AMA Journal of Ethics
Volume 23, Number 3 Apr 2021
Using force in caregiving is most often justified based on risk-benefit or best interest analyses. Careful, inclusive deliberation about whether force should be used in the course of a patient’s care is a rise-to-the minimum precursor of responsible force implementation, as is minimizing a patient’s risk of harm. Even when clinically indicated and ethically justifiable, force protocols drawing on physical, pharmaceutical, and legal means of restraint or seclusion can undermine therapeutic capacity in patient-clinician relationships, erode trust, and exacerbate emotional and moral distress for both patients and clinicians. These high stakes cum patients’ extreme vulnerability prompt us to consider how clinicians’ and organizations’ clinical and ethical obligations extend beyond harm minimization to compassion maximization. Although the words “compassion” and “force” rarely appear together, this issue investigates what their union could mean for and make possible in the enterprise of health care.