A CONSULTANT psychiatrist employed by the HSE has warned that psychiatrists have “too much power” and that rules on the use of electro-shock therapy need to be changed to protect patients.
Dr Pat Bracken, clinical director for the West Cork mental health service, was speaking at a private briefing for members of the Oireachtas on whether changes are needed to laws governing use of electroconvulsive therapy (ECT). These rules state that ECT can be used where a patient is “unable or unwilling” to give consent once it has been approved by two consultant psychiatrists.
Dr Bracken said this law meant there was no legal comeback for a patient who felt they had been harmed.
“In any other branch of medicine it would be unconscionable to allow a procedure to go ahead, except in the most dire emergency, without procuring consent, if not from the patient then from a next-of-kin,” he said.
He said ECT was the “most invasive procedure” currently used by psychiatrists and that research showed that at least a third of recipients had suffered substantial memory loss after treatment.
Citing official figures, he said it was clear that some psychiatrists were “ECT enthusiasts” and had a much lower threshold for using the procedure compared with others.
He said figures indicated that ECT use was approximately 70 times higher in Galway compared with Cork, a statistic he described as an “extraordinary degree of divergence” and worthy of an independent investigation.
The Oireachtas briefings – which involved both opponents and supporters of ECT use – were organised by Minister of State for mental health John Moloney. He is considering calls to remove section 59(b) from the Mental Health Act. This allows for the use of ECT where patients are “unable or unwilling to give such consent”. The Minister is due to make a recommendation on whether changes are needed by the end of this month.
In its presentation to Oireachtas members, members of the College of Psychiatry of Ireland said ECT was an “important treatment option” for the management of severe depression.
It said research showed it to be a safe and effective short-term treatment for depression, and was probably more effective than drug therapy.
Instead of deleting section 59(b), the college has recommended amending it so only those who are “unable” to consent to treatment may receive ECT. It says this would protect the right to treatment of a very small, but severely ill and incapacitated, group of patients to access a treatment that is, in many cases, life-saving.
