Unpacking Bedside Bioethics Ethical Issues in Posted Behavior Signs

There has been a proliferation of posted behavior signs over the last five years. They are now ubiquitous in both inpatient and outpatient settings and across pediatric, adult, and allied health practices. Named as notices for “Patients and Visitors,” these signs identify a range of conduct, from clinical noncompliance, use of profanity, and raised voices to acts or threats of physical violence. While these signs may offer a tangible signal from institutional leadership to staff that disruptive behavior is unacceptable, there is no empirical evidence that they are effective in reducing workplace violence or verbal attacks. Aside from the problem of efficacy, I argue that posted behavior signs are ethically troubling for the way they treat patients and families and for the impact they can have on them. I identify four distinct ethical concerns with these signs, which I believe require either their removal or their substantial modification.