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Restraint in paediatrics: A delicate balance.

Anne Preisz1,2, Paul Preisz2,3

  • 1Clinical Ethics, Sydney Children's Hospital Network, Sydney, New South Wales, Australia.

Journal of Paediatrics and Child Health
|September 5, 2019
PubMed
Summary

Restraining young patients in healthcare requires careful ethical consideration. Clinicians must balance patient safety with dignity, especially for those with serious illnesses requiring physical, chemical, or seclusion interventions.

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Area of Science:

  • Medical Ethics
  • Pediatric Healthcare
  • Patient Safety

Background:

  • Patient restraint in healthcare settings is under scrutiny.
  • Two distinct groups of young patients require consideration: infants/children undergoing procedures and those with serious illnesses necessitating restraint.
  • The practice of restraint, including 'hugging' versus 'holding,' warrants ethical reflection.

Purpose of the Study:

  • To examine the ethical considerations of patient restraint in pediatric healthcare.
  • To differentiate between restraint for simple procedures and restraint for behavioral disturbances in children and adolescents.
  • To emphasize the judicious use of all forms of restraint.

Main Methods:

  • Ethical analysis of patient restraint practices.
  • Review of literature concerning pediatric patient restraint.
  • Discussion of the balance between necessary restraint and potential harm.

Main Results:

  • Restraint for infants and young children during procedures may be reframed as 'hugging.'
  • Children and adolescents with serious psychiatric or organic illnesses often require restraint due to behavioral disturbances.
  • Any form of restraint (physical, chemical, seclusion) carries risks and requires careful ethical deliberation.

Conclusions:

  • The use of any patient restraint in healthcare necessitates ethical reflection and judicious application.
  • Clinicians must prioritize the dignity and privacy of young patients.
  • Balancing the need for restraint with the prevention of harm is critical for vulnerable pediatric populations.