Classics in ECT: ECT and Informed Consent, Am J Psych 1980

"Classics in ECT" brings you this commentary from 1980:

ECT and special problems of informed consent.

Culver CM, Ferrell RB, Green RM.Am J Psychiatry. 1980 May;137(5):586-91. doi: 10.1176/ajp.137.5.586.PMID: 7369404



The abstract is copied below:
The authors examine the question of whether severely depressed patients can validly consent to ECT, indeed whether anyone should be asked to consent to a treatment that some have held is disabling and beyond the range of rational choice. They suggest some clarification in the use of the terms "competent" and "rational." The authors present examples of cases where ECT may appropriately be used with and without a patient's consent. They conclude that except in cases in which patients may die without ECT, physicians will not err morally by respecting patients' informed decisions about treatment.

The pdf is here.


This is the piece that was the seed for the four subsequent articles in the Journal of Medical Ethics in 1983. This one starts out a bit iffy, gives Friedberg too much credit, then has four very positive ECT vignettes and ends up being very reasonable and supportive of ECT.
I recommend a full read (~ 20 minutes) for all ECT practitioners interested in the nuances of consent in difficult situations.

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