Using consentless practices on medical wards—A qualitative study
Joar Björk, Niklas Juth, Tove GodskesenBackground
In contrast to legally mandated coercive care in psychiatry, there is a paucity of studies on the use of coercive practices within somatic healthcare.
Aim
To gain an in-depth understanding of the practices used by nurses and other staff to provide somatic healthcare interventions to ill patients in the absence of informed consent.
Research design
Focus-group interviews were held, and the collected data were analyzed qualitatively using Reflexive Thematic Analysis.
Participants and research context
Participants (
Ethical considerations
All participants were informed about the study’s aims and voluntary nature, and provided oral consent before being interviewed. No sensitive personal information was recorded.
Findings
The qualitative analysis resulted in the identification of four main themes:
Conclusions
Consentless practices are frequently used on medical wards, and nurses and other staff are familiar with a wide array of such practices. Consentless practices are learned informally, mainly through observation. Staff with greater professional experience can deliver healthcare interventions without overt coercion, but may become habituated to using consentless practices. These findings raise a range of ethical concerns. Better opportunities for reflection and learning on this topic may improve the ethical climate on medical wards.