Ethical aspects of surreptitious use of disulfiram

Disulfiram has been in use for treating alcohol dependence since last more than 6 decades with good results. It is usually prescribed after taking informed consent from the patient. In India, it is increasingly being prescribed by quacks and general practitioners without appropriate knowledge at the behest of the family members. It seems ethically incorrect considering it doesn't fulfil the ethical and moral principle of patient autonomy. But looking at the issue from the perspective of autonomy of family members, it is often a desperate attempt to salvage their families. Relatives are often ready to bear the potential, often serious, side effects of disulfiram provided it ensures abstinence or at least significantly decreased consumption. Should we turn a blind eye when it comes to surreptitious use of disulfiram to alcohol dependent patients, especially if the benefits outweigh the potential risks, thereby giving precedence to beneficence and non-maleficence? Does end justify the means, or is it a strategy to subordinate the individual values to the values of family or society? An in-depth review of existing policies about philosophical aspects of practicing medicine and psychiatry is warranted by doctors and law enforcers including stricter policies for manufacturing, distributing and prescribing disulfiram.