Is It OK to Secretly Medicate Your Manic Husband?

A woman I know often complains about her “manic” husband. He is a war veteran in his late 50s who owns a very successful business and is the primary breadwinner for their family. (They have no children.) The wife, a woman in her early 60s who works part time and is dependent on his income, recently told me she dissolves melatonin in the water he takes with him to work in order to “calm him down.” She said, “I told him it was a nutritional supplement, something to help him because he sometimes doesn’t eat lunch.” I looked a bit shocked at her confession, and she immediately justified her actions by saying: “You don’t have to live with him. He doesn’t take his medications. Now he’s calmer.” She did not ask his permission to add melatonin to his drinking water.

Melatonin is not regulated in the United States — though in many countries it is available only by prescription — so legally speaking she is not “drugging” him without his knowledge or consent. And since he is under 65, this would not fall under elder-abuse laws in my state. But I am seriously considering revealing this subterfuge to her husband, whom I know. (She did not swear me to secrecy; in fact, I sensed from the way she told her story that I was not the first to hear of this.) Unfortunately, I have no confidence that confronting her would have an impact; she likes him better now that she’s secretly giving him substances with no regard for his long-term health or the deception. If my wife did this to me, I’d be apoplectic. I’d appreciate your counsel. — Name Withheld

From the Ethicist:

First, any benefits from this “treatment” could well be a second-order placebo effect. As an expert I conferred with confirmed, there’s no serious evidence that melatonin is a useful treatment for mania, and there’s no evidence to support this daytime, waking-hours use of melatonin at all. The main thing that melatonin has been shown to do is help induce sleep. Taking it during the day is an especially bad idea, because it can disrupt your body’s internal clock, and because daytime sleepiness can lead to accidents. In any case, if your friend’s husband is meant to be on other medications, he should consult with a doctor before taking melatonin (or any other drugs) regularly.

But it doesn’t matter whether I’m right about any of this. Medicating mentally competent people without their fully informed consent is wrong. Giving drugs to a spouse in this way is an abusive betrayal of marital trust. What you’ve learned about isn’t a past indiscretion; it’s a significant and ongoing wrong. He should be told what’s happening. Before you take that on yourself, though, do try talking with the woman about the implications of what she’s doing, and encourage her to come clean.