Reexamining Medical Restraints - 04/17/2018
Commentary — May 2016
Tex Med. 2016;112(5):15.
By Michael Brazos Fielder, MD
My greatest regret as an intern was prescribing medical restraints. Inherently controversial, restraints are often used on patients, against their will, to perform a procedure or to provide necessary care. This goes against the fiduciary model of the patient-physician relationship. One of my personal experiences ordering medical restraints provides an opportunity to reflect on this problematic intervention.
My 72-year-old patient had just suffered a severe infarct of his thalamus. I was his doctor when he arrived at the emergency department. It was evident this poor man's entire world had fallen apart. He was confused and crying out a woman's name repeatedly. He could not swallow or articulate his pain, and his blood pressure was as stubbornly unstable as his mood.
For nourishment, he needed nasogastric tube (NG) feedings, but he would pull the tube out when left unattended. To keep his NG...