ECT at Tolworth Hospital

“Hospital gave my mother ‘electric shock therapy against her will’ says Zac Goldsmith’s former aide” ran the headline in yesterday’s London Evening Standard.

The story concerned a woman who was given electroconvulsive therapy (ECT) without her consent at Tolworth Hospital in Surbiton. Her daughter was quoted:

“My mother was very unwell. A nurse told me she’d had electro-shock therapy,” said Ms Rahman. “We thought there would be a care meeting to discuss any plans like that. It is a huge decision. We had no idea this was going to happen. I was very angry.”

The article also include comments from Jane Harris of the charity Rethink Mental Illness:

“Many health professionals do not properly understand the rules around confidentiality and mistakenly think they can’t involve the family.
Close family members can play a key role in keeping their loved one well and, where appropriate, should be treated as partners not problems.”

The article said that the family is planning legal action. Presumably section 58a of the Mental Health Act was used. This allows psychiatrists to give ECT to patients who are considered incapable of giving consent if they get permission from a psychiatrist from the Care Quality Commission (who very seldom withhold permission). It would not be the first time that South West London and St George’s Mental Health Trust have been called upon to defend their use of ECT on non-consenting patients, as this 2003 news item from the BBC shows:

“A High Court test case examining the legality of forcing severely depressed patients to have electroconvulsive therapy (ECT) has been halted by a judge.

It was decided the case could go no further after it was revealed the woman at its centre, known only as K, had improved and no longer needed the treatment.”

It did not say which hospital was concerned. In 2003 it was still legal to give ECT under section 58 of the Mental Health Act to capable non-consenting patients, that is, people who could make a decision and decided they didn’t want ECT. When challenged by the patient’s lawyers, the hospital decided that the patient had improved and no longer needed ECT. The lawyers wanted to continue with the case as a question of principle, but Mr Justice Stanley Burnton declined their request.

The law was changed in 2007, and since the change came into force in 2009 ECT cannot be given under section 58A if someone, like the person in the 2003 case, is considered to be capable of making a decision and says no.

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