Covert Medication Administration

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Legal and Ethical Issues in Medication AdministrationKarla ShircliffClinical Pharmacology NR120November 13, 2012 Theresa Wischmann, RN, MSN

AbstractThis paper is about an article I found online, published by The American Academy of Psychiatry and the Law. I found it to be very interesting and relevant in regards to the treatment of non-compliant psychiatric patients. It is about the covert administration of medications to patients, or administering medication without the patient’s knowledge. It presents many legal and ethical questions which I will discuss.

The legal and ethical issues presented by this article are multiple and varied. I was not aware that this practice took place, but I am not surprised that it does. Covert medication administration to psychiatric patients who are not compliant is defined as administration of medication without the patient’s knowledge or consent. Although there have been no identified studies of covert medication administration in hospital emergency departments, the article reviews the prevalence of this practice in other clinical settings. There have also been no court rulings on this matter. There are many nursing ethical principles which can be identified at the core of this issue. First and foremost would be autonomy, or the agreement to accept another's right to self-determine a course of action, or support of independent decision making. When a psychiatric patient is non-compliant and presenting with idealizations in which he/she intends to do harm to him/herself or others, does it not seem that covert medication administration in this situation would be ethical in that it would prevent the patient from doing harm? Beneficence, or compassion, taking positive steps to help others, the desire to do good is at the core of our principle of patient advocacy. Do the legal and ethical implications of covert medication administration negate these core principles, or do they reinforce them? I believe that this is a...
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