Palliative care patients are not asked for consent for drugs used outside their licence

When prescribing drugs for use outside their licence most specialists in palliative medicine do not routinely obtain written or formal consent from patients, document the reason for unlicensed use in the patient's notes, or inform other professionals of unlicensed use, as has been recommended. When they do obtain consent, it is likely to be for the use of less established drugs and to be verbal rather than written. In their questionnaire survey to all 182 palliative care services in the United Kingdom, Pavis and colleagues (p 484) also found that palliative care specialists do not welcome strict adherence to these recommendations because of the number of drugs involved and the burden to patients and carers. This view is shared by the Royal College of Child Health, as the use of drugs outside their licence is also common in paediatrics.

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Relevant Article

Prescribing of drugs for use outside their licence in palliative care: survey of specialists in the United Kingdom

Hilary Pavis and Andrew Wilcock
BMJ 2001 323: 484-485. [Extract] [Full Text] [PDF]