There are several factors associated with the use of intrusive measures at residential facilities for children and youth with and without psychological and developmental disabilities. In the context of residential juvenile youth facilities, there has been a gradual move towards the recognition of resident autonomy. This has led to the discussion of when it is and is not appropriate to engage in physical restraint practices. These procedures have remained a common strategy for curtailing aggressive behaviors, as well as behaviors of significant psychological distress.
Several ethical debates come to mind when discussing the idea of intrusive measures on youth. For the sake of this post, the focus of the discussion will relate to the ideas of consequentialism and the impact of intrusive measures. Professionals in the field may argue that intrusive measures, such as physical restraints, have a negative impact on youth. This may include the development of fear, anger, and shame (Stewart et al., 2013). On the other hand, physical interventions have been utilized as a form of safety precaution to prevent youth from harming not only themselves, but others. Professionals have argued that restraint techniques should be appropriately applied for youth as interventions to control aggressive behaviors or suicidal situations, especially when a youth poses a danger to others or himself/herself (Stewart et al., 2013).
A physical restraint is defined as a technique that involves restricting a youth’s ability to move freely or limit the youth’s movement to minimize the risk of engaging in an aggressive behavior (Stewart et al., 2013). Due to a recent incident at Glen Mills School, a juvenile program, the impact of physical intervention on youth and the idea of autonomy has been a hot topic across juvenile facilities. It was reported that staff members engaged aggressively with a youth under the pretense of a physical intervention. The behaviors of the staff were identified as “assaultive”, (Gartner, 2018). The discussions following this incident have focused on the protection of autonomy, the appropriate techniques, and the judgement for when the techniques should and should not be utilized. It was clear from the report at Glen Mills School, that the youth’s autonomy was violated, as the techniques were not appropriately used and the justification for the physical intervention was not clear (Gartner, 2018).
The ethical dilemma surrounding physical restrictive interventions falls in line with the idea of consequentialism, which is the focus of the end result of a person’s actions (PSU, 2018). For example, staff members engaging with an aggressive resident should consider the situation and the overall impact of the behavior of a physical restraint. The idea would be to identify whether the restraint would cause more good than harm (PSU, 2018). Unfortunately, in several situations that result with the idea of a needed physical restraint, the judgement call is quick and circumstantial.
Gartner, L. (2018), I can’t breathe: Probe underway at Glen Mills after staff attacks boy. The Inquirer.
PSU. (2018). PSY 533: Lesson 03: Normative Ethics. (Lecture Notes). Retrieved from: https://psu.instructure.com/courses/1913945/pages/I03-normative-ethics?module_item_id=25041778
Stewart, S. L., Baiden, P., & Theall-Honey, L. (2013). Factors associated with the use of intrusive measures at a tertiary care facility for children and youth with mental health and developmental disabilities. International Journal of mental Health Nursing, 22, 56-68.