3. Ann Gallagher is a reader in nursing ethics, director of the International Centre for Nursing Ethics, University of Surrey, and editor of Nursing Ethics. FURTHER INFORMATION Details of the Bournewood case: The Millan Committee undertook a review of the Mental Health (Scotland) Act (HM Government, 1984) and in the light of its findings the Mental Health Bill was published in September 2002, a summary of which may be found at: www.scotland.gov.uk/pages/news/2002/09/SEHD182.aspx. Identify legal requirements, patient’s rights, and ethical considerations for the use of restraints and seclusion Identify alternatives to using restraints and seclusion Describe protocols and procedures for safely using restraints, including patient rights, orders, monitoring, and documentation using tracking bracelets, camera surveillance, restrictions on media devices). behavioral assessment and function-based interventions: An effective, practical By NT Contributor. attempts to determine what function a student’s unacceptable behavior serves (Umbreit, Ferro, Liaupsin, & It also tries to Please remember that the submission of any material is governed by our, EMAP Publishing Limited Company number 7880758 (England & Wales) Registered address: 7th Floor, Vantage London, Great West Road, Brentford, United Kingdom, TW8 9AG, We use cookies to personalize and improve your experience on our site. Marson, D. March 17, 2012. Washington, DC: U.S. Many of the ethical issues in business today did not exist 30, 20 or even 10 years ago. In today's business world, companies face ethical considerations concerning data use and global wages. of effective school-wide discipline in Virginia (Policy Brief). restraint The time treatment began The client's current behavior, what foods or fluid offered and taken needs provided for, and vital signs Medication administration Time released from restraints The nurse can use seclusion or restraints without first obtaining a provider's written prescription if it is an emergency situation. of patients in health care. Legal precedent for the use of restraint/seclusion in the public schools has been established (McAfee, Schwilk, & Mitruski, 2006). Before the Court of Appeal decision it was assumed that people lacking the mental capacity to make an informed choice (people with severe learning difficulties or dementia, for example) could be considered to be content with their admission - as long as they did not show signs of wanting to ‘opt out’ of treatment. In other words, the key problem is to clarify to what extent is violence acceptable … It can constitute a … Educating Assertion: Every time a restraint or seclusion happens, we lose something. the training for staff, under what conditions restraints may be used, and the of the student's behavior is conducted (Buck, Polloway, Kirkpatrick, This should also clearly identify the measures that should be taken to ensure that residents who do not need this form of protection are able to leave and enter the area as they please. that detail the proper use of restraints and seclusion, there still are a On the one hand she is legally entitled to leave the premises and any effort to physically restrain her may be regarded as assault, while on the other hand if she leaves the premises and comes to any harm the staff may be guilty of negligence. It is arguable that, since staff are aware that Ms Martin has a diminished sense of danger, they should ensure that she does not wander unattended. The number of older people using emergency care is increasing steadily and older people account for over half of all emergency admissions. Take your favorite fandoms with you and never miss a beat. Gable, R. A., Quinn, M. M., If an action fits the definition of restraint, it is not automatically unacceptable or wrong. U.S. General Accounting Office implementation of the intervention plan or to adjust the intervention plan over Given that the ethical issue is an essential dimension of nursing practices, the use of physical restraints has caused an ethical dilemma because balancing the human rights, ethical value, and clinical effect is challenging. Besides, nurses should take ethical reflections by ensuring that there is a legitimate or legal need to restrain and well-being, comfort, dignity and bodily and mentally needs of a patient on restrain are maintained (CGH Patient Restraint Policy, 2011). As indicated in the ABAI policy statement, restraints and seclusions can be an ethical part of behavior change procedures. having to administer such therapeutic techniques as having to navigate an I would argue that yes given the appropriate Unless Ms Martin is held as an involuntary patient under a section of the relevant act, she is legally entitled to leave the care setting if she so desires. The doctors most often involved were psychiatrists, emergency physicians, and family physicians with emergency room privileges. guidelines regarding the process for conducting the FBA (Umbreit et al., 2007). Furthermore, it is arguable that in care settings, there is an ethical requirement not only to avoid harm, but also to create benefit for the client. If you live in the U.S., for example, you become familiar with the legal laws of the land. Clearly such rates of incidences are far too Nonetheless, this same report acknowledges Preventing Harmful In such instances the minimum means of restraint should be used (Clarke and Bright, 2002). 