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Written by Irish Times Letters
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Monday, 08 February 2010 18:14 |
The Irish Times - Monday, February 8, 2010ECT without consent Madam,
– The recent debate about electroconvulsive therapy (ECT) (Healthplus,
February 2nd) is long overdue. ECT is a highly controversial treatment.
It has been the subject of debate and review in other countries in
recent years, which has led to it being effectively abolished in Italy,
and to it being available only in specialist centres in Belgium and
Germany.However, it remains, in certain quarters in Ireland, a
commonly used tool in the psychiatrist’s kit, and many psychiatrists
are very defensive about retaining it as a valuable alternative to
other treatments. Many recent studies and reviews of literature
(particularly user-led ones) have served to re-emphasise the
controversial nature of the treatment, pointing to the undeniably
common side effect of permanent memory loss, the dubious nature of the
“science” behind ECT and the lack of solid and convincing evidence as
to its longer-term efficacy.However, the current focus on the
merits or otherwise of ECT is muddying the waters of the issue that is
at the centre of the proposed amendment to Section 59 (b) of the
current Mental Health Act.This issue is to do with the rights of
a person detained under the Mental Health Act, to have proper
representation when a decision is being made to perform ECT on that
person.Under the present regime, ECT can be given to a
non-consenting patient solely on the signature of two consultant
psychiatrists. In any other branch of medicine it would be outrageous
to consider that a next-of-kin need not be consulted.Any such
decision should be a multidisciplinary one, taking into account the
opinions of other professionals involved in the patient’s care, as well
as the next-of-kin and any signed advance directive that the patient
may have made.The current Mental Health Act is out of line with
the progressive national mental health policy, A Vision for Change. The
proposed amendment should be whole-heartedly supported. – Yours, etc,Dr JOAN GILLER, Coolnagarrane, Skibbereen, Co Cork.
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