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Should I prescribe for my brother who is suffering from insomnia?

Dr John Holden, MDU medicolegal advisor, discusses the problem of prescribing for family members and suggests that if possible this should be avoided

Dr John Holden, MDU medicolegal advisor, discusses the problem of prescribing for family members and suggests that if possible this should be avoided

Q My brother is visiting for a month from the other side of the country. He has recently lost his wife and has been suffering from insomnia. He has been prescribed a short course of a benzodiazepine by his own GP, but left his tablets at home. He has asked me to write a prescription for him. Would it be unethical to help him out just this once?

A Where possible doctors should avoid treating members of their family. This is particularly true where controlled drugs are involved.

The GMC says: "Controlled drugs can present particular problems, occasionally resulting in a loss of objectivity leading to drug misuse and misconduct.

You should not prescribe a controlled drug for yourself or someone close to you unless: a) No other person with the legal right to prescribe is available to assess the patient's clinical condition and to prescribe without a delay which would put the patient's life or health at risk, or cause the patient unacceptable pain, and b) That treatment is immediately necessary to: i) Save life, ii) Avoid serious deterioration in the patient's health, or iii) Alleviate otherwise uncontrollable pain." (Paragraph 13, Good Practice in Prescribing Medicines, 2006)."

It adds that you must be able to justify your actions and must record your relationship and the emergency circumstances that necessitated your prescribing a controlled drug for yourself or someone close to you.

In the circumstances you describe, it may be better for you to ask another GP at your practice to assess your brother and, if necessary, write an appropriate prescription.

Note that if your brother is prescribed medication by a doctor who is not his own GP, it is in his best interest that his own GP be fully informed, provided he consents, in accordance with the GMC's guidance in Good Practice in Prescribing Medicines.

Dr John Holden is a medicolegal adviser with the MDU

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