Background. Current mental health legislation in the UK
makes provision for the use of certain
treatments in severely ill patients who are unable, or unwilling, to give
informed consent. Under the
terms of this legislation, electroconvulsive therapy (ECT) may be used,
usually to treat severely
depressed patients. A number of organizations have challenged this practice,
stating that ECT
should only be given with fully informed consent: it has been implied that
compulsory ECT (given without the patient's consent, under the terms
of mental health legislation)
find the treatment damaging and unhelpful.
Methods. A series of 150 patients receiving ECT in Aberdeen
was studied. A proportion of the series
(approximately 7%) received compulsory ECT. The views and treatment outcomes
patients were compared with those of patients giving informed consent for
Results. More than 80% of patients in both consenting and compulsory
groups considered ECT to
have helped them. Clinical outcome did not differ between the groups. Patients'
marked concordance with independent medical evaluation of outcome.
Conclusions. Outcome following ECT in non-consenting patients
is equivalent to that seen in
consenting patients whether rated by the patients themselves or by clinicians.
Overall outcome is
good, with more than 80% of patients benefiting from treatment. A ban on
compulsory ECT would
deny the access of seriously ill patients to an effective and acceptable