November 2, 1999

Dear Richard Nakamura, PhD and Matt Rudorfer, M.D.:

My understanding is that you both met recently with individuals concerned about your stubborn decision to reassure the nation that electroshock has been approved by the U.S. government for "safety and efficacy," despite your having absolutely NO scientific proof or documentation for that claim; your apparent intent is that your reassurance will be sent to millions of people, via a prestigious U.S. Surgeon General's report.

Where is your proof? Show us.

Since you have met with others, we would like to request a personal meeting with you about this matter as soon as possible, with representatives of our group, Support Coalition International. As Center for Mental Health Services can tell you, we have been one of the main groups working on human rights and electroshock this decade, and we represent 75 grassroots groups.

We are led by individuals who have experienced human rights violations in the "mental health system," including electroshock.

This e-mail with touch on just a few matters, because of the urgency of the situation.

The Food & Drug Administration -- the main government agency legally mandated to do so -- has *never* completed an examination of the electroshock device for safety and efficacy.

Never.

Where is your proof? Show us.

Despite the fact that the electroshock device impacts the most complex organ known -- the brain -- the FDA has illegally refused to complete examinations of the device for safety and efficacy.

It's impossible for you to deny this.

So how can you give a blanket endorsement of "safety and efficacy" of electroshock?

Let me give just a few examples in this note, there are plenty more.

None of the shock devices are regulated, and the amount of electrical energy they deliver (as measured in "joules"), varies wildly from machine to machine. Today, a typical shock device can deliver far more "joules" than previous machines.

Yet, the FDA has never looked into safety and efficacy.

So where is your "scientific" documentation for safety and efficacy of the electroshock device?

Where is your proof? Show us.

This is not a parlor room debate: Your endorsement could effect the brains and future and livelihood of countless Americans.

As more and more is learned about shock and the brain, you may be remembered the way 1950's doctors who blithely endorsed cigarettes are remembered today. History is not on your side.

Let me speak for a moment about the big picture: I have a personal interest in the history of science, and I've been examining the record of this millennium. Much of what we mistakenly call "science" is actually about POWER. So it is no surprise that a device that can be so intrusive into our very beings like electroshock, and that typically impacts one of the most de-valued members of our society (depressed elder women), and is promoted by one of the most powerful and unchecked professions in the U.S.... it is no surprise that there is a terrible and unscientific bias against evaluating this device for safety and efficacy.

What is surprising is that you would ignore the scientific and undeniable truth that this device is one of the few modern devices that has NEVER been investigated for safety and efficacy. NEVER.

Where is your proof? Show us.

I will give you just one example why your simplistic reassurance about safety and efficacy is unscientific and false.

Nine years ago, the American Psychiatric Association issued a guideline book about electroshock (though they were careful to put in a disclaimer that the book didn't necessarily reflect their official position). In that APA guide book on shock, there's sample informed consent material. And in that informed consent material, there is a reassurance that the risk of severe long-term memory problems is about 1 in 200 -- only .5 percent.

We were immediately suspicious, and for years we investigated that "1 in 200" number -- which is used widely, where the rubber hits the road, such as here in Sacred Heart in Eugene and in the State of Oregon's state mental health system's informed consent materials.

Well, the Washington Post did a large piece about electroshock, and we convinced them to investigate this number. They did investigate. The _Post_ found that the committee that wrote the guidelines consisted mainly of professionals with direct financial interest in the manufacturing of the devices. So the _Post_ asked them about the origins of that 1 in 200 number. One of the committee members explained that it was an "impressionistic" number NOT BASED ON ANY DATA AT ALL.

We wrote to the American Psychiatric Association board of directors. Now, the _Psychiatric News_ 7/18/99 (the APA's newspaper) there's an article about the brand new shock guidelines to be published soon by the American Psychiatric Association. And in that article it quotes Richard Weiner, ME, PhD about the model informed consent material in the new guideline: "There is also a more explicit statement in the sample consent form on the possibility of significant memory loss following ECT."

We've seen an advanced draft, and apparently they've quietly taken out that "1 in 200" reassurance. So for nearly a decade, thousands upon thousands of Americans have been reassured with this false ratio, and the federal government has done absolutely NOTHING -- no investigation of safety, no investigation of informed consent. We wrote the FDA many times about this problem, and they did nothing.

But perhaps due to our pressure, or because of the _Washington Post_ article, or their own conscience, the APA and Weiner have taken out that totally fraudulent and unscientific "1 in 200" number in their next proposed informed consent.

And meanwhile, what about YOU? You are going in the other direction. While the APA is covering its tracks after falsely reassuring the public, you are marching onward toward reassurance... based on what? Where is your scientific investigation of safety and efficacy, and of the risk of persistent memory loss of pre-hospitalization memories, for example?

For example, why have you not looked into the information from Texas, which has officially gathered information about deaths following electroshock, and has found that the death rate is far, far higher than what psychiatry has been claiming?

If you reassure the American public that shock has been officially investigated by the federal government for safety and efficacy you will be lying.

Where is your proof? Show us.

I've studied comparative religions, and there's one "sin" that they all agree upon: lying. It is wrong. And if that doesn't reach you, then just ask yourself about the SCIENCE.

To recap, the APA is getting MORE careful in this past decade, so they will pull a false reassurance about low risk of memory problems... and they publicly state they will be "more explicit" about "possibility of significant memory loss." And you? Why are you going in the opposite direction, where even the shock industry fears to tread? Why are you giving this unregulated device a false stamp of approval, paid for by the taxpayers?

Your actions are fraudulent, and would lead to lack of informed consent for electroshock for thousands upon thousands of Americans, with no scientific validity for your statement. That is immoral, that is criminal.

Imagine this is the 1950's, and you are about to give the stamp of approval for the "safety and efficacy" of cigarettes... how many years will it take to change that, to deal with the damage? How many minds and brains of Americans will be harmed, under FALSE reassurance? The use of fraud robs people of their FREEDOM to choose. Where is your moral courage?

Isn't this supposed to be the land of the free and the brave? Was that a lie?

Where is your proof? Show us.

We have a right to know, because our members' horrible experiences are the RESULTS of misguided stubborn and unscientific statements by people such as yourself.

I will copy this to two individuals in the Clinton administration who have told us they care about our voice being heard: Paolo del Vecchio and Jonathan M. Young. This is the time for them to prove what they have told us.