Senate passes medical stipulation for electroshock therapy

By MARY ALICE ROBBINS
Morris News Service

AUSTIN - Two physicians would have to certify that electroshock therapy is necessary for a patient 65 or older before that individual could begin a series of the treatments under a bill passed Friday by the Texas Senate.

Sen. Jerry Patterson, the bill's sponsor, said there have been instances of abuse in the use of electroconvulsive therapy - or ECT - for treating the elderly.

''This is to try to curtail that happening in the future,'' said Patterson, R-Pasadena. According to the American Psychiatric Association, ECT involves stimulating a patient's brain with a controlled series of electrical pulses to treat certain illnesses, such as severe clinical depression.

State records indicate that 46 percent of all patients who receive ECT in Texas are 65 or older - an age at which they are eligible for Medicare.

A random audit of hospital records by the Texas Department of Health found that some hospitals have given individual patients too many treatments and performed inadequate medical screening to determine whether a patient will benefit from ECT.

An on-site visit during March to the Pavilion at Northwest Texas Medical Center in Amarillo found that patients were admitted as voluntary inpatients to the facility even though they weren't competent to sign in as voluntary patients, according to a report on that visit.

The report also noted that Pavilion patients were asked and allowed to sign informed consents for ECT even though they were not competent to do that. The Pavilion has to stop ECT treatments.

Patterson had to weaken his bill to ensure its passage.

The bill he originally introduced would have required that any candidate for ECT receive a nonpsychiatric medical examination to determine that the treatment would not cause significant injury or death. It also would have made patients 65 or older ineligible for ECT treatment.

Before winning approval of the bill, Patterson deleted provisions that would have increased the reporting requirements on deaths following ECT.

Patterson said the reports he eliminated would have required brain tissue studies and other things that aren't necessary.

''The mission is to protect people. I think this will help do that,'' he said of his bill.