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Journal of Medical Ethics logoLink to Journal of Medical Ethics
. 1996 Jun;22(3):160–163. doi: 10.1136/jme.22.3.160

Exercising restraint: autonomy, welfare and elderly patients.

S Dodds 1
PMCID: PMC1376980  PMID: 8798938

Abstract

Despite moves to enhance the autonomy of clients of health care services, the use of a variety of physical restraints on the freedom of movement of frail, elderly patients continues in nursing homes. This paper confronts the use of restraints on two grounds. First, it challenges the assumption that use of restraints is necessary to protect the welfare of frail, elderly patients by drawing on a range of data indicating the limited efficacy of restraints. Secondly, it argues that the duty to respect individual autonomy extends to a duty to respect the autonomy of patients who are elderly, frail and living in nursing homes.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Agich G. J. Reassessing autonomy in long-term care. Hastings Cent Rep. 1990 Nov-Dec;20(6):12–17. [PubMed] [Google Scholar]
  2. Blakeslee J. A. Speaking out. Untie the elderly. Am J Nurs. 1988 Jun;88(6):833–834. [PubMed] [Google Scholar]
  3. Ejaz F. K., Jones J. A., Rose M. S. Falls among nursing home residents: an examination of incident reports before and after restraint reduction programs. J Am Geriatr Soc. 1994 Sep;42(9):960–964. doi: 10.1111/j.1532-5415.1994.tb06587.x. [DOI] [PubMed] [Google Scholar]
  4. Evans L. K., Strumpf N. E. Myths about elder restraint. Image J Nurs Sch. 1990 Summer;22(2):124–128. doi: 10.1111/j.1547-5069.1990.tb00189.x. [DOI] [PubMed] [Google Scholar]
  5. Evans L. K., Strumpf N. E. Tying down the elderly. A review of the literature on physical restraint. J Am Geriatr Soc. 1989 Jan;37(1):65–74. doi: 10.1111/j.1532-5415.1989.tb01571.x. [DOI] [PubMed] [Google Scholar]
  6. Jencks S. F., Clauser S. B. Managing behavior problems in nursing homes. JAMA. 1991 Jan 23;265(4):502–503. [PubMed] [Google Scholar]
  7. Moss R. J., La Puma J. The ethics of mechanical restraints. Hastings Cent Rep. 1991 Jan-Feb;21(1):22–25. [PubMed] [Google Scholar]
  8. Stead W. W. Tuberculosis in the elderly. J Am Geriatr Soc. 1984 Jan;32(1):82–83. doi: 10.1111/j.1532-5415.1984.tb05157.x. [DOI] [PubMed] [Google Scholar]
  9. Tinetti M. E., Liu W. L., Marottoli R. A., Ginter S. F. Mechanical restraint use among residents of skilled nursing facilities. Prevalence, patterns, and predictors. JAMA. 1991 Jan 23;265(4):468–471. [PubMed] [Google Scholar]

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