Voices of people who have received ECT

Abstract

Electroconvulsive therapy (ECT) is controversial but widely practised in India. We elicited perspectives, using qualitative interviews, from patients who received ECT and their relatives. Ethical issues related to personal autonomy, right to information, competence, informed consent and consent by proxy are discussed. We suggest strategies to ensure a basic minimum standard for obtaining informed consent for ECT in India.

Electroconvulsive Therapy: The Struggles in the Decision-Making Process and the Aftermath of Treatment

“…Nevertheless, as in the study reviewed by Rose, Wykes, Bindman, and Fleischmann (2005) and the study done by Rajkumar, Saravanan, and Jacob (2007), some of the patients in this study felt they were coerced into giving consent for ECT. In a study by Amazon, McNeedly, Lehr, and Marquardt (2008), patients said they felt they were too depressed to participate in the decision making process.…”

“…Only one study was found that examined both patients' and families' perceptions of having ECT. Rajkumar, Saravanan, and Jacob (2007) found that family members felt coerced to give consent for the treatment and patients expressed concerns regarding cognitive deficits. However, in this study interviews were conducted shortly after the patients completed their series of ECT, and this short follow-up did not allow for views of ECT's long-term effects.…”

ECT: Knowledge and Attitude among Patients and their Relatives

“…Many subjects explained they got adequate information regarding ECT / they found it very beneficial and most of them have positive attitudes toward ECT 11,12,13 . Rates of benefit ranged from 50% to 100% (average 71%) 18, 19, 20, and 21. Subject in some studies (53% to 98%, average 70%) perceived ECT agreed its beneficial effects and willing to do ECT again if required 13,22,23,24,25 . But knowledge of ECT among subjects is about "gross knowledge" about ECT.…”

Electroconvulsive therapy: A review of knowledge, experience and attitudes of patients concerning the treatment

“…Rajagopal 2008 ( n ϭ 50) 0% (16% near correct answers) * Other studies which have shown poor knowledge concerning ECT among patients (but have not given the proportion of patients with full understanding) include those by Jenaway 1993;Westreich et al 1995;Greening et al 1999;Rajkumar et al 2006Rajkumar et al , 2007Arshad et al 2007;Malekian et al 2009. World J Biol Psychiatry Downloaded from informahealthcare.com by Colegio Mayor de Nuestra Senora on 04/15/14…”

“…Rajkumar et al 2006Rajkumar et al , 2007Vamos 2008). Patients appeared to be particularly dissatisfi ed about not being told about side effects and risks associated with ECT (Johnstone 1999;SURE 2002;Tang et al 2002;Rose et al 2005;Vamos 2008;Malekian et al 2009).…”