Review of Maqāsid al-Syarī'ah in the Use of Physical Restraint to Reduce the Risk of Falls in Patients: Literature Review

Reducing the risk of patient falls is one of the most crucial Patient Safety Goals (SKP 6) in hospitals. In clinical practice in inpatient wards, geriatrics, neurology, and the Intensive Care Unit (ICU), physical restraints such as wrist/ankle restraints, body restraints, and full-length bilateral bed rails are still frequently used as pragmatic interventions to prevent patients from falling or dislodging medical devices. However, scientific evidence shows a restraint paradox: the use of unmeasured physical restraints often fails to reduce falls, triggers fatal entanglement injuries, worsens delirium and agitation, irreversibly reduces daily functioning within 72 hours, and violates human autonomy and dignity (karāmah al-insān). This paper examines the use of physical fixation to reduce the risk of falls through an analysis of the Maqāṣid al-Syarī'ah (Islamic principles) and the principles of Islamic jurisprudence (al-qawā'id al-fiqhiyyah) based on 18 reliable scientific literature sources from 2021–2026. The results of the study indicate that the basic law of restricting human movement is prohibited because it harms human dignity and has the potential to cause physical and psychological harm. However, physical fixation can change status to mubah or wajib temporarily on the basis of medical emergency (al-ḍarūrāt tubīḥ al-maḥẓūrāt) in order to maintain the safety of life (ḥifẓ al-nafs) in patients with impaired consciousness or acute agitation (such as post-surgery subarachnoid hemorrhage or critical delirium), with the strict condition that all non-restrictive interventions have been attempted, are carried out proportionally according to the level of emergency (al-ḍarūrah tuqaddar bi qadarihā), do not cause equal or greater harm (al ḍarar lā yuzāl bi mithlih), are accompanied by informed consent from the guardian/family, and are evaluated periodically every 2 hours according to accreditation standards and Sharia Hospitals.