The cost of safety: Balancing risk and liberty in psychiatric units

The systems approach is a widely accepted method for addressing healthcare adverse events. However, when adverse events are behavioral in nature, such as self‐injury or aggression, a systems approach can restrict patient autonomy. We propose guidelines for balancing safety and autonomy consideration...

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Bibliographic Details
Published in:Bioethics 2021-02, Vol.35 (2), p.173-177
Main Authors: Zhong, Rocksheng, Wasser, Tobias
Format: Article
Language:English
Subjects:
Adverse
Adverse events
Aggressiveness
Autonomy
Behavior
Bioethics
Critical incidents
Forensic psychiatry
Freedoms
Health care
Injuries
inpatient psychiatry
Medical ethics
Occupational safety
Occupational stress
Patient safety
Patients rights
Psychiatric units
risk management
Safety
Self destructive behavior
Systems approach
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Summary:The systems approach is a widely accepted method for addressing healthcare adverse events. However, when adverse events are behavioral in nature, such as self‐injury or aggression, a systems approach can restrict patient autonomy. We propose guidelines for balancing safety and autonomy considerations when developing systems for behavioral adverse events: interventions that do not limit patient liberty, or that therapeutically address the root causes of behavioral adverse events, should be fully utilized. Clinicians should collaborate with patients when designing systems that may restrict patient liberty. And clinicians should be supported in managing the stress that accrues from working in hazardous environments.
ISSN:0269-9702
1467-8519
DOI:10.1111/bioe.12804