§ Mr. Stevensasked the Secretary of State for Social Services if he intends in the new legislation on mental health to seek to ban the use of electro-convulsive therapy.
§ Sir George YoungIt is for the clinicians involved to decide what treatment is most suitable for their patients. On current evidence, I have no reason to believe that electro-convulsive therapy is being performed in this country other than in patients' best interests. The Government have no plans to prohibit its use.
§ Mr. Stevensasked the Secretary of State for Social Services if, in the absence 646W of legislative proposals to ban electroconvulsive therapy, he will bring forward provisions similar to those in California requiring fully informed consent procedures before such treatment is carried out and giving a right to refuse the treatment.
§ Sir George YoungThere is no legal provision authorising or implying that electro-convulsive therapy (ECT), or any other form of treatment, can be imposed on an informal (voluntary) patient without his consent; some 95 per cent. of patients in mental illness hospitals are informal. It is established good practice for the doctor to explain to the patient the nature, purpose and likely side-effects of any treatment, including ECT, before seeking his consent. The doctor would not then proceed to administer ECT unless the patient had given informed consent.
As to the 5 per cent. of in-patients in mental illness hospitals who are detained, the Department's view is that the Mental Health Act gives implicit authority to administer recognised forms of treatment for mental disorder, including ECT, without the patient's consent where necessary. Nevertheless, as with informal patients, it is good practice for the doctor to explain the treatment to the detained patient and, wherever possible, to seek his consent. Similarly, it is usual to explain the proposed treatment to close relatives, although a relative's consent has no standing in law.
The question of consent to treatment was discussed in the previous Administration's White Paper on the review of the Mental Health Act. I am presently considering how best to proceed with this review in the light of comments received.