Doctors admit to giving drugs by stealth

An ethics row has broken out in the medical profession over the need for doctors to lie to patients about the drugs they are being given. Doctors have admitted to slipping drugs in to cups of tea given to patients or giving a false description of the effects of the drugs.

One nurse was suspended after carrying out a consultant's orders to give an elderly patient a tranquilliser in his tea without his knowledge. No action was taken against the consultant, leading to charges of double standards being applied to doctors and nurses.

The practice of deceiving patients over drugs is believed to be widespread among physicians working with geriatric and psychiatric patients.

A recent survey of psychiatrists at Heathlands Mental Health NHS trust in Surrey found that 38 per cent of doctors admitted to having participated in surreptitious prescribing or having been economical with the truth.

Six doctors admitted to having ordered a drug to be given in a disguised way. Five said they had lied about the type of drug given. All thought their practice was justified.

Dr Peggy Norris, secretary of the European Doctors Union, which campaigns for patients' rights, said: "You don't give medication to a patient without their consent. If they are so mentally incapacitated that they cannot understand then at least the relatives should know."

David Curtis, a consultant psychiatrist at the Royal London Hospital, east London, said he was "appalled" by the practice of surreptitious prescribing. He said: "I had hitherto assumed that patients who claimed that such things were going on were paranoid, but I wonder now if on occasion my attempts to reassure them were misplaced."

The issue emerged after John Kellett, a consultant geriatrician in south London, revealed details of a case where a patient was sedated without his consent.

The patient, a 91-year-old widower, had become hypomanic and was not in a fit state to return from hospital to his residential home.

The man refused treatment and rather than give him a forced tranquilliser injection, Dr Kellett asked a nursing sister - the only member of staff trusted by the patient - to give him a tranquilliser, disguised in a cup of tea.

The patient was told of the action the next day and agreed it had been appropriate. However, on the orders of the chief nurse, the nursing sister was suspended. She has now returned to work after a period of depressive illness resulting from the disciplinary action.

In a letter, Dr Kellett, said: "I did not give the patient his drugged tea myself because he would not have accepted it from me; the nurse concerned naturally hesitated when I asked her to give it and I foolishly assured her that I would take full responsibility." Yesterday he spoke of his anger at the way the nursing sister had been treated.

"I think she should be given a formal apology and compensation for the damage caused to her," he said. "The nurse is still at work but if anybody refuses medication she becomes extremely anxious."

No action has been taken against Dr Kellett. Last night Stuart Horner, chairman of the British Medical Association's ethics committee, criticised hospital managers for the way they had handled the case. "What concerns us is that managers saw fit to deal with the two groups of staff separately. We really must treat all healthcare professionals alike. To go for the easy target sounds to me typical of managers," he said.