Current laws regulating ECT use in the severely ill, incompetent patient are so cumbersome that many patients who may only respond to ECT are denied the treatment. Several cases are presented that illustrate the inability of the current California law to effectively deal with complex clinical situations and the subsequent social, financial, and personal harm incurred by patients. It is suggested that the decision regarding use of ECT for incompetent patients can be best made through a medical, nonjudicial process, while protecting all the patient's rights--both to be treated as well as from inappropriate treatment.