The cost of safety: Balancing risk and liberty in psychiatric units

Rocksheng Zhong, Tobias Wasser

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


The systems approach is a widely accepted method for addressing healthcare adverse events. However, when adverse events are behavioral in nature, such as self-injury or aggression, a systems approach can restrict patient autonomy. We propose guidelines for balancing safety and autonomy considerations when developing systems for behavioral adverse events: interventions that do not limit patient liberty, or that therapeutically address the root causes of behavioral adverse events, should be fully utilized. Clinicians should collaborate with patients when designing systems that may restrict patient liberty. And clinicians should be supported in managing the stress that accrues from working in hazardous environments.

Original languageEnglish (US)
Pages (from-to)173-177
Number of pages5
Issue number2
StatePublished - Feb 2021
Externally publishedYes


  • adverse events
  • autonomy
  • forensic psychiatry
  • inpatient psychiatry
  • risk management
  • systems approach

ASJC Scopus subject areas

  • Health(social science)
  • Philosophy
  • Health Policy


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