Electroconvulsive Therapy (Re: coerced treatment)

Carrol Cox cbcox at ilstu.edu
Wed Jun 13 12:02:10 PDT 2001


Marta Russell wrote:
>
> Often these kind of "reports" are written by professionals who have
> conflicts of interest and push their preferred methods for career
> reasons. I don't know about Richard Glass but this statement is wrong:
>
> > As currently practiced, ECT
> > involves the use of informed consent, ultra-brief general anesthesia
> > and muscle relaxants ......
>
> Electroshock is going on without informed consent.
>

Marta, this probably varies state by state. I personally know more people who have been unable to obtain any sort of treatment than those who have been compelled. (That's merely from personal observation, and I don't believe political issues should be argued either way from personal observation or selected examples.) In any case, the issue of ECT should be separated from the issue of "coerced treatment" -- particularly as in this thread the term originally referred only to the treatment of addiction, not to mental illness in general.

Also, while the classification and diagnosis of mental illnesses is obviously still primitive, some gains have been achieved, and the various clusters of mental illnesses should not be lumped together in a discussion of this sort. E.g., one real advance has been more precision in the diagnosis of schizophrenia (which is not to say that diagnosis is at all sure yet), with a consequent reduction in the number of persons so diagnosed.

I think we should take it for granted that, in general, "coerced treatment" is to be opposed, but that only opens, not closes, the topic of the best ways (within the current political framework and given current knowledge) of coping with mental illness.

As to ECT, it is profoundly different. And most, not all, of those I know who have received the treatment have benefited from it. The loss of memory which it can cause has either not occurred for them or has been limited enough not to interfere with their life. One of my aunts received ECT many decades ago (under the 'old' system as it were), and she committed suicide -- after telling one of her sisters that it was the loss of memory she could not abide. But there were a number of other factors operating too, including husband and children who had no understanding of her condition. I know one or two people who began and chose not to continue ECT treatment. Others who have received it indicated that were they ever again to be in the same condition they would consent to further ECT treatment. An overwhelming proportion of suicides are of those suffering from depression, and for many (given current knowledge) it is, quite literally, ECT or death.

Most of the subscribers to this list are knowledge workers, and a break in the continuity of our memory could be utterly disastrous. I've read Paradise Lost innumerable times; also _Capital_; any interference, even slight, with those memories might represent an actual break in the continuity of my life. But clinical depression itself harms the memory, as do chaotic social circumstances.

These issues can't be viewed one-sidedly.

Carrol



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