Cooperation with neuroatypical patients – legal and ethical aspects, strategies for minimising coercion

Children with neurodevelopmental disorders, such as autism spectrum disorder and intellectual disability, often struggle to cope with new and stressful situations, especially during medical procedures, including diagnostic tests, wound care, vaccinations, and dental treatment. The requirement to undergo such procedures may provoke intense anxiety and result in non-cooperation. This lack of cooperation stems both from the individual’s functional characteristics and the medical staff’s inadequate preparation. Consequently, staff and caregivers may resort to physical restraint (direct coercion) to ensure safety or complete the procedure. While sometimes necessary, such measures carry a risk of inducing or intensifying psychopathological symptoms, traumatising the patient, and fostering aversion to future healthcare encounters. Given the increasing prevalence of neurodevelopmental disorders and the growing number of patients requiring specialised support, an appropriate approach is essential. This requires staff education, development of adequate legal regulations, and the application of practical strategies tailored to individual patient needs. This article aims to discuss the functional characteristics of children with neurodevelopmental disorders, present practical strategies for enhancing their cooperation with medical personnel, and analyse the legal aspects of using various forms of restraint. The aim is to provide practical guidance for medical staff and highlight the need for further research into effective and safe methods of supporting this particularly vulnerable patient group.