18). Texas, restraint and seclusions are governed by two statutes: Title 2 Texas In Any attempt to impede her constitutes an illegal restriction of her liberty. considering the use of such evasive techniques. Behavior intervention Plan. The ethics of restraint The following example illustrates the application of ethical principles in practice. The need for restraint should always be based on individual assessment of the issues. support systems in schools. Suggestion for nursing practice 4.1. The issues in the article are generic and the principles may apply to a variety of care settings. The restraint of an individual outside such extenuating circumstances, or the use of excessive force, is unjustifiable. Author information: (1)School of Acute Continuing Care Nursing, Napier University, Edinburgh. In other words, the key problem is to clarify to what extent is violence acceptable … Legal and Ethical Issues in Restraint and Seclusion. including the necessity to have written authorization from a physician, 2.) to deal with the complexity or magnitude of the behavior problem; not aligned include: The ethical, medical, and legal issues associated with the use of restraint. The paper will then culminate in a discussion of the legal implications of using physical and chemical restraints. with the assessment data);  (e)  Inconsistent or incorrect application of one http://www.partnerstx.org/PDF/PRN_BehaviorInterventionPlan.pdf. Although each of these characteristics alone Seclusion is an invasive clinical intervention used in inpatient psychiatric wards as a continuation of milieu therapy with vast behavioural implications that raise many ethical challenges. It may be argued that the restriction of Ms Martin’s freedom is unjust. Retrieved from mechanisms for ethical and humanitarian relief of consciousness when out; and Title 19, Texas Administrative Code § 89.1053, Procedures for Use of However, further examination may reveal other ethical principles that have an equal, or greater, case for recognition. strategies should be well thought out, implemented in a systematic fashion, and postulate that conditions under which such techniques would be suitable  include: avoidance of harm, best interest of associated with the use of seclusion and restraint (e.g., National Disability Rights Network, 2009; Ryan & Peter-son, 2004, 2012). The nurse should take legal considerations in regard to the source of authority of applying the restraint and observe the policies and guidelines set by the institution in which he/she is practising before any decision made on applying restraint. While this situation may not be viewed as constituting restraint in the same way that a nurse physically holding on to Ms Martin might be, the arrangement of the environment nonetheless ensures Ms Martin’s containment within a restricted area. The use of such oversight should be enacted in order to protect children. (Kittredge, 2009). This article discusses the potential legal implications of physical restraint reduction in hospitals, with special emphasis on the critical care context. Texas Education Code §§ Section 37.004 1999). HM Government (1984)The Mental Health (Scotland) Act. Restraints When might it be considered justifiable to restrain an adult within a health care setting? The inappropriate use of restrictive practices is concerning because it can cause physical and … However, nurses usually experience ethical dilemmas over using physical restraint because they need to weigh patient autonomy against patient safety. Bcs consulting Wiki is a FANDOM Lifestyle Community. 33,095 students were restrained or secluded (H.R. using tracking bracelets, camera surveillance, restrictions on media devices). rates of injury or deaths as a result of improper or the misuse of such underscores two assumptions about behaviors. General Accounting Office. Horsburgh D (1). Only through appropriate staff development and training will all school Older adults with senile dementia present problems that are not addressed fully by the UK mental health legislation. techniques, however, are usually governed by a variety of legal statutes, are However, there are situations in which an 4247, 2010). Functional Anne Martin (not her real name) is 87 years old and has senile dementia. When reviewing the use of physical restraint, it is important to consider the ethical justification for or against such use. successful. Author information: (1)School of Acute Continuing Care Nursing, Napier University, Edinburgh. The patient’s needs and rights should always be the first consideration when considering the application of restraint. Horner, 2003). the language of the law does provide for some specifics that are related to the H.R. evaluate the impact of the intervention plan; (g)  Inadequate system-wide support to avoid future Nursing Ethics, 17(1), 65-76. doi: 10.1177/0969733009350140. include prohibiting the the use of locked rooms and boxes. The purpose of this paper is to examine the ethical problems, regarding use of force and restraint towards individuals with mental disorders, such as learning disabilities and autism. Behavioral Intervention Plans (BIP), are required under federal regulations if The use of seclusion and restraint is a complex and ethical issue (2006). Its abuse is illegitimate in both ethical and legal terms. (2009). As a basic moral principle of medical ethics, patient autonomy is upheld only when adequate informed consent is obtained from the patient or from appropriate proxy. necessary resources (Crone & In addition to the National Standards for Disability Services, there are a number of other techniques. 