Covert administration of medicines is a complex issue and people might have different views on what it involves and whether it is acceptable practice. Generally, it is defined as the administration of a medicine disguised in food or drink to a patient without their knowledge or consent.

Covert administration of medicine should not be considered a routine practice and must only be initiated in exceptional circumstances.

Covert administration of medicines may only be used when a patient is confirmed as not having the mental capacity to accept or refuse to take medicine, otherwise it is considered unethical and could result in disciplinary action. The person lacking capacity will not understand the need for their medicine or the consequences of not taking it, despite receiving appropriate support to learn this information. At all times, efforts must continue to be made to give medicine openly.

Decisions on whether to use covert administration should be made on a case-by-case basis, and be centred on the individual's best interests, as per the Mental Capacity Act 2005. The medicine(s) involved in covert administration must be considered essential for the person's health or wellbeing or for the safety of others. Healthcare professionals must also consider how likely capacity is to return and when this may occur €“ in some cases, treatment may be reasonably delayed until capacity returns.

If covert administration of medicine is undertaken, this must follow relevant local policy. Healthcare professionals must also determine whether the person lacking capacity has previously given consent or refusal for treatment in the form of an advance decision or statement, as well as whether they have nominated someone else to make such decisions for them using a valid Lasting Power of Attorney.