Working with people with dementia, I am very aware of many of the ethical and legal implications surrounding the issue of capacity and consent. I believe that we have a number of reasonable safeguards regarding the administration of medicines in my clinical area but have to admit that in the past we have been involved in the covert administration of medication with strange tasting tea, crunchy porridge and the infamous spoon of jam. The turning point came when one of our patients refused to have an injection that was due and, when faced with this, we realised that we could not simply go ahead and give it.