ABSTRACT
Most legislation that regulates what in some jurisdictions are known as ‘restrictive interventions’ focus on physical and mechanical restraint and seclusion. However, some, including Bernadette McSherry and Victoria’s Royal Commission into Mental Health Services, have advocated the regulation of chemical restraint for those who are mandated inpatients within psychiatric wards. With reduction in the use of other forms of restrictive interventions, the use of chemical restraint is becoming more important and more controversial. This raises difficult definitional and policy issues that have also been encountered in the setting of aged care residences and locations where persons with intellectual disabilities live. Part of the difficulty exists in the purposes for which sedating medication is administered to treat illness or to manage behaviour, or a combination of the two.
This chapter will review policy issues, including the application of the doctrine of double effect, the need to protect persons in congregate care and providers of clinical care, and the relevance of the Convention on the Rights of Persons with Disabilities, and will have regard to diverse definitional approaches adopted in Australia and internationally. In doing so, it will argue for a ‘middle path’ to make the administration of sedating medication to persons with a range of disabilities more accountable.
