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Covering It Up? Questions of Safety, Stigmatization, and Fairness in Covert Medication Administration

Published online by Cambridge University Press:  01 January 2021

Abstract

This paper examines the practice of covert medication administration from an organizational ethics perspective. This includes consideration of vulnerability and stigmatization, safety, and fairness (justice) in terms of the culture of health care organizations and the relevance of policies and processes in relation to covert medication administration. As much of the discussion about covert medication administration focuses on patients and health care providers, this analysis aims to help expand the analysis of this practice.

Type
Symposium Articles
Copyright
Copyright © American Society of Law, Medicine and Ethics 2017

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References

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Both the nature of fiduciary relationships and trust in the patient-health care provider relationship are addressed by the three other papers in this special issue. See Abdool, R., “Deception in Caregiving: Unpacking Ethical Considerations in Covert Medication”; L. Munden, “The Covert Administration of Medications: Legal and Ethical Complexities for Health Care Professionals”; Sheldon, T., “Proof in the Pudding: The Value of a Rights-Based Approach to Understanding the Covert Administration of Psychotropic Medication to Adult Inpatients Determined to Be Decisionally-Incapable in Ontario's Psychiatric Settings,” Journal of Law, Medicine & Ethics 45, no. 2 (2017).Google Scholar
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While this article does not address the use of covert medication administration, its organizational focus and discussion of factors that impact managing care situations safely is informative and relevant. See Martin, T. and Daffern, M., “Clinician Perceptions of Personal Safety and Confidence to Manage Inpatient Aggression in a Forensic Psychiatric Setting,” Journal of Psychiatric and Mental Health Nursing 13, no. 1 (2006): 90-99. As well, if some health professional colleges argue that covert administration of medications ought not to be done, (see Munden, , supra note 4), the obligation and onus on these colleges and healthcare organizations to provide other alternatives via policies, procedures, and training is further heightened.CrossRefGoogle Scholar
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See also Sheldon, , supra note 4 for further discussion about fairness in terms of patients being able to contest or appeal being given medications covertly.Google Scholar