IntroductionIn France, a new law now requires very strict supervision of seclusion and mechanical restraint measures for patients submitted to compulsory, unconsented psychiatric care. Many professionals perceive this law, along with other recent laws and rules, as reflecting defiance towards psychiatry professionals, and, above all, as utterly inapplicable except at the cost of medical and administrative chaos. This law has put in place a strict (overly strict?) framework for the use of seclusion and mechanical restraint in unconsented psychiatric care. No such legal framework is in place, however, for psychiatric or non-psychiatric emergency units. Yet, psychiatric emergency teams look after patients in crisis, agitated and potentially dangerous for others or for themselves. For them, alternative, non-coercive measures are not always appropriate or effective. More coercive measures, may, with demonstrated clinical evidence, be required. Objectives and methodsThe work presented here reviews the medical, legal and ethical considerations which need to be taken into consideration in light of the lack of a framework defined by the law. This work is based on interviews with different experts, and it also considers legal data. It was conducted before the recent law was passed, a law that does not cover medical practice prior to hospitalization in any event. ResultsIt appears that the practice of physical restraint in emergency departments is sometimes necessary. A study of the latest decisions in French case law shows that emergency services must, in certain situations, take necessary measures for patients “such as restraint, chemical treatment or [intensive] surveillance”. If not, they run the risk of being found legally at fault. Case law also teaches us that physical restraint in emergency services must be carried out in accordance with non specific recommendations of good practice. This legal framework is not well-known to all practitioners working in emergency units. It ought to circulate more, thanks perhaps to the release of a scientific article that can synthetize this information. In addition, in the absence of specific good practice recommendations for the implementation of physical restraint in emergency services, more work is needed, on standardization, on protocols for the implementation of physical restraint, and on monitoring trackers. Finally, this works endorses monitoring the use of such coercive measures, in order to plot out its extent, to analyze its evolution over time and ultimately to reduce recourse to it. This work submits a proposal to that end. ConclusionIronically, in emergency departments there may ultimately be less forensic risk in physically containing than in not containing - provided that it is done with appropriate supervision. Of course in emergency departments even more than elsewhere such measures are temporary and do not always result in admission to compulsory psychiatric care. Such measures must be proportionate with the perceived risk or danger. In our opinion, the present legal void, which permits all the flexibility that emergency care requires, must not be followed by the legal inflexibility currently applicable to coerced hospitalization. But it is necessary that every medical decision be justifiable, solidly argued and traced.