| Viscount 2006-08-15, 2:24 am |
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http://www.stuff.co.nz/stuff/0,2106...77a7144,00.html
Shocks given without consent
15 August 2006
By KIM RUSCOE
About 130 people have been given shock treatment without their consent
in the past two years, a Health Ministry report shows.
Mental Health deputy director Jeremy Skipworth said that, of the 612
severely depressed patients who received electroconvulsive therapy
between mid-2003 and mid-2005, only 80 per cent consented.
Two-thirds of those treated were women, most aged over 40.
"Sometimes people are so unwell they are not actually able to give
consent," Dr Skipworth said.
"It's not appropriate for them to be deprived of the ability to be
treated just because they're so sick they can't agree to it."
Those people were committed under the Mental Health Act and given shock
treatment after a second opinion had been given from a qualified
psychiatrist, Dr Skipworth said.
Family members were also consulted.
Green Party health spokeswoman Sue Kedgley said the controversial
treatment was being given without consent more often in some districts
than others. The highest rates of unconsented-to treatments last year
were given by Tairawhiti, Capital and Coast and Auckland health boards.
Dr Skipworth said no one in New Zealand was given ECT against their
wishes if they were competent to make decisions about their treatment.
ECT was proven internationally to be an effective treatment for severe
depression, with eight out of 10 patients responding well to it.
It was used when anti-depressant medication, psychotherapy or both had
been ineffective, or when medication was too slow or caused severe side
effects.
It was also the safest form of treatment when patients were also
suffering a physical illness or were pregnant.
Side effects included short-term memory loss, headaches, muscle
soreness and nausea.
Methods of administering ECT had improved greatly since its "misuse" in
the 1960s and 1970s, when large numbers of people suffering a variety
of mental illnesses were given it without anaesthetic or muscle
relaxant.
A new treatment for severe depression being tried in the United States
had produced promising results, he said. But the trial group was small
and it was yet to be seen if the results could be replicated in a
larger group.
The US study found a single intravenous infusion of a general
anaesthetic agent, Ketamine, could relieve symptoms of severe
depression within two hours and remain effective for up to one week.
Most medications available at present did not start to relieve the
symptoms of depression for several weeks.
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