In my last post I looked at the latest statistics from the Care Quality Commission in England which showed that the use of electroconvulsive therapy (ECT) on people who are unable to consent is at a record high. Since there are no reliable statistics available on the overall use of ECT in England it is impossible to say what proportion of ECT patients are non-consenting. In Scotland, where statistics are published, it is one in three. I have been wondering if non-consenting patients would eventually outnumber consenting patients; if ECT would become a treatment predominantly given to people who are not in a state to have any say in the matter.
It appears that, according to a recent BBC report, this has already happened in Northern Ireland. The law is different in Northern Ireland and ECT can still be given to people who don’t consent to ECT even if they retain capacity. The BBC report says:
“In total, 96 patients in Northern Ireland were treated with ECT in 2014-15, both with consent and without. The BBC has learned that within that year there were 53 referrals to carry out electroconvulsive therapy on patients without their consent.”
If those numbers – 53 out of 96 – are correct then it means that the majority of patients are non-consenting.
Bizarrely, in the same report, the BBC says:
“The vast majority of ECT treatment courses are chosen by the patients themselves. Sometimes however the shock therapy is administered without the patient’s consent.”
If their own figures are correct, then patients no longer consent in even a slender majority of courses, let alone a vast majority (and consenting isn’t of course quite the same as choosing).
I am not sure where the BBC got their statistics from – possibly the Regulation and Improvement Quality Authority (RQIA). The RQIA first published a report on the administration of ECT in Northern Ireland in 2012 (I discussed it here). Reports for 2012/13 and 2013/14 are also available on the RQIA website, but I have been unable to find one for 2014/15. Each of the three reports says that, during the period covered, “..the age range for all patients varied from 22 to 95 years.” This seems rather an unlikely coincidence.
Another place where the use of ECT on non-consenting patients has overtaken its use on consenting patients is the Northern Territory in Australia, which I shall look at in my next post.
PS (July 2017). Since I wrote this post the Regulation and Quality Improvement authority has published statistics on ECT use 2014/15. They have the same figure as the BBC for the total number of people undergoing ECT, that is, 96. But they say that there were 38 requests for authorisation to treat a patient without their consent, lower than the BBC figure.