Using ECT in Emergency Clinical Situations Against Patient's Autonomy: A Case Study Analysis

Out on PubMed, from authors in Spain, is this paper:

Using Electroconvulsive Therapy (ECT) in emergency clinical situations against patient's autonomy: A case study analysis.

Payán Ellacuria E, Astobiza AM.Bioethics. 2025 Mar 24. doi: 10.1111/bioe.13413. Online ahead of print.PMID: 40123549

The abstract is copied below:

In this paper, we present a comprehensive case study analysis of a specific legal order issued by the Court of First Instance Number 6 of Santiago de Compostela on March 21, 2023. The focal point of the case study is the utilization of Electroconvulsive Therapy (ECT), a specific neurotechnology, in an emergency clinical situation. The objective of this article is to examine the legal and bioethical dimensions surrounding the use of ECT, shedding light on the ethical implications and decision-making processes involved in such cases. The analysis delves into the legal aspects of the case, considering relevant laws and regulations governing the use of ECT. The examination includes an exploration of the court's interpretation of the legal framework within the context of emergency situations, highlighting the specific legal arguments presented in the court judgment. Additionally, the article provides an in-depth bioethical analysis, exploring the ethical principles that come into play when making decisions about ECT in emergency clinical scenarios. The examination considers the delicate balance between respecting patient autonomy and promoting beneficence, while also addressing potential harms and adverse effects associated with ECT. We also consider the moral issues created by the court judgment, specifically those involving patient autonomy and the invasive nature of the process, particularly in cases of mental illness.

Keywords: ECT; Electroconvulsive Therapy; bioethical considerations; case study analysis; emergency clinical situation; legal considerations.

The paper is here.

And from the text:

This is a terrible article, full of misinformation and anti-ECT propaganda. Clearly the authors know little about the clinical realities of ECT. 

I do hope our Spanish colleagues will take note and write to Bioethics with evidence-based concerns about this poorly considered hit piece.