SOURCES OF PUBLIC PREJUDICE THERAPY AGAINST ELECTRO-CONVULSIVE

Recent legislation in NSW betrays a prejudice against electro-convulsive therapy. Factors probably contributing to popular prejudice against ECT are discussed. Australian and New Zealand Journal of Psychiatry 1989; 23:453-460 In a previous paper, attention was drawn to the distinct prejudice against ECT manifested in the provisions (not yet in force) of the 1983 NSW Mental Health Act governing the administration of this treat-ment. This is evident chiefly in the consent require-ments. For any other form of medical, surgical, or psychiatric treatment, including even psychosurgery, various forms of authorisation are provided for patients who are deemed incapable of giving informed consent. (Indeed, in the case of a non-voluntary patient, even if these are deemed capable of giving informed consent- and are therefore, as one would have supposed, competent to withhold it- there is provision for authorisation to be obtained for the per-formance against their will even of a non-life-saving surgical operation). It is not the purpose of this paper to discuss these latter provisions, which may seem open to question, and they are mentioned only in order to contrast them with those governing ECT, which, in practical effect, allow no substitute for the patient’s informed consent. Many patients suffering from delusional depression, would have to be regarded, strictly, as lacking the competence to give informed consent, even though such a patient might be willing enough tokeceive the treatment. (A patient in a clinically similar psychoti