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In Shocked! ECT

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Sample ECT Consent Form
Written by Juli Lawrence   
PDF Print E-mail
Feb 17, 2007 A +  A -  RESET  

From Fletcher Hospital in Vermont

Patient Information Electroconvulsive Therapy

 

Details how ECT is administered and how many ECT treatments are needed to treat depression.

 

Details side effects of electroconvulsive therapy including memory loss.

 

Serious medical complications from ECT are rare, however there is a remote possibility of death and irregularities of heart rate and rhythm.

 

Section of ECT consent form that explains rationale for ECT, benefit of ECT and how ECT treatment works.

 

Section of ECT consent form that explains ECT procedure step-by-step and risks of ECT including confusion to serious medical complications like heart attack and death.

 

Section of ECT consent form that explains potential of memory loss from ECT. Side effect of ECT is poor memory functioning.

 

Signature page of ECT consent form notes that the doctor gives no guarantee that ECT will be effective.

next: ECT and Informed Consent
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Last Updated( Feb 11, 2009 )
reviewed by: Harry Croft, MD
Psychiatrist, HealthyPlace.com Medical Director
 

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