Ethics & law
Is it right to hide medication in patients’ food?
Marika Davies, a medicolegal adviser, gives advice on some common ethical dilemmas faced by medical students
What you witnessed is known as covert medication, which is the practice of hiding drugs in food or drink so that the patient takes their drugs unknowingly. It is sometimes used when patients who lack capacity refuse treatment that is considered necessary for their physical or mental health: but its use is controversial. The Royal College of Psychiatrists says that covert medication is justified when it enables the provision of effective treatment to someone who would otherwise reject it.1 However, others describe it as a form of deception that is overly paternalistic, and express concern that it might be overused to meet the needs of staff rather than patients.
In a court case involving the covert administration of strong sedatives to a 92 year old woman, the judge said that the use of covert medication “must always call for close scrutiny.”2 He said it was an interference with the patient’s