Cheung Pracy P Y, Yam Bernard M C
Institute of Criminology, The University of Cambridge, Cambridge, UK.
J Clin Nurs. 2005 Mar;14 Suppl 1:34-40. doi: 10.1111/j.1365-2702.2005.01145.x.
Despite initiatives to raise the awareness of patient autonomy among healthcare providers, the use of physical restraints on frail or confused older patients continues to be a common practice in many healthcare settings. This paper examines the relationship between patient autonomy and the use of physical restraints by drawing on the literature contradicting its efficacy and the assumption that its use is necessary to protect the welfare of patients. It argues that the paternalistic use of physical restraints without patient's informed consent is morally unjustified and is an unequivocal violation of their autonomy. The duty to respect individual autonomy should be extended to a duty to respect the autonomy of older people who are being restrained. Only in this way can their human dignity and quality of life be enhanced.
尽管采取了各种举措来提高医疗服务提供者对患者自主权的认识，但在许多医疗环境中，对体弱或神志不清的老年患者使用身体约束措施仍是一种常见的做法。本文通过借鉴与身体约束措施的有效性相矛盾的文献以及认为使用该措施对于保护患者福利是必要的这一假设，来探讨患者自主权与身体约束措施使用之间的关系。文章认为，在未经患者知情同意的情况下家长式地使用身体约束措施在道德上是不合理的，并且明确侵犯了他们的自主权。尊重个人自主权的义务应扩展为尊重被约束老年人自主权的义务。只有这样，他们的人格尊严和生活质量才能得到提高。
