Ethical Issues with Posted Patient Behavior Signs

AbstractThere has been a proliferation of posted behavior signs in the past five years, which are now ubiquitous in both inpatient and outpatient settings and across pediatric, adult, and allied health practices. Named as notices for "Patient and Visitors," these behavior signs identify a range of conduct from clinical noncompliance, use of profanity, and raised voices to acts or threats of physical violence. While these signs offer a tangible signal from the institution's leadership to their staff that disruptive behavior is unacceptable, there is no empirical evidence that behavior signs are effective in reducing workplace violence or verbal attacks. Aside from the problem of efficacy, posted behavior signs are ethically troubling for the way they treat patients and families and for the impact they can have on them. We identify four distinct ethical concerns with posted behavior signs that we believe require either removal or substantial modification of these signs.