In Connecticut, psychiatric patients can still be given shock treatments against their will.
In fact, electroconvulsive therapy is a standard medical practice in the United States and around the world — despite the risks of permanent brain damage or worse.
Positives … and negatives
The use of electric shocks to the brain to temporarily arrest various disorders, ranging from depression to catatonia and schizophrenia, has been around for 80 years.
It was first used successfully on a patient in a Roman hospital, and went on to become a standard procedure in hospitals around the world.
ECT was so common that it was often administered on an outpatient basis, and was purportedly seen as little more frightening than a painful dental procedure.
Yet in its early years, before anesthetics were applied properly, ECT caused extreme convulsions and bone fractures.
Nazi doctors used it to euthanize mental patients.
Homosexuality, considered a mental disorder, was “treated” with it.
Yet shock treatments came to cement its reputation as a backward and barbaric practice through its portrayal in the movie “One Flew Over the Cuckoo’s Nest,” where an unruly patient played by Jack Nicholson is repeatedly punished with electric shocks.
But in recent decades, ECT has been largely redeemed in the United States and United Kingdom — and many patients routinely approve it to treat their own disorders.
Sometimes, however, the patients are not so willing.
In Britain, a 57-year-old woman suffering from “catatonic” depression died after shock treatment caused heart failure.
A more prominent case made headlines last year in Connecticut.
A “John Doe,” whose parents were acting as his conservators, was given electroconvulsive therapy against his will.
So the man turned to a nonprofit legal service for help.
According to the Connecticut Post, Gina Teixeira of the Connecticut Legal Rights Project said that the man “obviously was sophisticated enough to contact me and ask me to file an appeal,” stating that he is “really scared” of the treatment and its effects.
Yet the Connecticut Attorney General intervened on behalf of the Bridgeport facility that had ordered the recurring ECT treatments, and the patient received the first round of shock treatments in mid-May 2019.
Teixeira was then able to halt further treatment after telling a judge that the facility failed to get approval from a medical panel, as required by law.
As this case faded from the headlines, another debacle arose in Connecticut.
This one involves a woman who was confined “against her will” in a government psychiatric ward for five years, undergoing electro-convulsive treatment involuntarily around 500 times.
While Teixeira was able to get a court order to stop the shock therapy, Connecticut law allows the facility to petition every 45 days to renew the shock treatments.
The ECT industry
An op-ed in Reason magazine also noted that an extensive review of scientific studies of ECT concluded that the risks of shock treatments could not justify its usage.
Yet across the country, many states still permit involuntary electroshock treatments, requiring physician approval and a court order that according to the Minnesota City Pages is more of a “bureaucratic formality” than any sort of “serious deliberation.”
Anti-ECT advocates such as Connecticut’s Teixeria say that alternative treatments, such as psychiatric medication, get overlooked in these situations.
Critics say that the ECT industry — which generates $1.8 billion in costs annually, half of which is covered by Medicare — enriches itself by exploiting these weak constraints.
In fact, one of the few legal constraints on the industry in the United States appears to be a 2018 ruling in a class-action lawsuit against companies that make ECT machines.
The ruling has resulted in one such company, Somatics, adding a warning in the manual for its ECT machines: “in rare cases, patients may experience … permanent brain damage.”