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Ect: not optional for all

MagazineDecember 1996 (Vol. 7 Issue 9)Ect: not optional for all

If you're like me, you thought that shock treatment went out with lobotomies in the Fifties, something that these days more properly belongs in in the fiction of Sylvia Plath or films like One Flew Over the Cuckoo's Nest

If you're like me, you thought that shock treatment went out with lobotomies in the Fifties, something that these days more properly belongs in in the fiction of Sylvia Plath or films like One Flew Over the Cuckoo's Nest. But the staggering fact is that electroconvulsive therapy is alive and well, with some 20,000 patients a year in Britain alone getting at least five shock treatments apiece.

In fact, shock therapy is enjoying somewhat of a comeback after falling into disrepute in the 1970s. Max Fink, professor of psychiatry at the State University of New York at Stony Brook, once waxed effusive about the treatment, echoing the view of much of mainstream medicine these days: "ECT is one of God's gifts to mankind. There is nothing like it, nothing to equal to it in efficacy or safety in all of psychiatry." Lately, in America, the Food and Drug Administration has proposed relaxing restriction on the use of ECT machines, and all the major institutions of mainstream medicine the National Intitutes of Health in America, the Council of the Royal College of Psychiatrists in the UK are solidly behind it.In the past few years, some of the major American institutions have performed ECT on patients as young as 8.

It is true there is nothing like ECT in psychiatry nothing about which we know so little or have studied in such little depth. All that we understand about applying electrical jolts to the brain is that we may be simply causing the types of short term personality changes similar to those seen in head injury patients, such as euphoria and no memory of events.

But perhaps the most astonishing of all these statistics is the number of cases of shock therapy which are still administered involuntarily. In the UK, some 3000 patients or a sixth of all those treated with ECT still receive the treatment against their will.

MIND, the National Association for Mental Health, has performed some research on compulsory shock therapy, and discovered thaat patients had inadequate safeguards for all sorts of compulsory psychiatric treatment. However, in numerous cases, the single purpose for a patient getting "sectioned" that is, forceably detained was to give ECT without consent.

In the study, researched by Phil Fennell of the Cardiff Law School, MIND found a high use of emergency powers permitting treatment without a second opinion. ECT was used in more than a fifth of all these cases of emergency sectioning, including in children.

Even if a patient isn't straitjacketed and the jolts forcibly applied, many patients most of whom are elderly and female are receiving treatment without proper consent.

This is an outrageous injustice. Scores of patients are dying, and thousands more losing their memory from a treatment that no one understands, and no one has bothered to find out if indeed it works at all.

That anyone still believes this is the way to treat all but the most desperate cases of depression is the most shocking fact of all.


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