Regulation of Electroconvulsive Therapy

Carol Sanger, Columbia Law School

Abstract

Regulation of ECT has generally focused on whether the patient or his representative effectively consented to the treatment. The highly intrusive nature of ECT and the unique circumstances of those patients who are likely to receive it create particularly difficult legal issues concerning the validity of the patient's consent. This Note will examine the various methods that are available to protect the rights of patients for whom ECT is proposed. After briefly explaining the nature of the therapy, the Note will discuss the efficacy of judicial remedies with respect to both competent and incompetent patients. It will argue that, because of the peculiar nature of ECT, special procedures that ensure the existence of consent to state-administered ECT may be constitutionally required. It will then address specific procedures legislatively enacted by several states for the regulation of ECT and will assess their constitutional limitations, with emphasis upon the problem that a regulatory scheme, in its effort to protect patients from unconsented therapy, may interfere with the right of patients to consent to privately administered ECT.