Seanad fails to vote on electroconvulsive therapy

A CONTENTIOUS Seanad vote on the administration of electroconvulsive therapy (ECT) was last night adjourned without an expected vote on the issue.

It is not yet clear whether the new leader of the Seanad will let debate on the issue continue today.

A Seanad vote on the proposed amendment of section 59 of the Mental Health Act does not amend the bill, but sends it to the Dáil for a decision.

The arguments around the administration of ECT are very nuanced, but nevertheless contain fundamental differences.

They centre around 59b of the Mental Health Act (MHA) which says that if someone is “unwilling or unable” to make a decision for themselves then they can be given the treatment on the opinion of two consultant psychiatrists.

In essence, it allows ECT to be administered to patients against their will and without their consent.

The lobby group Delete 59b, of which former head of the Mental Health Commission Hugh Kane is a part, maintains this means mental health patients are the only group of medical patients not to have protection with regard to their consent or lack of consent to medical treatments.

Mr Kane said for him the issue is about basic rights around consent.

If the controversial wording is deleted, according to the lobby group, patients would be extended the protection of the common law whereby a doctor can give treatment without consent in an emergency.

Amnesty International Ireland said while it believes the MHA is currently in breach of international human rights and needs to be amended, this proposal does not go far enough.

“We fully support the need to amend section 59 of the MHA but would like to see the bill go further and ensure there are stronger human rights safeguards and protections for people who lack capacity; our concern is that common law will not provide these safeguards.”

Amnesty’s believes that while section 59 raises serious human rights concerns, simply removing it without the necessary capacity legislation in place is not good enough as there is no requirement under common law that a second independent opinion be obtained or that the matter be referred to an independent review body. Amnesty is lobbying for more detailed reform of the act which must be reviewed by November.

Elsewhere, the College of Psychiatry says the word “unable” must be retained as it can be a life-saving treatment in severe cases.

“About 40 people each year are treated with ECT under the provisions of Section 59 of the Mental Health Act 2001. These are some of the most severely ill patients in the country and usually, but not invariably, have impaired capacity,” a spokesperson said.

“The College of Psychiatry supports the right of any patient to refuse to have ECT if they have the capacity to make such an informed choice.”

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