Covert treatment involving the administration of medicines without the knowledge of the patient is difficult to justify ethically and legally. In our case, Mrs. T does not have sufficient ethical or legal basis to do so. In addition, the psychiatrist should advise her against such an undertaking, particularly since Mr. T appears to have decision-making capacity and has not exhibited aggressive behaviour. If aggression becomes emergent or evident, institutionalised care should be considered. Within this setting, covert treatment may be justifiable, if it is necessary to stabilise Mr. T’s condition. Otherwise, open discussion and transparency of medical intervention are not only consistent with ethical and legal requirements of respecting Mr. T’s dignity as a person, but also indispensable components to a viable long-term response to a challenging illness.