ECT without consent

Madam, – I have read and re-read Dr Siobhan Barry’s letter (December 14th).

In her third paragraph, she says “some mental illness requires treatment against the person’s wishes, including prescribed ECT”. She describes this as being a “human right to be given effective treatment” which right is “ethically founded” and which “all doctors are properly ethically required to protect”.

This seems to mean that psychiatrists are acting ethically in prescribing and requiring a person involuntarily to undergo ECT. It further seems to mean that not only are these psychiatrists acting ethically but that they are, in fact, ethically required to do so (ie impose ECT against the person’s wishes in relevant circumstances) in order to “protect and uphold the right to treatment”.

As a psychotherapist, I am required by professional ethics to “respect clients’ rights to self-determination and autonomy”, to “ensure that the client consents to participate at all stages of counselling and respect clients’ right to discontinue at any time”. (Code of Ethics of the Irish Association for Counselling and Psychotherapy).

If I am reading Dr Barry’s letter accurately, how could two therapeutic professions adhere to such seemingly divergent ethical positions? And what is the legal/constitutional basis for the human right referred to in her letter? – Yours, etc,


Castle Grove,


Co Dublin.