The ethics of physical restraints in critical care.

The use of restraints in the critical care setting represents an extreme end on the continuum of behavioral management. Restraints increase a person's vulnerability to neglect, harm, and exploitation and are associated with significant physical harm and devastating psychologic consequences. The central values of respect for persons, preventing harm, and promoting positive outcomes often conflict when physical restraints are used. This article explores the ethical issues confronting critical care nurses as they weigh the potential harms associated with restraints against the primary commitment to the patient's health and safety. The challenge for critical care nurses is to establish more humane and dignified forms of care for critically ill patients.