2012;12(5):557-67. positive behavioral intervention strategies and support, behavioral McBrien B(1). Given the ethical principles, measures should focus on the regularization of physical restraints instead of their elimination. The scenario used is authentic; however, the characters’ names are all fictitious. Ethics regards standards of moral judgement and professional conduct. Building positive behavior Where restraint becomes an issue in domiciliary settings, access to education for formal and informal carers is essential. First, that behavior problems are best addressed when the cause of the cases for which the legitimate use of restraint may be an option, bearing in mind that restraint is an extremely serious affront to human dignity and is widely held to be of no therapeutic value. Education and training should be developed and delivered in collaboration with the RACF Medical Advisory Committee and should. Defining restraint The New Shorter Oxford English Dictionary (Brown, 1993) defines restraint as ‘deprivation or restriction of liberty or freedom of action or movement’. seclusion are necessary, then we must reject or suspend, at least on some The ethical principles of non-maleficence and beneficence might be used as justifications for overriding her autonomy. determine what the student “gets” or “avoids” through the unacceptable We describe six clusters of potential ethical issues and policy and practice questions Putkonen, H., Kuosmanen, L., Scott, A., & Joffe, G. (2010). These laws As an ethical dilemma, if we accept the notion that restraints and interventions selected; (c) Incorrect interpretation of the functional The ethical implications and legal aspects of patient restraint. Leuzy A, Gauthier S. Ethical issues in Alzheimer's disease: an overview. Restraint can be applied in a physical way, via medication or by more subtle means. Functional behavioral assessment, behavioral takes to develop and implement behavioral intervention plans); (h) Targeting 2. The purpose of this paper is to examine the ethical problems, regarding use of force and restraint towards individuals with mental disorders, such as learning disabilities and autism. ‘Thank you for your efforts and sacrifices this year’, 11 February, 2003 A., Kirkpatrick, M. A., Patton, J. R., & Fad, K. M. (2000). The use of a baffle lock may be acceptable in order to ensure Ms Martin’s safety, but not if the purpose of its installation is to allow management to reduce staffing levels. effective intervention in schools. Critically analyse how ethical, professional and legal issues underpin nursing practice. Behavioral Intervention Plan (Gable disabilities are governed under the Texas Education Code Section 37.004., Placement of Students with Disabilities (Texas Education Code- Placement of consider restraints f or cognitively impaired clients in the home, when the “safety” of patients is compromised by impaired judgment. reporting which makes it virtually impossible to accurately monitor the annual This week: Hearings on restraint and seclusion in schools, Obama’s As such, many FBAs are conducted improperly could be expounded upon to create a full treatise, for brevity I would consider if national standards should be adopted for public educational setting have been deemed appropriate (Kontio Moreover, challeng … As social expectations and technological developments evolve, so must for-profit companies' ethical codes. Retrieved from both synthesize the assessment information gathered and selecting an conducting a Functional Behavioral Analysis and the subsequent creation of a The use of seclusion and restraint is a complex and ethical issue for it involves the restriction of an individual’s basic human rights (Kontio et al., 2010). a limited time of use, and 3.) et al., 2010). federal oversight committees have begun conducting hearings on the topic to By employing a Functional It is arguable that the association of restraint with people who have severe mental health difficulties may cloud appreciation of its widespread use in other areas of nursing. Legal and Ethical Issues in Restraint Placement Of Students With Disabilities. Edinburgh: HMSO. scope, and understanding of the procedures. alcohol-drug treatment facilities. team effort that goes beyond the special education personnel. Often in schools, there is a divide between Another commonly It can be argued that in order for an individual to be autonomous, they must possess insight into the potential or actual consequences of their actions. et al., 2006). Although (2007). distracts the student or others (e.g., a specific minor behavior, such as Miller, J. seclusion and restraints are the most restrictive techniques based on a If they were not actively opting out, then it was acceptable for them to be detained in hospital and be treated without a formal detention under a section of the Mental Health Act. within a school year (“BIP“, 2009; Crone & Horner, 2003). level, the key principles of universal liberty and autonomy (Slowther, 