SEANAD REPORT:ANY REVIEW of the rules governing the administration of Electro Convulsive Therapy (ECT) should ensure that international best practice continued to be taken into account, Minister of State for Health John Moloney said.
He was responding to a Bill in the names of Green Party members Deirdre de Burca and Dan Boyle and Independent member David Norris seeking to prohibit the involuntary administration of ECT to patients without their informed consent.
Ms de Burca said this was a highly controversial treatment and while it was supported by many practitioners in the psychiatric profession, it was bitterly opposed by many patients and their families and by some mental health professionals.
The issue of informed consent was central to the legal change being proposed. The Mental Health Commission rules governing the use of ECT stated that a patient must be considered capable of giving informed consent for ECT, including anaesthesia, unless there was evidence to the contrary.The involuntary use of this procedure could no longer be justified. Advance directives would allow patients to give consent or otherwise in advance, or to empower a named individual to do so on their behalf.
Mr Moloney said there were diverging views within and outside the psychiatric profession on the necessity and efficacy of ECT.
"However, it remains a recognised treatment for severe mental illness and is sometimes used to treat persons with severe depression who do not respond to drug treatment. A review and meta-analysis which was published in the highly respected medical journal the Lancet in 2003, concluded that ECT is probably more effective than drug therapy.
"Of course, it can be a feature of severe mental illness that a person's judgment may be so impaired that they lack insight into their own condition. Where a person is involuntarily admitted under the provisions of the 2001 Act, for treatment that they might not otherwise receive, it is I believe, incumbent on the State and treating clinicians to provide them with the most effective treatment for their condition," he said.