they all have a right to well being, to self-fulfilment and to as much control over their own lives as is consistent with others (British Association of Social Workers 2002).Professional Judgement and patient preference cannot be suspended if practice is to be safe and effective rather than routine(DOH 2005) Alex had to attend this session as it was within his Timetable, how could it have been effective?, he was unhappy and

The aim of this essay is to presents a critical analysis over the nursing dilemmas around capacity and her limitation by presenting example from the author’s practical experience. The names of the patients will be replaced with pseudonyms for confidentiality purposes according to the Nursing and Midwifery Council NMC(2015) Code of Conduct. Consent is often misunderstood. Mental Capacity is a complex topic and often health professionals tend to provide treatment which may be in the patient 's best interests but not always in accordance with his will and preferences thus adhering to Personal-Centred Approach. Further will be discussed Assessment of capacity and risk assessment, The Principle of Best Interests, Deprivation of Liberty Safeguards(DOLS), accepting Advanced decisions if they are in place. Moral and ethical considerations asociated with mental capacity will be presented throughout the essay.

“Unlike most other mental health advocacy organizations in the world, MindFreedom is financially independent from pharmaceutical companies, governments, religions, and mental health systems” (MindFreedom - Fighting Back Against Human Rights Abuses in the Mental Health System 1). This organization is comprised of those who have experienced involuntary psychiatric treatment; as well as their family members and allies. The focus of this group is on human rights violations. Although their arguments and objectives address involuntary commitment, they are not advocating for the violent population. They believe that all people possess the same rights in regards to mental health care, and that those rights include the ability to decline psychiatric treatment. However, their website also states that “There can be no doubt, to reiterate, that people in mental distress and crisis can present challenges for those around them...” (MindFreedom - Fighting Back Against Human Rights Abuses in the Mental Health System 3). The argument of this group is focused heavily on the medication aspect of treatment. However, involuntary commitment can be performed without forcing a patient to take medication. Often, medication is prescribed to help the patient, though it is not a required aspect of treatment (Treatment Settings

Physicians, in their daily practices will tell you, not all patients when being examined will comply with the doctor’s wishes. Likewise, Law Enforcement. Police, can tell you also not all calls went as smooth as it should most of the times. Nearly all doctors will agree that children, and the mentally incompetent, are the most difficult patients to deal with. Because of incompetence, these patients are not able to make decisions for themselves. Doctors are presumably likeable people, because, when you are sick, they make you healthier, although for others, doctors can be villains. Patients whose doctor’s force treatment on them perceive this as a violation of their rights. The use of force should be mandatory when patient health becomes life threatening to themselves and the public at large.

In behavioral health nursing, using physical restraints is a very integral aspect to the overall health and well-being of patients and staff. Although this is still a very prominent and sensitive subject amongst healthcare professionals, I deemed it important that my facility implement and utilize physical restraints on our behavioral health unit. Nurses need to be educated on the use of restraints, which lead to my self-education on this topic. Nurses need to be aware of the benefits and the consequences that restraints can have on a patient.

The use of restraints for psychiatric patients has been in existence for a long time. In the 17th and 18th centuries, the use of mechanical restraints was deemed acceptable and required in the asylum environment (Carr 2012). However, there has been ethical dilemma on the usage of any form of restraints in caring for patients. Hughes, Zammit and Cordina (2014) explained that there has been a long discussion about restraint methods in health care settings, the usage of both physical and chemical forms of restraint in clinical practice, and to whom such methods would be appropriate

In Australia it is a requirement for a person to give consent when receiving any medical treatment. Whether it be consent by an adult on behalf of a minor or an adult consenting for themselves. This concept appears to be quite candid; however when faced with a complex and challenging situation, it becomes difficult to distinguish the validity of the individual’s consent. The case Re Bruce [2015] will explore the legal and ethical issues of medical consent in exceptional circumstances. The examination of relevant legislation including the Guardianship and Mental Health legislation and the Universal Declaration on Bioethics and Human Rights will assist in answering this question. Furthermore, a number of stakeholder positions, such as spouses, medical practitioners and contents of the law and its application in practice will be investigated in order to identify if this case possess a lawful justification.

In the psychiatric world the use of sedatives, seclusion, and restraints may be helpful in the moment, but later can have some harmful outcomes that affect the psychological, emotional, and physical well being of the patient. Sedatives are drugs that slow down the physical and mental characteristics of one's body. Many times sedatives are referred to as tranquilizers. Sedatives are only available by prescription and many times are used for medical reasons. Sedatives have been known to be used to help treat pain, anxiety, panic attacks, and insomnia. The drugs work by intensifying the amount of neurotransmitter-gamma-aminobutyric acid (GABA). The neurotransmitters help to control the rate at which nerve impulses travel. Sedatives have also been

Wide variation in the duration of mechanical restraint episodes was reported between countries. For example, the mean duration of restraint in German psychiatric hospitals was found to be 10 hours compared to 49 hours in Switzerland (Martin et al. 2007). In

Western medicine values individual autonomy, to an extent. That extent is measured by an individual’s ability to think rationally. But, what does rationality mean in the face of complex medical decision-making? What does autonomy mean when a doctor deems an individual with a mental illness lacks capacity and needs treatment? The purpose of this essay is not to persuade readers that individuals with mental illness do not need support at times. Rather, the purpose is to make readers question the criteria for involuntary hospitalization. Through defining capacity and exploring what capacity means for individuals who are mentally ill, I argue that it is not ethically justifiable for mental illness to be a criterion for involuntary hospitalization.

The uses of physical restraints for medical purposes are valued in the patient safety and ethics by performance of evidence of best practice. According to Craven a singular definition of a restraint “any manual method, physical, or mechanical device, material, or equipment that immobilizes or reduces the ability of a patient to move his or her arms, legs, body, or head freely” (2013). By this definition we can also rule out that orthopedic devices, dressings or bandages, or any other equipment used in the patients physical examinations or tests to protect the patient are not considered restraints (Craven, Hirnle, & Jensen, 2013). The most common circumstances to use medical restraints take place in intensive care units (ICU) where

Restraints of any kinds are administered by a protocol that ensures that it is properly and correctly applied. Though patients are not independent at the time when a decision to restraint is taken, explaining to them why the restraints are needed to protects their right to self determination. By doing this, autonomy will be considered, and they do not feel restraints used as a punishment. If a patient is unconscious or not competent enough to consent for restraint, then substitute decision maker should be involved to get consent on behalf of a patient. Nurses should closely monitor the patient with restraints to ensure safety, look for the earliest and safest time to remove the restraints, and frequently offer help to a person with restraints