ECT Anonymous - Research Information - May 1999 - When ECT is Administered

Written by Juli Lawrence

As with the hypothalamus, when ECT is administered involvement of the hippocampus is inevitable:

"Whatever the part of the hippocampus may be in the total picture of electroshock, it must be involved in the highest degree because of its low epileptogenic threshold." (W. T. Liberson and J. G Cadilhac, 'Electroshock and rhinencephalic seizure states,' Confinia neurol., 13, 1953)

What IS going on? Guarding against potential medicolegal exposure is an important consideration. [Note: Although the plaintiff in the first of the following cases lost his case, psychiatry subsequently changed the practice which caused his injuries, with ECT modified by anaesthesia and muscle relaxants afterwards becoming standard practice]:

"Summing up, the Judge stated that "a professional man was not guilty of negligence if he acted in accordance with a practice which was accepted by a competent body of men skilled in that particular art, merely because there was a body of opinion which took the opposite view". He emphasized that the use of E.C.T. was progressive and that "the jury must not look with 1957 spectacles at what happened in 1954", suggesting that failure to use relaxants might now be considered negligent." (J. C. Barker, 'Electroplexy (E.C.T.) Techniques in Current Use,' J. Ment. Sci. (1958), 100)

"Occasionally, doctors have covered up the TD problem: In the important Rennie v. Klein right-to-refuse treatment case, psychiatrists were found to have failed to record evidence of TD, to have denied the prevalence of the syndrome and to have disciplined staff members who persisted in noting dyskinetic symptoms on patient charts. One of the hospitals under litigation had previously told accrediting officials that no patients suffered TD, but a court-ordered study found that 25% to 40% of the patients had TD (Brooks, 1980).

The largest award yet, over $3 million, was made in 1984 in Hedin and Hedin v. United States of America, based on overprescribing and lack of monitoring by a V. A. hospital (Gualtieri et al., 1985). ... The APA [American Psychiatric Association] believes that the lawsuits would have failed if psychiatrists had documented in medical records their monitoring for TD symptoms and their discussions of risks with patients and families. ... [The possibility exists] that TD malpractice may become more likely to be determined by "strict liability" than by "community standards of professional care." The strict liability approach...holds that the product or treatment is so inherently dangerous that the defendant bears a type of automatic responsibility for the detrimental outcome." (Phil Brown and Steven Funk, 'Tardive Dyskinesia: Barriers to the Professional Recognition of an Iatrogenic Disease,' J. Health & Social Behav., 27, 1986)

As well, resistance to recognition plays a part, as was found with Tardive Dyskinesia (TD), now publicly acknowledged as a movement disorder - induced by the neuroleptic drugs extensively used in psychiatry, although listed as a 'mental disorder':

"Psychiatrists often held that symptoms were due to other pathological conditions. For example, many early reports cited the presence of brain damage as evidence for dismissing the existence of persistent TD. ... Subsequent failure to accept evidence of TD or to take adequate measures must be seen as stemming from a desire to protect the pharmacological advances from criticism." (Phil Brown and Steven Funk, 'Tardive Dyskinesia: Barriers to the Professional Recognition of an Iatrogenic Disease,' J. Health & Social Behav., 27, 1986)

"It is suggested by the literature and by observation that ECT-damaged patients exhibit unique behaviour disorders which should not be diagnosed as schizophrenic, psychoneurotic, etc. ... Observers often view these patients as flighty, undependable and angry without apparent reason. It is suggested here that ECT damage be investigated and treated in its own right as an important mental impairment." (R. F. Morgan, 'Electroshock: The Case Against,' IPI Publishing Ltd., 1991)

Once one reads what individual psychiatrists actually say, the level of intellectual and scientific dishonesty - especially official denial of precise knowledge that permits ECT to remain forever a speculative or "progressive" treatment - beggars belief.

"ECT has been held by some to be an intrusive physical technique with inherently unacceptable risks and hence beyond the range of rational choice... We hope the day will soon arrive when we can be more precise in communicating the magnitude of the risks involved.... ... We do not believe that our current lack of precise knowledge makes the patient's decision inordinately difficult; many treatments for which we ask consent in medicine contain a much greater zone of uncertainty about outcome than does ECT." (Culver, Ferrell and Green, 'ECT and Special Problems of Informed Consent,' Am J. Psychiat 137:5, 1980)

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