If a patient is physically combative, attempting to injure providers, and less restrictive interventions have been attempted, four-point restraints are indicated in order to protect all involved. Likewise, if a patient is a threat to oneself and less restrictive interventions have been unsuccessful, four-point restraints may be indicated. Less restrictive restraints, including chemical, must be proven unsuccessful before application of four-point restraints. If waiting to restrain a patient creates a risk of serious harm to the patient or others, four-point restraints may be appropriate. If the patient is refusing care and has not been deemed incompetent, restraints may not be used in order to force compliance, even if the refusal of care results in the death of the patient.