The issue of informed consent is a hot one. The problem with the informed consent statements that exist today is that they just aren't honest. They gloss over the main points about ECT - that's it is a temporary fix, and that memory/cognitive damage *does* occur. |
In a continuing education course for ECT practitioners, Max Fink tells participants they are legally safe by using the informational pamphlets from the ECT machine manufacturers, plus videotapes (he does go a little bonkers in self-love, envisioning himself a TV star - kind of comical).
If you can write in your chart that the family saw the Mecta booklet, "you're home free" legally, says Fink, in advising
these guys on how to protect themselves in case of lawsuit.
That's what's important - protection. Fink goes on to explain how to "save yourself the hassle of consent."
This audio clip requires the Real Player, available for free download at http://www.real.com (you can try and use Windows Media Player, but you do so at your own risk. It may or may not work, and please don't write me telling me it won't work if you're not using the REAL PLAYER!) More about Max Fink.
Here are some examples of informed consent forms and informational booklets given to patients.
First, read what a doctor who runs informedconsent.org has put together as a model informed consent form. This eye doctor says: "So that I may clearly state the content and conditions of my consent to
permit medical and surgical procedures, I write my orders at home and
bring them to the treatment facility. My orders override any and every
blanket consent form I am asked to sign. Make them a permanent part of my
medical record and provide me the following choices:" and then goes on to list everything in detail. I suggest that if you or a loved one is considering ECT, you adapt this kind of language into your own consent form and insist on these measures. This will make YOU a truly INFORMED consumer, and not just a submissive patient at the mercy of the powers that be.
From Fletcher Hospital in Vermont, the informed consent form on ECT. Begin here.
Also from Fletcher, the form used when beginning maintenance ECT.
From the American Psychiatric Association, a sample consent form.
From Dr. Richard Abrams, a sample statement from his book "Electroconvulsive Therapy," the bible for ECT practitioners. Abrams explains how to reduce your risk of litigation. (if you're an ECT doc)
Here is a copy of the Somatics (Abrams' company) brochure for patients. Please do NOT take this as serious information about ECT. This is what Somatics (leading manufacturer of ECT machines and accessories) gives/sells to doctors/hospitals who do ECT. What Abrams writes in this brochure to patients and families is not even close to what he tells doctors. If in the brochure, he says 2 plus 2 equals nine, in his book to docs, he says 2 plus 2 equals four. One of these days I'll try and put up a lengthy critique, but you can do it yourself if you read the literature and compare it to what this brochure says.
Inside (sorry about the coffee stains...I use it as a coaster sometimes - hey, at least I don't use it as TP!)
More about Richard Abrams.
More information on informed consent may be found in the "Studies" section of ect.org.