Monday, May 23, 2005

Covert Drug Administration: `Win Battle, But Lose War'  Psychiatric News story - " Surreptitious administration of medications may seem like a tempting option for nonadherent patients, but the disadvantages may outweigh any benefits. Spiking a child's food or drink with medication may be an acceptable necessity when there's no other way to give a drug. Adults are another matter, even for those with severe mental illness who cannot or will not take their medicine. The practice of covertly administering drugs may seem like a minor matter, but it touches on legal and ethical issues of the patient's competence, autonomy, and insight, wrote [the authors] in the April issue of Psychiatric Services. ... Research on the extent of the practice is spotty but suggestive. Drugs were given covertly at some time in 24 of 34 residential, nursing, or inpatient units in southeast England, according to a study in the August 2000 issue of the Journal of the Royal Society of Medicine. ... Little information is available on the extent of the practice in the United States, said former APA President Paul Appelbaum, M.D., now chair of APA's Council on Psychiatry and Law, but he thinks it is rare in inpatient settings, given professional sensitization to informed consent and knowledge of how to obtain consent or what to do if the patient is not competent..."