Misinformation from the ECT Manufacturers

An insidious source of misinformation about ECT's effects on memory are videotapes marketed by some of the ECT device manufacturers (Somatics, MECTA) and made available to patients, family members, and shock facility professionals in the United States and Canada. There are no disclosures in these videos identifying either Somatics or MECTA as manufacturers of ECT devices (Find, 1986; Grunhaus, 1988).

MECTA's (1987) video for professionals, Health Information Network, features a panel of "experts," Richard Weiner of Duke University, Harold Sackeim of New York State Psychiatric Institute, and Charles Welch of Harvard Medical School, each interviewed in turn. Welch says: "I tell my patients they may experience a temporary loss of memory during the time they're having the treatments and for several weeks after that." In another MECTA video designed for individuals and family members, the narrator is slightly more honest: "We know that 80 to 90 percent of the patients who received bilateral ECT will report that their memory has recovered within 3 to 6 months after the treatment, while 10 to 20 percent may report a change in the quality of the memory." (Grunhaus, 1988).

Another educational video prepared by Somatics features Max Fink (1986), leading proponent of ECT in the United States. Fink states:

The usual thing that patients complain about and the family complains (about) is the patients has a loss of memory and that occurs in every patient. Every patient has a loss of memory for the treatment itself...Now when we give a patient treatment over three or four weeks they tend to have a fuzzy idea of what happened in the hospital. but (other than) the treatments themselves, the patients do not forget what happened in their early life, they don't forget what happened in their childhood, they don't forget the telephone, they don't forget the names of their children, they don't forget their work, and they have no difficulty in learning these things after the treatment is over when they're better...Now some doctors and some people have said "Well electroshock erases the mind and it's like erasing a blackboard." That's nonsense. If there is any erasure, it is for the events during the hospital. In many ways we're very grateful that patients forget that. After all, it's not a pleasant time of your life. For a depressed patient to be in the hospital, it's not pleasant and they forget that, that's fine.

In 1990, the APA published recommendations from an ECT Task Force aimed at specifying the "standard of care" regarding the administration of ECT throughout the United States (APA Task Force, 1990). Weiner, Fink and Sackeim, who appear on the previously mentioned MECTA and Somatics videos, are three of the six members of the Task Force. Fink has admitted in a court deposition to receiving royalties from videos created and marketed by Somatics (Aubrey vs. Johns Hopkins Hospital, 1991). Psychiatrist Richard Abrams, the most frequently referenced author in the Task Force Report, owns Somatics (Breggin, 1992, p. 13). Psychiatrist Barry Maletzky, one of the authors cited in the Report, is viewed in one MECTA video "pitching" that company's device to potential purchasers (Maletzky, 1987). Numerous videos, books and brochures created or marketed by these companies are mentioned in the appendix of the Task Force Report. The names and addresses of all four ECT device manufacturers are also listed. The APA Task Force Report on ECT might more appropriately be deemed The Manufacturers' Task Force Report on ECT. (5)

In a sample informed consent form appended to the Task Force Report, the following statement (which has appeared in numerous scientific and professional articles) appears: "A small minority of patients, perhaps 1 in 200, report severe problems in memory that remain for months or even years" (APA, 1990, p. 158; Foderaro, 1993, p. A16). The number, however, has unclear origins. This author located only two "one in 200" estimates in the ECT literature. One mention comes from a book by Fink (1979, p. 52) who states:

Spontaneous seizures are a rare manifestation and may be considered evidence of persistent altered brain function. From a review of various reports, I estimate that post ECT organic syndrome, including amnesia and tardive seizures to persist in one in 200 cases.

Fink provides no specific references or data for his estimate. (6) Even so, the figure again appears in the appendix of his book, in a sample of informed consent (p. 221). The other "one in 200" estimate this author located comes from an Impastato (1957) study, but rather than citing cases of permanent memory loss, Impastato is citing the death rate for ECT recipients over 60 years of age. Another inaccurate statement in the Task Force Report was noted by Breggin (1992, p. 14) Citing the Freeman and Kendell (1980) study, the Report states that "a small minority of patients" report persistent deficits. Unless 30% is a small minority, the APA is misinforming the public.

One finding stands out from follow-up studies, including those without conspicuous intimidation factors (Brunschwig, Strain, and Bidder, 1971; Janis, 1950; Small, 1974; Squire, 1986; Squire and Chace, 1975; Squire and Slater, 1983): a majority of subjects continue to believe they were permanently injured due to ECT. The "small minority" statistic put out by the ECT industry, by the APA, and further emulated by the FDA, has no factual basis.

Patient's claims of years of permanent memory erasure as a result of ECT, then, are invalidated by "cognitive tests." Squire and Slater's (1983) estimate of an "authentic" eight month memory gap is transformed by manufacturers into "memory changes of events prior to, during, and immediately following the treatment" (MECTA Corporation, 1993, p. 84). Unfortunately, phrases similar to these by the manufacturers, which suggest that memory loss is narrowly restricted, have come to be regarded as sufficient by numerous state Medical Disclosure Panels. Consequently, potential patients clearly receive inadequate information regarding memory loss and ECT as part of informed consent (see, for example, Texas Department, 1993, p. 2; Texas Medical Disclosure Panel, 1993, p. 14). As has been shown, more persons (the majority of ECT recipients) are convinced they are suffering permanent memory dysfunction as a result of ECT, and the memory gap is much wider (at least 8 months) than is currently reported or implied within their various informed consent protocols by the manufacturers of ECT devices, the APA, and various mental health authorities. Past and potential ECT recipients were and are being grossly misinformed.

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