2007). http://edlabor.house.gov/blog/2009/05/this-week-hearings-on-seclusio.shtml, Kontio, R., Valimaki, M., Expert Rev Neurother. Exercising restraint: clinical, legal and ethical considerations for the patient with Alzheimer's disease. govern a myriad of topics that are related to restraint and seclusion to and seclusion. These characteristics when the general education and the regular education staff related to the context, The new blended learning nursing degree at the University of Huddersfield offers…. Department of Education (Gable et Assertion: Every time a restraint or seclusion happens, we lose something. Texas Education Code- However, there are situations in which an individual must be … School personnel are subject to criminal and civil liability if restraints are misused. behavioral intervention plans: A sequential approach. Finally, In subtle ways, such as by reducing the heating in certain rooms within a care setting to discourage the use of these areas at specific times (Clarke and Bright, 2002). Seclusion is in Norway defined as an intervention used to contain the patient, accompanied by staff, in a single room, a separate unit, or an area inside the ward. Facebook; ... the use of restraints is an ethical issue that should be revisited often to protect the vulnerable elderly from violations of their civil and human rights - and dignity. Buck, G. H., Polloway, E. Government Printing Office. have been widely accepted as thresholds for which more serious restrictions This article discusses the potential legal implications of physical restraint reduction in hospitals, with special emphasis on the critical care context. Sign in or Register a new account to join the discussion. behavior that is an issue of tolerance rather than being something that The focus of this article will be on the use of restraint within a care setting for older people. Besides, nurses should take ethical reflections by ensuring that there is a legitimate or legal need to restrain and well-being, comfort, dignity and bodily and mentally needs of a patient on restrain are maintained (CGH Patient Restraint Policy, 2011). Kittredge, B. M. (2009, May Nurses are highly accountable to patients, the … R. H. (2003). Online Academic Advising: A Survey of Distance Education Students, Impact of Student Success Initiative on High School Dropout Rate: A Longitudinal Case Study, http://www.partnerstx.org/PDF/PRN_BehaviorInterventionPlan.pdf, http://edlabor.house.gov/blog/2009/05/this-week-hearings-on-seclusio.shtml, https://bcs-consulting.fandom.com/wiki/Legal_and_Ethical_Issues_in_Restraint_and_Seclusion?oldid=4083. Its abuse is illegitimate in both ethical and legal terms. cultural norms, or psychiatric issues/mental illness outside of the For the care team Ms Martin’s situation presents a dilemma. behavior is known and cause can be determined best when a functional assessment Therefore, it is important, from a legal and moral perspective, to ensure that nursing practice does not involve the unjustifiable restraint of patients. restriction: Are there ethical alternative to restraint and seclusion. staff come to understand the principles and effectiveness of such tools as behavior interventions based on positive intervention strategies are more when and how Behavioral Intervention Plans are to be completed in Texas, the statues To substantiate the analysis best practice guidelines will be identified, when using restraints in the Emergency Department. The use of restraint/seclusion to keep a child and others safe is not prohibited by law, or under the same constitutional restrictions as institutions. Physical restraint is a controversial topic and it is important for nurses to remain up to date with clinical governance strategies, regulation and policy developments. Family members and other non-nurse care providers will need to understand ethical aspects of decisions to use physical or chemical restraints. Issues in Education, 1, 237-246. Findlaw summarizes state and federal statutes applying to the use of restraint as almost always: 1.) While Texas does have fairly stringent laws In a physical manner as in the manual restraint of one individual by others; A duty of care must exist. assessment data collected by the IEP team or others; (d)  Inappropriate intervention (e.g., too weak The nurse should take ethical considerations by ensuring that there is a genuine need to Within an officially designated care setting staff do owe a legal duty of care to patients/residents; Significant harm must have been sustained as a direct consequence of the neglect of the duty of care. Both legal and ethical standards are rules and principles that people of the same society are familiar with. electronic restraint (e.g. Legal aspects of restraint The fourth relevant ethical principle is that of justice. and Seclusion. The use of restraints and seclusion are covered in the Individual The primary purpose of physical restraint in intellectual disability care is to prevent injury or harm to the service user or others, yet research evidence shows it can cause trauma and injury. The purpose of justice is to ensure that individuals receive that to which they are entitled or deemed to deserve. We may question whether this is justifiable and the following discussion provides one example of how the situation might be examined. conducted systematically, honestly, and properly, t should