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Electroconvulsive therapy is still given to patients who don’t want it

We are writing in relation to an article published by the Irish Examiner on December 25, which stated that President Higgins has “formally outlawed compulsory ECT in Ireland”.

The article states that “under the measures, doctors will no longer be able to use ECT without patients’ permission”.

If only this was the case.

Though the term “unwilling” to consent to the administration of ECT was deleted from the Mental Health Act, 2001 (s. 59 (1) (b)), the reality is that, under the 2001 Act, people can still be administered ECT without their permission once their treating psychiatrist and another psychiatrist deem they are “unable” to consent.

Any advance decision they make in regard to such administration is non-legally binding under recently-enacted capacity legislation.

This, in effect, means that any person who is “unwilling” to consent can still be administered ECT, if he/she is found “unable” to consent, even if that person clearly states in advance he/she does not want to have ECT and/or the family disagrees with it also.

According to Mental Health Commission statistics, the majority of people being administered ECT without their consent in Ireland in 2013 were deemed “unable” to consent (39/46).

The assessment of capacity is subjective.

People are often found to lack the capacity to consent when they are refusing treatment.

Until advance healthcare directives are made legally binding for decisions in relation to ECT under the Mental Health Act 2001, people will continue to be administered ECT without their permission.

This is an important human rights issue, which needs to be addressed in the upcoming review of the Mental Health Act.

Maybe then we will be able to read that President Higgins has indeed “formally outlawed compulsory ECT in Ireland”.

Dr Fiona Morrissey

Lydia Sapouna

Dr Harry Gijbels

Critical Voices Network Ireland

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