Stricter control on electric shock therapy urged

By MARTIN JOHNSTON

A Government review of electric shock therapy wants stricter controls imposed on who is given the controversial treatment.

But two health service consumer groups say this recommendation does not go far enough.

"It's meaningless," says Anna de Jonge, whose 3000-signature petition to Parliament against electro-convulsive therapy (ECT) led to the review.

Mrs de Jonge, of the Patients Rights Advocacy group in Hamilton, says the "barbaric" treatment causes brain damage and memory loss. She wants it banned.

The late novelist Janet Frame was one who underwent the so-called shock therapy.

Mainstream psychiatry regards ECT as a safe and effective treatment and a key therapy for severe, life-threatening depression when there are reasons against using medicines.

The Health Ministry last year commissioned the ECT review, chaired by Auckland University's Professor Craig Anderson, to investigate the safety and efficacy of the therapy, and other matters, acting on a recommendation of the health select committee, which had considered the petition.

A draft report by the reviewers, marked confidential but obtained by the Herald, makes a provisional recommendation that ECT should not be given to a "competent" patient who objects to it.

Currently, voluntary patients' written consent must usually be obtained before starting ECT. But those under compulsory assessment or treatment can be given it against their will if the responsible clinician and a specially appointed psychiatrist consider it to be in their interests.

The reviewers say that overriding opposition to ECT from patients who are competent to decide is an unjustified use of state power.

But they believe that if implemented, "this recommendation may prove to be of greater symbolic than practical importance".

" ... we have no reason to believe that ECT is commonly administered to competent patients against their will; and a high level of competence is required by law in the case of a refusal that is likely to have very serious consequences for the patients. The more serious the consequences of a consent, or a refusal of consent, the higher the level of competence that is required".

But Mrs de Jonge, who was disappointed by the draft report and is making a fresh submission to the reviewers, said recommending withholding ECT from competent patients who refused would in effect be meaningless as patients under compulsory assessment or treatment were drugged.

"Once you're drugged you're not competent."

Steve Green, of the Citizens Commission on Human Rights, said the recommendation was a step in the right direction, but it would not increase patients' rights since clinicians "could get around it very easily".

Contentious therapy

* Electro-convulsive therapy induces an epileptic fit by passing electric current through the patient's brain via electrodes held on the temples.

* About 400 patients a year have ECT. This may be fewer than in the late 1990s, when the number of courses of treatment delivered tripled in five years.