24 Mar 2011

The latest iteration of the Mental Health Care Bill is expected to put
strong checks on the use of electro-convulsive therapy (ECT), which is used
rampantly in India. Popularly known as shock therapy, it involves
administering precise electric shocks to the brain to stimulate specific
nerve cells, to kick-start severely depressed patients. It has been
demonised in movies like One Flew Over the Cuckoo’s Nest — the violent
seizures, and the calm it creates later, put off observers. However, many in
the medical community defend its use as a highly effective last-ditch
treatment for depression.
After a couple of Italian doctors hit upon the method in 1938 and
successfully treated a patient for hallucinations and confusion, albeit
temporarily, ECT has been a standard line of mental treatment. Its use has
waned as anti-depressant drugs took off after the 1970s and 1980s, but for
the most recalcitrant cases, measured convulsions have been known to lift
depression. As the Yale surgeon and bio-ethicist Sherwin Nuland has said,
modern treatment looks nothing like the early ECT methods, before there was
an effective way to paralyse the muscles, leading to the dangerous grand mal
convulsions.

However, for all the refinement of the procedure now, there are ongoing
studies that claim that ECT’s benefits are short-term, and that it can
impair memory and the ability to absorb new information. In India, of
course, it’s only with these amendments to the Mental Health Care Bill that
anaesthesia has been made compulsory, and necessary checks installed —
direct ECT will be avoided, and it will not be used on minors. However, the
most important improvement could be to make sure the patient’s informed
consent is available, wherever possible, and that the psychiatrist who
recommends the treatment lays out the benefits and the possible
side-effects.

http://www.indianexpress.com/news/shock-doctrine/766561/

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