by clinical and nursing professionals contacted, shows that there is a culture of respect for the dignity and rights of the patients, limiting its use essentially with motives of security to the patient and third parties. As for the prescription and administration of medication in the absence of the physician (designated SOS medication), this follows a protocol authorisation, evident in the patient’s clinical process. The administration of tranquilizer medication, in this context, is not necessarily perceived or qualified by professionals as a measure of restraint. If it is admissible the use of protocols for administration of certain drugs, the rule is not universally valid for all medicine. There is a need to distinguish different situations (v.g., antipsychotics, sedatives, tranquilizers) in order to ensure prescription and administration according to best practices and guarantees that medication constitutes a chemical constraint is understood to be a constraint by all professionals. The clear definition of the drugs which, associated with other conditions, corresponds to a constraint would strengthen, in my opinion, the guarantees of the patients, and also the safety and liability of the professionals who manage them, especially if they are not physicians. After the visit of the facilities for newly admitted patients (intensive intervention service), a general assessment concluded that they presented good hygiene conditions, lighting and overall good maintenance conditions. The privacy is sufficiently ensured, both in the wards and the bathrooms. During the visit, two patients were in the «isolation room». One of the patient’s situation was particularly unsettling, by how disproportionate this grievous constraint measure seemed, considering the apparently unaggressive behaviour. According to the staff, this is a measure used due to the lack of alternative to ensure proper surveillance (the patient will require permanent monitoring, and, temporarily, there were not enough technicians), this was expected to be overcome in a short period of time, and absolutely prevented from future. The day, in which the visit occurred, the two «isolation rooms» had been occupied for more than twenty four hours. The patients confined there have limited visual contact with the outside by means of a small acrylic rectangle on the metal door of the room, which abuts the corridor where you can’t always find a health care professional. Patients are, however observed regularly, in particular through the surveillance cameras, which transmit the image to the nursing room. Also found to be disturbing, in which regards the treatment conditions and respect the dignity of patients, was the unmitigated noise that one of the patients constantly emitted by beating, with a regular rhythm, with his heel in the metallic door of the room It was an especially distressing situation, since the patient occupying the adjoining room, also in isolation, suffered from a psychotic disorder which made him believe that he was in a war zone. From a therapeutic perspective this was referred not be a suitable solution. The justification offered, invoked the limitations of the physical spaces and an 82 |