This reflection paper is intended to examine various ethical solutions to a case study proposed by authors Sen, Gordon, Adshead, and Irons, who are forensic psychiatrist experts. Given the case study and solutions, this papers intends to seek the solutions that will closely follow the Bioethics principles studied in class (Nonmaleficence, beneficence, autonomy and justice) as best possible.
The case study described below was selected from the article Ethical dilemmas in forensic psychiatry: Two illustrative cases. This particular case touches the subject of psychiatric disabilities, which would be one of the important focuses of my dissertation, and the main reason for electing such case. The paper will offer a case study description, a discussion
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The patient’s quality of life and mental state could be improved by use of some measure of restraint when he is interacting with other patients in the general-ward area. This would be in the form of a restraining belt around his chest, which would keep his hands at the side of his body so that they could not be used to attack others. This would help to ensure that he spent more time in association with and also protect the safety of, other patients. Also, it allows for the possibility of engaging him with some limited form of occupational therapy to improve his quality of life. However, it was not possible to get his consent to the use of restraints even intermittently, as he was not capable of giving free and fair consent. The clinicians also continued to be concerned about the safety of other patients on the ward if he was brought out into association without any form of restraint. Conversely, there was considerable anxiety among the staff about using restraint. The hospital management also raised concerns about the ethics of using mechanical restraint and the risk of bad publicity for the hospital. In the US, substantial flexibility is allowed in the use of mechanical restraint, but a state court in Montana established constitutional requirements for the use of such procedures in psychiatric