Covert administration of medicines

Information on the relevant resource and processes regarding the covert administration of medicines

This information relates to the administration of medicines in food or drink to people unable to give their consent to or refuse treatment. It should be read in conjunction with:

Nurses and midwives involved in decisions relating to administration of medicines in this way must act within the principles of The Code, NMC 2008 and ascertain and record the support, or otherwise, of the rest of the multi-professional team, and where appropriate family members, carers and others. It is inadvisable for nurses and midwives to make a decision to administer medication in this way in isolation. They will need to refer to local and national policies and apply the requirements of the law, particularly in relation to capacity. Some forms of disguised medication are recognised in law, for example, if a person is lawfully detained under a section of the relevant mental health legislation.

As a general principle, by disguising medication in food or drink, the patient /client is being led to believe that they are not receiving medication, when in fact they are. The covert administration of medicines is only likely to be necessary or appropriate in the case of patients or clients who actively refuse medication but who are judged not to have the capacity to understand the consequences of their refusal.

As well as the ethical and legal considerations the nurse or midwife needs to consider that administering medicines in this way may alter their therapeutic properties rendering them ineffective and not covered by their product licence. This is a matter to be discussed with the pharmacist as part of the decision making process.

Further information

This information was reviewed in September 2013.

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