The Ethical and Legal Challenges Related to CBR (Complete Bed Rest) Patients

Authors

  • Mohammad Ali Abbaspour Razi Clinical Research Development Unit, Guilan University of Medical Sciences, Rasht, Iran
  • Hamid Mohammadi Kojidi Department of Forensic Medicine, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
  • Kourosh Delpasand Department of Medical Ethics, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
  • Ahmad Mashkoori Department of Medical Ethics, School of Health and Religion, Spiritual Health Research Center, Qom University of Medical Sciences, Qom Iran https://orcid.org/0000-0002-6111-6643

Keywords:

Medical ethics, Patients, Ethics

Abstract

CBR is occasionally prescribed for conditions like preterm labor, pregnancy-induced hypertension, and low back pain. However, recent research questions the medical efficacy of extended CBR. Moreover, enforced immobilization may infringe upon patient autonomy, dignity, and quality of life. Legal issues also arise if adequate informed consent is not obtained before prescribing severe activity limitations. To explore the ethical and legal challenges of prescribing prolonged complete bed rest (CBR) for patients. CBR is a treatment that severely restricts patient mobility and autonomy, which necessitates careful consideration of ethical implications. A comprehensive literature review was conducted in medical ethics, legal journals, and general databases. Cases involving CBR were analyzed to identify common ethical dilemmas and areas of legal ambiguity. International guidelines on restricting patient mobility were also incorporated. Key ethical challenges identified include insufficiently informed consent procedures, failure to consider less restrictive alternatives, and disregard for patient preferences. Legally, CBR may constitute unlawful imprisonment if not medically justified or if consent is invalid. International disability rights were also shown to apply. Complete bed rest raises profound medical ethics and legal concerns that warrant careful consideration and additional safeguards whenever used. More research is needed to balance treatment efficacy with respect for patient autonomy and well-being. 

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References

1. Tsai DF. How should doctors approach patients? A Confucian reflection on personhood. J Med Ethics. 2001;27(1): 44-50. Abbaspour et al Abbaspour et al 19 | J Iran Sci Asso Med Ethi, 2025, Volume 1, Issue 1

2. McLean SA. What and who are clinical ethics committees for? J Med Ethics. 2007;33(9): 497-500.

3. Rasoal D, Skovdahl K, Gifford M, Kihlgren A. Clinical Ethics Support for Healthcare Personnel: An Integrative Literature Review. HEC Forum. 2017;29(4): 313-46.

4. Brower RG. Consequences of bed rest. Crit Care Med. 2009;37(10 Suppl): S422-8.

5. Sanjari M, F Z, Larijani B. Ethical Codes of Nursing and the Practical Necessity in Iran. Iranian journal of public health. 2008.

6. Winkelman C. Bed rest in health and critical illness: a body systems approach. AACN Adv Crit Care. 2009;20(3): 254-66.

7. Swick H. Toward a Normative Definition of Medical Professionalism. Academic medicine : journal of the Association of American Medical Colleges. 2000;75: 612-6.

8. Jagsi R, Lehmann LS. The ethics of medical education. Bmj. 2004;329(7461): 332-4.

9. Ben-Haroush A, Yogev Y, Mashiach R, Meizner I. Pregnancy outcome of threatened abortion with subchorionic hematoma: possible benefit of bed-rest? Isr Med Assoc J. 2003;5(6): 422-4.

10. McCall CA, Grimes DA, Lyerly AD. "Therapeutic" bed rest in pregnancy: unethical and unsupported by data. Obstet Gynecol. 2013;121(6): 1305-8.

11. Dunn Dsn RLL, Handley PhD RMC, Carter Dsn RMR. Antepartal Bed rest: Conflicts, Costs, Controversies and Ethical Considerations. Online Journal of Health Ethics. 2006;3:4.

12. Allen C, Glasziou P, Del Mar C. Bed rest: a potentially harmful treatment needing more careful evaluation. Lancet. 1999;354(9186): 1229-33.

13. Akinbodewa AA, Adejumo OA, Adejumo OA, Adebayo FY, Akinbodewa GO, Alli EO, et al. Evaluation of administration of discharge against medical advice: Ethico-legal considerations. Niger Postgrad Med J. 2016;23(3): 141-5.

14. Alfandre DJ. "I'm going home": discharges against medical advice. Mayo Clin Proc. 2009;84(3): 255-60.

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Published

2025-03-30

Issue

Section

Research articles

How to Cite

The Ethical and Legal Challenges Related to CBR (Complete Bed Rest) Patients. (2025). Journal of the Iranian Scientific Association of Medical Ethics, 1(1), 13-19. https://jirme.ir/index.php/JIRME/article/view/14