CMS Publishes Patients’ Rights Rules on Use of Restraints and Seclusion; An Expert Responds
After the Centers for Medicare & Medicaid Services recently issued new rules (to become effective Feb. 6, 2007) mandating more rigorous training of health care workers in the use of restraints and seclusion, we received a response from Linn Cohen-Cole, who is a nationally known expert and writer on restraint and seclusion, committed to ending their use. Among her published work is “Restraint and Seclusion: The Physiologic Catastrophe of Psychiatric Control and the Fallacy of a Psychiatric Science.” She has testified before the President’s New Freedom Commission on Mental Health and has consulted with the National Association of State Mental Health Program Directors and others on this issue.
More information about the new CMS rules is available at the following link: http://www.medicalnewsservice.com/fullstory.cfm?storyID=4281&fback=yes.
Cohen-Cole has agreed to allow her remarks to be posted. She writes:
“The improvements they suggest are Orwellian. They are training people in ‘proper’ abuse, in careful anti-human rights actions. They do not understand the fundamental principle that mammals (of any kind) can’t go through [seclusion and restraint] without massive physiologic consequences (and that is leaving off all of the massive psychological ones).
“They are also missing the point that mental health patients really do finally deserve to be full-fledged human beings as measured by their also having the full panoply of human rights (or at least a recognition that their rights are being violently violated) and should not be captive victims anymore of a field that is unbound by human rights or even standard law. . . .
“What does ‘freedom from the inappropriate use of all restraints and seclusion’ mean except to imply there is appropriate use? And where are there any legal avenues set up for these patients, whose freedom is bandied about as an empty word? Where is the slightest effort to establish the most basic of safeguards: due process? . . . How about actual freedom? How about laws to allow patients to reach a lawyer mid-restraint? These people do not even have habeas corpus rights, as a prisoner would.”
Responding to a written comment by Eric B. Broderick, D.D.S., M.P.H., acting deputy administrator of the Substance Abuse and Mental Health Services Administration that “Today we are taking needed steps to solidify training requirements and essential reporting to reduce and ultimately eliminate seclusion and restraints,” Cohen-Cole added, “They haven’t the first clue that elimination takes only saying, ‘This is wrong to its core and it’s over.’ ”
(See also the Hartford Courant’s coverage.)
posted by Susan Rogers
More information about the new CMS rules is available at the following link: http://www.medicalnewsservice.com/fullstory.cfm?storyID=4281&fback=yes.
Cohen-Cole has agreed to allow her remarks to be posted. She writes:
“The improvements they suggest are Orwellian. They are training people in ‘proper’ abuse, in careful anti-human rights actions. They do not understand the fundamental principle that mammals (of any kind) can’t go through [seclusion and restraint] without massive physiologic consequences (and that is leaving off all of the massive psychological ones).
“They are also missing the point that mental health patients really do finally deserve to be full-fledged human beings as measured by their also having the full panoply of human rights (or at least a recognition that their rights are being violently violated) and should not be captive victims anymore of a field that is unbound by human rights or even standard law. . . .
“What does ‘freedom from the inappropriate use of all restraints and seclusion’ mean except to imply there is appropriate use? And where are there any legal avenues set up for these patients, whose freedom is bandied about as an empty word? Where is the slightest effort to establish the most basic of safeguards: due process? . . . How about actual freedom? How about laws to allow patients to reach a lawyer mid-restraint? These people do not even have habeas corpus rights, as a prisoner would.”
Responding to a written comment by Eric B. Broderick, D.D.S., M.P.H., acting deputy administrator of the Substance Abuse and Mental Health Services Administration that “Today we are taking needed steps to solidify training requirements and essential reporting to reduce and ultimately eliminate seclusion and restraints,” Cohen-Cole added, “They haven’t the first clue that elimination takes only saying, ‘This is wrong to its core and it’s over.’ ”
(See also the Hartford Courant’s coverage.)
posted by Susan Rogers
Labels: advocacy, seclusion and restraint
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