NHRCK Recommends Improvement of Routine 'Compulsory' Prescriptions in Psychiatric Hospitals When Necessary

National Human Rights Commission of Korea building. Photo by National Human Rights Commission

[Asia Economy Reporter Lee Gwan-joo] The National Human Rights Commission has recommended improvements, stating that psychiatric institutions prescribing 'as-needed (PRN: pro re nata) restraint' without a psychiatrist's diagnosis can excessively restrict the physical freedom of hospitalized patients.

On the 17th, the Human Rights Commission accepted a complaint filed by Mr. A, who is hospitalized at a certain psychiatric institution, against the hospital director, and recommended that the hospital provide human rights education to staff and discipline employees who failed to record physical restraints.

Mr. A, hospitalized at this hospital, filed a complaint with the Human Rights Commission, claiming that he suffered human rights violations by being restrained, including being tied continuously for 48 hours and only receiving injections in an isolation room during the admission process. The Commission determined that Mr. A was continuously restrained for a total of 23 hours and 50 minutes during the first three days of hospitalization: 3 hours and 50 minutes for the first restraint, 4 hours for the second, 14 hours for the third, and 2 hours for the fourth.

In response, the hospital argued that although restraints were lifted in between, due to Mr. A's violent behavior and the risk of staff assault, they had no choice but to restrain him again. They also stated that the attending physician, upon leaving work, instructed that "restraint is possible as needed if the patient's condition is severe and aggressive behavior is intense."

However, the Human Rights Commission judged that the hospital did not comply with the Ministry of Health and Welfare's "Isolation and Restraint Guidelines." The guidelines stipulate that restraint should be limited to a maximum of 4 hours per instance and 8 hours continuously, and if the maximum allowable time is exceeded, a face-to-face evaluation by a psychiatrist and a subsequent appropriateness assessment must be conducted. The hospital failed to follow these procedures, as the third restraint lasted 14 hours despite the presence of an on-duty physician, who did not perform a face-to-face evaluation.

Additionally, the Commission explained that the hospital's medical records showed that when there was a PRN prescription from the attending physician stating "restrain if necessary," nurses mechanically recorded "under the attending physician's instructions" in the isolation and restraint execution logs. The Human Rights Commission viewed the excessive restraint based on PRN prescriptions, which violates the Ministry of Health and Welfare guidelines, as an infringement on constitutionally guaranteed physical freedom, and recommended improvements in practice and measures to prevent recurrence.

This content was produced with the assistance of AI translation services.