The views and outcomes of consenting and non-consenting patients receivingECT

Background. Current mental health legislation in the UK makes provision for the use of certain treatments in severely ill patients who are unable, or unwilling, to give informed consent. Under the terms of this legislation, e lectroconvulsive therapy (ECT) may be used, usually to treat severely depre ssed patients. A number of organizations have challenged this practice, sta ting that ECT should only be given with fully informed consent: it has been implied that patients receiving compulsory ECT (given without the patient' s consent, under the terms of mental health legislation) find the treatment damaging and unhelpful. Methods. A series of 150 patients receiving ECT in Aberdeen was studied. A proportion of the series (approximately 7 %) received compulsory ECT. The v iews and treatment outcomes of compulsory patients were compared with those of patients giving informed consent for treatment. Results. More than 80 % of patients in both consenting and compulsory group s considered ECT to have helped them. Clinical outcome did not differ betwe en the groups. Patients' views showed marked concordance with independent m edical evaluation of outcome. Conclusions. Outcome following ECT in non-consenting patients is equivalent to that seen in consenting patients whether rated by the patients themselv es or by clinicians. Overall outcome is good, with more than 80 % of patien ts benefiting from treatment. A ban on compulsory ECT would deny the access of seriously ill patients to an effective and acceptable treatment.