The issue I found a challenge and one i had never thought about, is temperatures of food affecting potency, I expect hot foods could be far more of an issue than cold. Consider an adult with learning disability who consistently rejects all oral medication, including anticonvulsants. In registration studies, these arrhythmias, which require cardioversion, occurred in 1. Finally, if covert medication contravenes contemporary ethical practice, can it ever be made ethical by the inclusion of additional safeguards? Patients were not given other antiarrhythmic drugs within 24 hours of ibutilide fumarate infusion in this study. Longer monitoring is required if any arrhythmic activity is noted. Others think of it as a means of daring to care, while doing no harm Singh, 2008.
An unwise decision must be respected if the patient has capacity. If we insisted on consent patients might suffer from being denied care they could not validly reject. . Prescribers are bound by law and by the demands of good practice to consider the extent to which a person can make decisions regarding taking medications for themselves. He admits to having consulted in the same hospital and being prescribed medications but since last two weeks having been off it and complains of homicidal and suicidal ideations. Conclusion: The practice of covertly administering medications is one that has potential to endanger public safety and breach legal and professional requirements, Wright 2002. Wong et al 2005 also holds with this view that stopping treatment that has proven to significantly decrease a presenting behaviour is contrary to the ethical principle of non-maleficence and that the covert administration is the least disturbing for the client and those around him.
Box 1: The Mental Capacity Act 2005 The Mental Capacity Act 2005 is a law that applies to all adults aged 16 years and over. Pediatric Use Clinical trials with Corvert in patients with atrial fibrillation and atrial flutter did not include anyone under the age of 18. Care homes are to ensure that if a decision is taken to covertly administer medicine to an adult care home resident, then a management plan should also be agreed and recorded after a best interest meeting. Only if it is essential to prevent deterioration both mentally and physically should medicine be administered covertly, not to be used in any other way to justify control of behaviours, then this requires the support of carers, relatives and the multi-disciplinary team and is reviewed regularly and not accepted as the norm. Staff should be given guidance as to the criteria that should be considered when reaching a decision on whether covert medication could be justified; a policy and a set of guidelines can assist in directing the staff through their decisions, and avoid overuse and abuse related to its practice. Regulations for service providers and managers.
Dictionary reference of Medication is: a drug or other form of medicine that is used to treat or prevent disease. Covert administration of medicine is the disguising of medication on food and drink. Definition It is understandable that in practice, healthcare professionals may not be acutely aware as to what is and what is not considered covert administration of medicines. In this process one needs to take into account his wishes before he was found incapable. Twenty-four hour responses were similar. The practice of administering covert medication is controversial.
There were no conditions relating to this medication contained in the care plan. This disturbing picture is usually attributed to a culture of fear surrounding the practice in which written guidelines are lacking and concern about getting into wrangles with law drives the practice underground. For patients detained under the Mental Health Act, assessment should be considered appropriate for a person with a mental disorder who requires treatment for that illness but who is refusing that treatment. This area is interesting because the previous report showed approximately 5. If it is agreed, a plan should be made after the meeting to make sure it is done safely and reviewed regularly to check if it should continue. People who eat a varied diet are unlikely to develop a severe primary vitamin deficiency. The administration of covert medication can be controversial and can lead to misunderstanding and confusion.
A person with intellectual disability will have difficulty providing informed consent throughout their lifetime. Such events may be related to professional practice the 8 rights; right patient, right medication, right dose, right route, right time, right documentation, right reason and right effect. Concluding Remarks It should be clear from the discussion above that the use of covert administration will depend upon a number of variables. Within this case this has been followed and all staff appear to be aware of why the administration of medication might occasionally need to be covertly. In my assertion, these ethical issues concern mainly whether concealed medication violates patient autonomy and undermines trust in the physician-patient relationship. Nursing Mothers The excretion of ibutilide into breast milk has not been studied; accordingly, breastfeeding should be discouraged during therapy with Corvert. The nurse also has the responsibility of the medication to be given.
For example, if a patient has not been taking their antihypertensive medication for a fortnight but their recent blood pressure readings are within acceptable parameters, it may be more appropriate to continue without medication and for this decision to be reviewed at defined intervals. In the post-cardiac surgery study see , one or two intravenous infusions of 0. Metabolism and elimination In healthy male volunteers, about 82% of a 0. Percent of patients who remained in sinus rhythm 24 hours after dosing. We will discuss these points as the paper unfolds. Moreover, the great reverence afforded to individual autonomy and independence in developed societies may not generalize to cultures in developing countries where familial interdependence is stronger and collective goals of the family are dominant.