To the Editor. —The study of Physical and Pharmacologic Restraint of Nursing Home Patients With Dementia by Sloane et al 1 reminds us that the care of nursing home patients with dementia requires sensitivity and expertise. It is certainly true, for example, that psychotropic medication is often misused or overused in this population. Unfortunately, Sloane et al use an inappropriately broad definition of pharmacologic restraint that does injustice to many who care for geriatric patients and ignores the psychiatric and legal issues surrounding this term. Pharmacologic or chemical restraint is a legal (not medical) term, arising from litigation involving the involuntary (usually intramuscular) administration of antipsychotic agents. Such practices have been severely constrained, eg, the Rogers decision ( Rogers v Okin ), 2 precisely to protect what Sloane et al call liberty. Sloane et al use a much broader definition of pharmacologic restraint, which they say exists when the patient had