The dark side of the healing volt

Last week, as Kitty Dukakis (twenty-six year amphetamine habit from the age of twenty; then some problems with alcohol and depression; in recent years a few short courses of unilateral ECT) was promoting the book (Shock: the healing power of electroconvulsive therapy) she has written with journalist Larry Tye, an altogether darker story of ECT emerged from the Appellate Division of the Supreme Court of New York.
Simone D, a Spanish-speaking woman, has been a resident of Creedmore Psychiatric Hospital for twelve years. Over this period she has received several courses of ECT (a total of 148 treatments) under court order. One course in 1996 was stopped because of the damage it was doing, but the courts continued to authorize further treatments even though there appears to be little hope that Simone will ever recover sufficiently to leave hospital or be allowed to make her own decisions about treatment. On this occasion the court voted, by a three to two majority, not to allow an appeal against the latest permission to administer ECT. One of the two dissenting judges had this to say:

"Simone D. was first admitted to Creedmoor Psychiatric Center in 1994 and suffers from a severe depressive disorder. Since 1995, she has undergone, over her objection but pursuant to previous court orders, at least 148 ECT treatments. Prior efforts to help her with medication failed to improve her condition. After two unsuccessful applications in July and September 2005 for permission to administer ECT to Simone D., the petitioner applied again in November 2005. The petition and supporting papers showed that without ECT Simone D. becomes depressed, stops eating and drinking, and requires nasogastric tube feeding. Allegedly, the ECT will diminish her assaultive behavior, enable her to eat, enhance self-care, and promote her ability to socialize. At a hearing on the petition, the court rejected the request of Simone D.'s counsel that it appoint an independent psychiatrist. The petitioner called one of its psychiatrists, Dr. Ella Brodsky, who opined that Simone D. lacked the capacity to make a reasoned treatment decision and that ECT is the least restrictive alternative because there is no other choice..." Read more