Layla Hughes and Paula Lane describe the implications of restraint procedure in intellectual disability practice in Ireland, and how policy changes affect nurses

This article explores the ethicolegal and political factors associated with physical restraint in intellectual disability practice in Ireland.

The primary purpose of physical restraint in intellectual disability care is to prevent injury or harm to the service user or others, yet research evidence shows it can cause trauma and injury. Physical restraint is a controversial topic and it is important for nurses to remain up to date with clinical governance strategies, regulation and policy developments.

In recent years, there has been debate regarding the use and misuse of the restrictive practice of physical restraint, particularly in care settings where vulnerable clients reside. In intellectual disability services, nurses face difficult decisions in caring for clients when managing challenging behaviour.

The protection and safety of the service user is of utmost importance and includes: legal considerations regarding professional duty of care and consent; political matters of advocacy and power; human rights; and ethical principles.

Ethics require a moral approach that ‘first does no harm’, engaging in beneficial practices that serve to uphold the best interests of service users and engender public trust.