Measures involving deprivation of liberty
Between protection and self-determination
How families deal responsibly with deprivation of liberty measures.
Aids are a natural part of everyday life for many families with children with disabilities. They are intended to provide support, safety and participation. However, some measures operate in a sensitive border area: where assistance no longer merely provides support, but restricts freedom of movement or overrides a child's will, experts speak of measures involving deprivation of liberty - FEM for short.
This raises difficult questions, especially in inclusive family life:
How much protection is necessary?
When does protection become deprivation of liberty?
And how can safety and self-determination be reconciled?
What are measures involving deprivation of liberty?
Deprivation of liberty measures are interventions that restrict a child's physical freedom of movement or freedom of choice - regardless of whether they are well-intentioned or intended to ensure safety.
These can include
- Restraints with straps on the bed, chair or wheelchair
- Bed rails that prevent the child from getting up independently
- Tables or devices from which a child cannot free themselves
- Locking rooms or doors
- Removal of important aids (e.g. walking aids)
- Sedative medication that suppresses behavior or the urge to move
It is important to note: Not every safeguarding measure is automatically an FEM.
The decisive factor is always
- Can the child escape the situation?
- Does the measure correspond to the child's recognizable will?
- Are there milder alternatives?
Aids: support or restriction of freedom?
Aids are often at the center of this area of conflict. One example:
A special seat with a harness can help a child to sit stably, play at the table or eat - this can enable participation. However, if the same harness is used in such a way that the child can no longer stand up even though they want to, it can become a measure that deprives them of their liberty.
The difference is not in the aid itself, but in
- the application
- the duration
- the purpose
- and the will of the child
Aids should enable - not restrain.
Legal framework: What applies in Germany?
In Germany, the protection of children from unjustified deprivation of liberty is clearly regulated by law.
Family court approval
In many cases, measures involving deprivation of liberty for children that last longer or are used regularly require the approval of the family court.
This applies in particular to measures in:
- Facilities for the disabled
- Youth welfare facilities
- Nursing and care facilities
The court checks:
- Is the measure necessary?
- Is it proportionate?
- Are there alternatives?
- Is it actually in the best interests of the child?
Uniform nationwide - different in practice
The approval requirement for FEM is regulated nationwide. There are no different state laws on this.
However, the practice of the courts can vary from region to region - for example, in terms of how rigorously it is examined or how quickly decisions are made.
FEM in intensive care, short-term care & hospice
Where do particular challenges arise?
- Intensive care services for children
- Short-term care facilities
- Children's hospices
Why is the topic particularly sensitive there?
- Children are often connected to medical devices
- Safety measures may seem vital
- Care situations change
- Stays are sometimes short-term or limited in time
What also applies here?
- Security does not automatically justify deprivation of liberty
- Measures must not be taken for routine or organizational reasons
- The principle of the mildest means also applies in these settings
- Parents must be informed and involved
- Family court approval may be required for genuine FEM - even for short stays
Particularly important:
Protective positioning or close supervision ≠ Fixation against the child's will.
The limit must be assessed individually.
Who bears responsibility?
The responsibility for measures involving deprivation of liberty does not lie solely with the parents.
Care services, facilities and professionals also have their own legal and professional responsibility to avoid FEM, examine alternatives and obtain approval.
Parents can and should:
- Ask questions
- Express doubts
- Demand transparency
This is not mistrust - it is care in action.
What parents can do specifically
It can help to address the following points, especially before a stay in a facility or when starting intensive care:
- What safeguarding measures are common?
- When is it considered an FEM?
- How is the will of my child perceived?
- Are there concepts for avoiding FEM?
- Who applies for court approval if necessary?
- How will I be informed if something changes?
Clear agreements protect everyone involved - but above all the child.
Conclusion
Children with disabilities need protection, support and sometimes also special safeguards.
But they also have a right to self-determination, dignity and co-determination.
Measures that deprive children of their liberty must never become a habit - even if they are well-intentioned.
Because real support does not mean holding children down, but giving them as much freedom as possible and as much protection as necessary.
Tips from the community:
Take a close look.
It helped us to look closely: Why is a safeguard being used? If it was just a matter of organization or rest, we looked for alternatives together with the facility.
Focus on our child.
We always involve our child as much as possible. Even small signs or reactions help to understand what feels right or wrong.
Tummy time is important to us.
For us, the most important step was to take our gut feeling seriously. If something didn't feel right, we talked about it - even if it was uncomfortable.
Special bed
The restless bed from KayserBetten has saved our nights and our sleep.