4. Measures of Restraint and Treatment without Consent

Restrictive measures such as electronic monitoring, locking up, bedside rails or isolation and treatments without consent are prohibited as a rule. Nevertheless, such measures or treatments may be arranged subject to strict conditions. 

The practical situation

Measures of restraint are those that limit patients’ freedom of movement and that are imposed without their voluntary and informed consent. They infringe patients’ personal liberty and may compromise their dignity. Measures of restraint include, for example, electronic surveillance, locking doors, fitting side rails to beds to prevent falls and isolation.

Measures of restraint

A measure of restraint may only be imposed by way of exception and following consultation with the nursing staff. This may only be done if a patient’s behaviour seriously endangers their own health and safety or the health and safety of others, or substantially disrupts communal life. The measure must be appropriate and other, less restrictive measures must have been unsuccessful. If it is not an emergency situation, the restriction of any patient’s freedom of movement must be discussed with them beforehand. Cost-saving measures must not be used as a justification. Restriction must be documented and must only be imposed for a limited period. Moreover, the situation must be reviewed regularly to determine whether the measure must be continued or can be ended.

Treatment without consent

Treatment without the patient’s consent is only permitted under certain, very restrictive conditions, usually in cases of involuntary committal. It may only be considered if there are no other, less rigorous alternatives. It must be ordered by a doctor. The concerns of the affected person must be taken into account as far as possible.
The regulations governing measures of restraint and treatment without consent vary from one canton to another. It is therefore advisable to consult the cantonal legislation for more information.

What needs to be documented?

All measures of restraint must be documented in a report. Your therapeutic representative must be informed about the measure and is entitled to see the report at any time. This provides effective protection against misuse. The report must state the name of the person who ordered the measure and its nature, duration and purpose.
Before treatment without consent is given, the doctor must inform the affected person and a trusted individual of that person’s choice of the decision in writing (for example, a member of the family or another person close to the patient, someone working for a patient rights organisation or the social services).

What can I do to prevent a measure of restraint or treatment without my consent?

You, your legal representative, your therapeutic representative or your relatives can apply to the competent authorities in your canton to have such measures forbidden or stopped.

We cannot offer personal advice. Please refer to the page Options of Counselling and contact the appropriate office. Many thanks.

Last modification 08.07.2020

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Federal Office of Public Health FOPH
Healthcare and Related Professions Division
Health Equity Section
Schwarzenburgstrasse 157
3003 Bern

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