Along with my colleague, Elizabeth Peel, I was invited to write a post for the OUP Blog highlighting the arguments in a paper of ours that was recently published in the Medical Law Review. The blog post draws out several of the arguments from our paper (which is open access for a short period: download it now!), and yet no-one seems to have taken much notice. When we were invited to write for the blog, we were told that the blog has 8,000 subscribers and has over 40,000 visits every month. So why would a contribution on this important issue not make much of a splash?
There could be all sorts of reasons â perhaps itâs not quite on the zeitgeist of where the media focus is on caring for people living with dementia; perhaps the argument in the paper is too âlegalâ and so not quite amenable to media interest in the blogosphere; perhaps the recently reported reduction in antipsychotic prescribing makes everyone think this is a non-issue; or perhaps until there are other ways to âtreatâ âchallenging behaviourâ in dementia, nobody is interested in the limitations of the current methods. Itâs hard to tell. Certainly any and all of these might be contributory factors. But I think this is an important issue, and one that itâs worth shouting about, so Iâm going to try again here!
In the article âHe was like a Zombieâ: Off-label prescription of antipsychotic drugs in dementia’, we argue that most antipsychotic drugs:
- are not tested for use in elderly people with dementia;
- are not licensed for use in elderly people with dementia;
- have serious side effects including stroke and death when prescribed to elderly people with dementia
- should be better regulated
We also highlight that in our empirical research, carers of people with dementia report a range of other harms associated with the use of this class of drugs to treat behavioural symptoms in the people they care for. In the paper, we explore the potential for legal redress for these harms and find that there is little or no chance of legal claims being successful.
As we think again about how people who canât stand up for themselves are vulnerable to abuse at the hands of the professionals responsible for their care (for example the Winterbourne View scandal), we need to think again about all sides of the interface between care, law and regulation. The current regulatory frameworks offer little comfort to those who are harmed by âcareâ that is not criminally abusive. So as well as thinking again about how we regulate social care, I think the antipsychotics issue demonstrates why we might also need to think again about health care and those who canât consent to treatment. Without going into the intricacies of medical negligence, people with dementia harmed by the prescription of antipsychotic drugs to treat behavioural symptoms currently have no chance of compensation or access to justice even though it is widely known that they can be harmful. I think it is time this changed. What do you think?