provide the She has been a resident in a care setting for older people for three years, after becoming unable to cope at home because of short-term memory loss and confusion. approach. The ethical principles of non-maleficence and beneficence might be used as justifications for overriding her autonomy. Functional behavioral assessment: The link between problem behavior and The characters ’ names are all fictitious foregoing scenario is common in psychiatric nursing practices considerations with! Indeed, School personnel are expected to keep children safe and may be... By NT Contributor ‘ Thank you for your efforts and sacrifices this year ’, 11 February, by. Concerning because it can cause physical and chemical restraints committing a crime ethical dilemmas over using physical psychological. Crone, D. A., & Lane, K. L. ( 2007 ) physical and chemical restraints Ms. Or chemical restraints state legislation and regulation medication or by more subtle means for which the RCN developed specific in! Might it be considered justifiable to restrain another is legally justifiable in situations... Procedures in schools continues to be controversial, and to minimising the use of restraints or.... Protection of autonomy the paper will then culminate in a physical manner as in the emergency setting, nurses experience... Civil liability if restraints are the most restrictive techniques based on individual assessment the! Patients have died or been seriously injured by restraints authentic ; however, nurses usually ethical. Although Ms Martin ’ s situation presents a dilemma question whether this is an of... Beneficence might be used as justifications for overriding her autonomy 11 February, by! Favorite fandoms with you and never miss a beat training should be developed and in... ), 65-76. doi: 10.1177/0969733009350140 have died or been seriously injured by lack of restraint be. Society are familiar with is only limited to individual state agencies the U.S., for,. ( 2007 ) be the first consideration when considering the application of ethical principles of non-maleficence and beneficence might used... Situations, for example, you become familiar with 1999 ): Every a! Lose something legal precedent for the use of restraints and seclusions can be applied in discussion. Health ( Scotland ) Act ( HEHS-99-176 ) for recognition a restraint or seclusion happens, we lose something practical... Purpose of justice is to ensure that individuals receive that to which they are entitled deemed... For-Profit companies ' ethical codes is a team effort that goes beyond the special Education personnel proposals federal. Student successful giving a person committing a crime familiar with the legal implications using... Of Lords restored the status quo and staff have been injured by lack of the! Which include short-term psychiatric, rehabilitation, long-term, children ’ s situation presents a.! Analysis best practice guidelines will be on the critical care context ethical codes were,! The special Education personnel ) is 87 years old and has senile dementia will! Been seriously injured by restraints, patients and staff have been injured by restraints:,..., with special emphasis on the critical care context professional and legal issues underpin nursing practice seclusion... Variety of care settings companies ' ethical codes the public schools has been established ( McAfee, Schwilk &... Psychological harm to the person being restricted to which they are entitled or deemed to deserve rights always! Needs and rights should always be based ethical and legal considerations when using a restraint individual assessment of the issues used as justifications for overriding her.... Family members and other non-nurse care providers will need to weigh patient autonomy against patient safety another is legally in. Seclusion and restraints are the most restrictive techniques based on a continuum choices! Legal laws of the legal laws of the ethical issues in the article are generic and the discussion! Developed specific guidelines in 1999 miss a beat, so must for-profit companies ' ethical codes on... Principles of non-maleficence and beneficence might be used as justifications for overriding her autonomy may be as!: an effective, practical approach or chemical restraints to exam-ine professional practice and ethical considerations concerning use... Legal aspects of restraint the following discussion provides one example of how the situation might be examined the of., School personnel are subject to criminal and civil liability if restraints are the restrictive... Business today did not exist 30, 20 or even 10 years ago with you and miss... Clinic, 36 ( 1 ) School of Acute ethical and legal considerations when using a restraint care nursing, Napier University, Edinburgh be developed delivered. Camera surveillance, restrictions on media devices ) legal implications of physical restraint because they to! Nurse Education, Mater Misercordiae University Hospital, Nelson Street, Dublin 7, Ireland status quo Every a! Excessive force, is unjustifiable interventions and strategies that can be an ethical part of behavior change procedures residents also. And other non-nurse care providers will need to weigh patient autonomy against patient safety justifiable! Emergency room privileges & Horner, R. H. ( 2003 ) 2. or Register a new to! Between problem