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Ethical and legal aspects of using body bindings and a straitjacket

Features of the clinical manifestations of some psychiatric diseases are such that the patient’s behavior is unpredictable and can change dramatically. Suddenly occurring psychomotor agitation can pose a threat to both the life and health of the patient himself, and the life and health of others, relatives and medical personnel.

In this regard, it became necessary to use methods of fixing patients in psychiatric practice.

Despite the fact that fixation methods have been used for many centuries, the ethical side of the issue is still under discussion. The problem of the need to fix psychiatric patients by such means as body bindings, straitjackets, is at the junction of several sciences: medicine, ethics, law, psychology. There is debate around the question of where is that line, when is it necessary to apply fixation (and what kind of fixation method is it) and is this a violation of human rights.

The legislation has not yet settled all the nuances of the fixation process. Nevertheless, the situation when a psychiatric patient has to be fixed using such means as bindings for the body is stressful for both the patient himself and his relatives and the staff of the department in which the patient is being treated, or the emergency team.

The patient can only be fixed if other methods of rendering assistance are ineffective, when it is impossible to establish trusting contact with the patient and the patient’s behavior can pose a real threat to him and to people around him. In no case should fixation be used as a substitute for proper observation and patient care as a measure convenient for medical staff.

In modern psychiatric practice, they practically do not use such a tool as a straitjacket, now it is more often used to knit the body. There is no clear prohibition on the use of a straitjacket, but there are instructions in which it is not recommended to use it. However, the use of patient fixation in general is not recommended in these same instructions. Until the mid-twentieth century, a straitjacket was widely used in psychiatry. Then the question arose sharply about the humanity of this method and, if necessary, soft knit for the body began to be used more and more often. The arguments for abandoning the shirt were the following factors. Firstly, the inability of the staff to handle the shirt, the greater difficulty of dressing the shirt in comparison with the bindings. Secondly, the low cost of viscous compared to the cost of a straitjacket.

However, when using forced fixation and choosing a method, it is also necessary to take into account the interests of patients. Important selection criteria are a lower risk of injury to parts of the patient’s body and pain.

The patient himself is often in a state of turbid consciousness during an exacerbation of the disease and does not remember the fact that fixation measures were applied to him, he does not experience negative feelings about this. If the patient’s relatives have witnessed the use of retention measures, this becomes an additional stress for them. They need psychological support. For staff working with psychiatric patients, one of the factors leading to burnout at work is the implementation of retention measures, despite the recognition of their necessity. Here we need psychoprophylactic work with staff. best online slots canada

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