Understanding Covert Medication

Posted: 25th October 2024
by Hannah Cullen
Covert medication refers to administering medication to a person without their knowledge or consent. This practice is particularly relevant in situations where an individual lacks the capacity to make informed decisions about their own treatment. It is commonly discussed in the context of healthcare, particularly in mental health settings or for individuals with severe cognitive impairments.
A lack of capacity to make decisions about taking medication, does not automatically mean that medication can be given covertly. Administering medication covertly must be heavily scrutinised due to the significant interference with autonomy it presents. The person must have to be deemed to be lacking capacity before the decision for covert medication can be made.
Healthcare providers must weigh up the benefit of administering the medication over depriving the person of their liberty when it comes to a decision on medication. Health care professionals must act in the best interests of the person, and on occasion, this can mean that receiving the medication outweighs the person’s own wishes and feelings about taking the medication. The medication must be shown to be essential to the person’s well-being and that no less-restrictive options are available. It must be practical and proportionate to the person’s situation.
Covert medication must be legally authorised or there may be a risk of professional misconduct. In most cases, covert medication takes place where the person is deprived of their liberty. If covert medication is being used, then this must be listed as a condition within the standard authorisation.
A thorough assessment must be conducted to determine the person’s capacity and to justify the use of covert medication. This usually involves a multi-disciplinary team and thorough documentation. The decision-making process should be well-documented, including why covert medication is deemed necessary and how it will be administered.
Even when covert medication is deemed necessary, there should be efforts to communicate with the person in a way that they can understand so they remain involved with their own care. The use of covert medication should be regularly reviewed. The reviews should involve family of the person and their Relevant Persons Representative (RPR) if applicable.
Covert medication remains heavily scrutinised by the Court of Protection due to the significant ethical implications on autonomy and informed consent. It may amount to a violation of a person’s rights, even when done with the intention of benefitting the person. Without thorough regulation and monitoring, there is a risk of misuse or abuse of the medication, and it should only be used in genuine cases where it is absolutely necessary and justified.
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