Ethical debate: Sex, drugs, and the invasion of privacyRespect for privacy and the case of Mr KCommentary: Hospital can never be homeCommentary: Silence may be the best advocacyCommentary: Nurses should recognise patients' rights to autonomyCommentary: Patients should have privacy as long as they do not harm themselves or others

doi:10.1136/bmj.316.7135.921

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Ethical debate: Sex, drugs, and the invasion of privacy

Patients who are in hospital for long periods may want the same level of privacy they have in their own homes. A clinical team from John Radcliffe Hospital Oxford describes the case of a young man with multiple sclerosis who was suspected of taking cannabis while in hospital for respite care. An ethicist, nurse, doctor, and manager from the Multiple Sclerosis Society give their views on the issue.

Respect for privacy and the case of Mr K

Julian Savulescu, clinical ethicist,
Rachel Marsden, unit support nurse,
Tony Hope, reader in medicine, honorary consultant psychiatrist

^aOxford Radcliffe Hospital, Oxford OX3 9DU,
^bChurchill Hospital, Oxford OX3 7LJ,
^cUniversity of Oxford Medical School, John Radcliffe Hospital, Oxford 0X3 9DU
Anandgiri, Thorpe Underwood York YO5 9ST
Multiple Sclerosis Society of Great Britain and Northern Ireland, London SW6 1EE
Royal College of Nursing, London W1M 0AB
Health Law Department, Boston University School of Public Health, Boston, MA 02118-2394, USA

Correspondence to: Dr Hope

In Britain, the patient's charter specifies standards of rights and dignity for patients. Little guidance is given about what this means in practice, other than the desirability of providing separate washing and toilet facilities for men and women in hospital. Respect for privacy, however, goes far beyond this. Here we consider the case of Mr K (box).

Mr K and the cannabis cake

Mr K, a former carpenter and artist, is 35 years old. He has multiple sclerosis, which was diagnosed 10 years ago. Mr K has lived with his mother since his wife left him seven years ago. He needs full assistance with activities of daily living, and this is provided by his mother. Respite care is arranged at a rehabilitation hospital
Mr K's mother asked if her son could smoke cannabis in the rehabilitation hospital. “He has smoked since he was a teenager. I was against it for a long time, but it's one of the few things he can enjoy now. He gets very agitated if he doesn't get his dope, and his spasms are much worse.” After consultation with colleagues, the ward sister told Mr K's mother that staff could not knowingly allow him to consume illegal substances on hospital premises
Mr K was admitted to hospital. Every day his mother brought him a cake, which he ate with relish. One nurse suggested that the cake might contain cannabis. The staff were in a …