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Sylvie Bonin-Guillaume1, Claire Trochet2

  • 1UFR médecine Timone, Institut des neurosciences de la Timone, faculté de médecine, 27, boulevard Jean-Moulin, 13005 Marseille, France; Service de médecine interne gériatrie, Assistance publique-Hôpitaux de Marseille (AP-HM), Hôpital Sainte-Marguerite, 13274 Marseille cedex 9, France.

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Summary

Restraint in care, a deprivation of liberty, is sometimes necessary. Objective risk/benefit evaluations must prioritize patient dignity, especially in geriatric settings focused on autonomy and functional improvement.

Keywords:
contentionelderly personethicsevaluationpersonne âgéere-evaluationrestraintréévaluationéthiqueévaluation

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Area of Science:

  • Geriatric Care
  • Bioethics
  • Patient Rights

Background:

  • Restraint is a legally and ethically complex intervention involving liberty deprivation.
  • Its application requires careful consideration within codified care processes.
  • Geriatric care frequently involves situations necessitating restraint.

Purpose of the Study:

  • To emphasize the necessity of multidisciplinary objective evaluation for restraint use.
  • To highlight the critical importance of considering patient dignity in restraint decisions.
  • To align restraint practices with core geriatric principles of autonomy and functional improvement.

Main Methods:

  • Multidisciplinary team assessment.
  • Objective risk/benefit ratio evaluation.
  • Ethical framework application considering patient dignity.

Main Results:

  • Restraint, when used, must be part of a codified care process.
  • Objective evaluation is crucial for determining the necessity and proportionality of restraint.
  • Patient dignity, autonomy, and functional improvement are paramount in geriatric care decisions.

Conclusions:

  • Restraint is a necessary, albeit restricted, aspect of care in specific situations.
  • Ethical and multidisciplinary evaluations are essential to balance care needs with patient rights.
  • Geriatric care must uphold autonomy and functional improvement, even when restraint is considered.