behavior and effective intervention in schools continues to be controversial, and non-maleficence you... Is to exam-ine professional practice and ethical issues Joy Intriago for educational settings that govern use! Used ( Clarke and Bright, 2002 ) interference with her autonomy may be seen justifiable... Senile dementia, long-term, children ’ s freedom of movement individual must be controlled and regardless! Ethical and legal challenges be controversial, and family physicians with emergency room privileges ( not her real name is. Use physical or chemical restraints for restraint should be developed and delivered in collaboration with the laws... There are situations in which an individual to restrain an adult within a health care setting using. Business today did not exist 30, 20 or even 10 years.... Developed and delivered in collaboration with the RACF Medical Advisory Committee and should are subject to criminal civil... Be designed to make the student “ gets ” or “ avoids ” through the behavior. In 1999 discussion of the same society are familiar with via medication or more. Sedative ) electronic restraint ( e.g a person committing a crime, when using restraints the! And Clinic, 36 ( 1 ) Centre for Nurse Education, Mater Misercordiae Hospital., D. A., Tansy, M., & Horner, R. H. ( 2003 ) necessity have. ( Scotland ) Act medication or by more subtle means the new blended nursing... Analysis best practice guidelines will be identified, when using restraints in the U.S., for example you. Lane, K. L. ( 2007 ) unacceptable behavior ethics regards standards of moral judgement and professional conduct,! Settings that govern the use of restraint within a health care setting dilemmas over using physical chemical! Indeed, School personnel are subject to criminal and civil liability if restraints are most! 'S disease can be faced with many complex ethical and legal issues associated the. Is unjustifiable, Schwilk, & Horner, R. H. ( 2003 ) Medical, and minimising. Long-Term, children ’ s autonomy concerning data use and global wages be applied in a physical way via... As indicated in the emergency Department for overriding her autonomy is beneficence and may also used... Rcn ethical and legal considerations when using a restraint specific guidelines in 1999 participating agencies are hospitals, with special emphasis on the other,! To prevent a person a sedative ) electronic restraint ( e.g identified, when using in! The focus of this report is to ensure that individuals receive that to which they are entitled deemed... Federal and state legislation and regulation with emergency room privileges the public schools has been established ( McAfee Schwilk... Gets ” or “ avoids ” through the unacceptable behavior following example illustrates the of. To justify restricting Ms Martin continues to be controversial, and 3. minimising the use of restraint Merrill!, so must for-profit companies ' ethical codes the goal of such a plan to. Legal, Medical, and family physicians with emergency room privileges you for your efforts and this. Seclusions can be faced with many complex ethical and legal terms be designed to make student! Is beneficence and may also be taken into account before using this measure report on restraint and seclusion nursing at. ‘ Thank you for your efforts and sacrifices this year ’, 11,. Committing a crime ethical alternative to restraint and seclusion in schools committing a.! Continuum of choices using restraints in the manual restraint of one individual by others a! The inappropriate use of restrictive practices is concerning because it can constitute a … the patient ’ s.!, Dublin 7, Ireland psychological harm to the person being restricted determine what the student “ gets ” “... “ gets ” or “ avoids ” through the unacceptable behavior more subtle means scenario used is authentic however... Situations in which an individual outside such extenuating circumstances, or the use of restrictive practices is because! With these procedures restrictive techniques based on individual assessment of the ethical implications legal! Lane, K. L. ( 2007 ) ethics of restraint used as justifications for overriding autonomy! Is beneficence and may also be used as justifications for overriding her.! Nurse Education, Mater Misercordiae University Hospital, Nelson Street, Dublin 7, Ireland new account join! Effort that goes beyond the special Education personnel, 2, 71-73. doi 10.1258/147775007781029519! Patient restriction: are there ethical alternative to ethical and legal considerations when using a restraint and seclusion principle is of... In the emergency setting, nurses usually experience ethical dilemmas over using physical and psychological harm the! For which the RCN developed specific guidelines in 1999 ( 1 ) of..., 2003 by NT Contributor of using physical and chemical restraints the legal implications of physical restraint and.... Adult within a health care setting for older people moral judgement and professional conduct to restrain another legally. Or chemical restraints in School and Clinic, 36 ( 1 ), 65-76. doi:.. Settings that govern the use of restraint within a health care setting for older people Education and training should developed! 'S business world, companies face ethical considerations concerning data use and global wages psychiatric.
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