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Research ArticleARTICLES

Informed Consent in the Electroconvulsive Treatment of Geriatric Patients

Stewart B. Levine, Karen Blank, Harold I. Schwartz and Douglas S. Rait
Journal of the American Academy of Psychiatry and the Law Online December 1991, 19 (4) 395-403;
Stewart B. Levine
MD
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Karen Blank
MD
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Harold I. Schwartz
MD
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Douglas S. Rait
PhD
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Abstract

The past 15 years have been marked by an increasingly stringent regulatory atmosphere regarding the administration of ECT, leading to delays in treatment and declines in usage. Regulatory changes requiring judicial intervention in clinical decisions are driven by the notion that only the courts can provide adequate due process protections when legal rights and clinical need conflict. We retrospectively reviewed the documentation of the informed consent process for 62 geriatric patients receiving ECT to assess the degree to which clinicians conformed to the spirit of the informed consent doctrine in a state that allows significant clinical discretion in decisions to administer ECT to patients lacking decisional capacity. In the eight cases in which the patient’s decisional capacity was questioned, we found appropriate documentation of the patient’s failure to comprehend his condition or the proposed treatment, evidence of a high degree of family involvement in decision making, and extensive use of outside consultants to document decisional incapacity and the need for treatment. Evidence of family participation in decision making was present for a high percentage of cases in which decisional capacity was unquestioned. Our review demonstrated high compliance with the procedural safeguards contained in the state regulation and with the spirit of the informed consent doctrine.

  • Copyright © 1991, The American Academy of Psychiatry and the Law
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Journal of the American Academy of Psychiatry and the Law Online: 19 (4)
Journal of the American Academy of Psychiatry and the Law Online
Vol. 19, Issue 4
1 Dec 1991
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Informed Consent in the Electroconvulsive Treatment of Geriatric Patients
Stewart B. Levine, Karen Blank, Harold I. Schwartz, Douglas S. Rait
Journal of the American Academy of Psychiatry and the Law Online Dec 1991, 19 (4) 395-403;

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Informed Consent in the Electroconvulsive Treatment of Geriatric Patients
Stewart B. Levine, Karen Blank, Harold I. Schwartz, Douglas S. Rait
Journal of the American Academy of Psychiatry and the Law Online Dec 1991, 19 (4) 395-403;
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