About ten years ago the American Medical Association Journal of Medicine published an article entitled “The Ethics of Electroconvulsive Therapy.” It is still pertinent. There is no new information about the effectiveness or the safety of ECT, and the FDA has still not approved the use of any ECT device.

     “First, do no harm.”

     The article starts off with this well known ethical precept of the healing profession, and the authors then go on to list all the known harmful effects of ECT which make it  impossible for any  psychiatrist in good  conscience to prescribe this brutal therapy to anyone.

     Only when there is no alternative treatment available or when a treatment is administered solely to save a life can it be ethical to administer a medical procedure that does harm. There are alternative benign treatments available instead of ECT, the authors show, and they point out that ECT has never been shown to actually save a life by its application in a dire situation.

     The authors note the numerous, non-harmful alternative behavioral treatments available which work with a patient’s consciousness, personal strengths, and social network. Too often ECT is given, they say, merely because of doctors’ unfamiliarity with non-biological interventions or with their frustration that their patients are not recovering quickly enough.

     The authors also mention the revenue stream that can be an incentive for  institutions offering ECT sessions.

     They point out that the electrical induction of a seizure from ECT (by running up to 460 volts through an anesthetized patient’s brain) frequently leads to “an acute organic brain syndrome  characterized by amnesia, apathy, and euphoria” and they conclude that ECT is not safe. It produces  degrees of memory loss and of other adverse effects on cognition “in nearly everyone who receives it.” These symptoms last for weeks or months after their last treatment. ECT is not safe.

     Nor is it effective. Eighty-four percent of patients relapse within the first six months after they’ve had ECT administered to them. There is also no decrease in suicides from its use, per studies, and some increase in suicide rates might actually follow ECT.

     Authors Loren Mosher, MD and David Cohen, PhD also conclude that it is impossible to obtain proper informed consent from a patient because no patients would consent to such a barbaric treatment if they were adequately informed of its true effects. Patients who have signed the informed consent  permission papers do so only because have they have been coerced—grossly or subtly—to do so. The authors also note that no study has ever been
published which describes the actual ECT consent forms used in different institutions, despite the fact that ECT defenders’ claims that informed consent is always “scrupulously” obtained.

     There is potentially a legal as well as an ethical issue here, because a patient has the legal right to give informed consent only after receiving a full disclosure about ECT. Without going over with a patient the negative side effects of ECT, the alternatives available to ECT, and the consequences of doing nothing regarding the condition, a patient hasn’t been given the information he is legally entitled to in every state before he agrees to have ECT.

     With 100,000 patients being administered ECT every year in America, how can there be so many medical “professionals” – psychiatrists — who still fail to uphold their oath not to “do harm”?

     The charge for a two to three minute ECT session on a patient ranges from $300 to $1000, and the normal course of ECT sessions for each patient is six to twelve visits. Most patients then require further ECT maintenance sessions to prevent “relapses.”

     Those lucrative fees are apparently more than enough to justify a  psychiatrist doing a little harm.