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Using Antipsychotics for Self-Defense Purposes by Care Staff in Residential Aged Care Facilities

An Ethical Analysis

Bibliographic Data

ID21598554
AuthorsHojjat Soofi (0000-0002-7429-6970, Macquarie University, corresponding author)
Year2022
Volume31
Issue4
Pages487-495
Publication date2022-10-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueCambridge Quarterly of Healthcare Ethics (JOURNAL)
Journal identifiersISSN: 0963-1801 • E-ISSN: 1469-2147
PublisherCambridge University Press (CUP) (PUBLISHER)
DOI10.1017/s0963180122000391
PMID36398518
OpenAlexW4309476413
LanguageEN
Citations received1
References cited4

People with dementia at times exhibit threatening and physically aggressive behavior toward care staff in residential aged care facilities (RACFs). Current clinical guidelines recommend judicious use of antipsychotic (AP) medications when there is an immediate risk of harm to care staff in RACFs and non-pharmacological interventions have failed to avert the threats. This article examines an account of how this recommendation can be ethically defensible: caregivers in RACFs may have a prima facie ethical justification, in certain cases, to use APs as an act of self-defense. The author examines whether such uses of APs meet the three commonly invoked conditions of ethically permissible acts of self-defense—namely, the conditions of liability, proportionality, and necessity—and argues that such conditions obtain only in a restricted range of cases. The liability constraint can be satisfied if residents are the only ones who are causally responsible for the threats they pose. Further, the condition of proportionality obtains if there is sufficient objective ground to demonstrate that the harm of using the medications does not outweigh the good to be secured. Lastly, the necessity condition obtains when the medications are used at their lowest effective dosage and caregivers in RACFs can reasonably assume that, for the purpose of averting threats posed by residents, the use of APs is the only available course of action. Not meeting any of these fairly stringent conditions renders uses of APs as acts of self-defense in RACFs morally impermissible actions

Dementia · Harm · Liability · Political science · Prima facie · Psychological intervention · Free Will and Agency · Healthcare Decision-Making and Restraints · Law · Medicine · Nursing · Patient Dignity and Privacy · Psychology · Social Psychology

  • Using Antipsychotics for Self-Defense Purposes by Care Staff in Residential Aged Care Facilities

    Open Access•Hojjat Soofi•Cambridge Quarterly of Healthcare…•2022

  • The Basis of Moral Liability to Defensive Killing

    Open Access•Jeff Mcmahan•Philosophical Issues•2005

  • Using Antipsychotics for Self-Defense Purposes by Care Staff in Residential Aged Care Facilities

    Open Access•Hojjat Soofi•Cambridge Quarterly of Healthcare…•2022

  • Ethics of War and Peace

    Open Access•Henrik Syse, Gregory Reichberg et al.•Journal of Peace Research•2000

  • Necessity in Self‐Defense and War

    Open Access•Seth Lazar•Philosophy & Public Affairs•2012

Unique citing works1
Citations per year0.25
Citation span2022 - 2022 (1)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 1

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