To the Editor.—The study by Quill1 in a recent issue of the Archives noted that 53% of the patients receiving nasal tube feedings had physical restraints used to prevent those patients from pulling out their feeding tubes. He suggests that in patients with severe irreversible illness who pull out their feeding tubes the use of restraints probably burdens rather than benefits the patients. The frequency with which restraints were used in Quill's study is probably true for many hospitals and is probably even worse in many nursing homes. This is quite unfortunate, as physical restraints are detrimental to patient care for the following reasons: (1) physical restraints severely limit the patient's physical activity and thus promote bedsores, muscle atrophy, and frozen joints; (2) restraints force a patient to be dependent on nursing staff for virtually every activity of daily living; (3) it is humiliating for a patient to be
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