Exercising restraint: clinical, legal and ethical considerations for the patient with Alzheimer's disease.
The number of older people using emergency care is increasing steadily and older people account for over half of all emergency admissions. In the emergency setting, nurses caring for older people with Alzheimer's disease can be faced with many complex ethical and legal challenges. Moreover, challenges such as the use of physical restraint can precipitate conflict when the nurse is placed in the precarious position of doing good, respecting autonomy and avoiding paternalism. Although, there is no complete set of "rules" that can provide nurses with an answer to each dilemma, it is of significant value for nurses to have sound knowledge of ethical and legal positions in order to analyse the many complex situations that they may encounter.
McBrien
Barry
B
Centre for Nurse Education, Mater Misercordiae University Hospital, Nelson Street, Dublin 7, Ireland. bmcbrien@mater.ie
D000368:Aged; D000544:Alzheimer Disease / Q000451:nursing*; D019985:Benchmarking; D016529:Emergency Nursing / Q000941:ethics / Q000458:organization & administration; D004636:Emergency Service, Hospital / Q000941:ethics / Q000458:organization & administration; D028663:Ethical Theory; D015577:Geriatric Assessment; D006801:Humans; D007258:Informed Consent / Q000941:ethics / Q000331:legislation & jurisprudence; D007494:Ireland; D008297:Male; D016743:Mental Competency / Q000331:legislation & jurisprudence; D009014:Morals; D024802:Nurse's Role; D009730:Nursing Assessment; D026706:Paternalism; D010344:Patient Advocacy / Q000941:ethics / Q000331:legislation & jurisprudence; D017410:Practice Guidelines as Topic; D012149:Restraint, Physical / Q000009:adverse effects / Q000941:ethics / Q000331:legislation & jurisprudence; D018570:Risk Assessment; D017751:Safety Management / Q000941:ethics / Q000458:organization & administration; D012945:Social Values