Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-23T04:23:05.605Z Has data issue: false hasContentIssue false
  • English
  • Français

Electroconvulsive therapy, capacity and the law in Ireland

Published online by Cambridge University Press:  13 June 2014

Ross Dunne ,
Adam Kavanagh  and
Declan M McLoughlin
Ross Dunne*
Affiliation:
Department of Psychiatry, Trinity College Dublin, St Patrick's Hospital, Dublin 8, Ireland
Adam Kavanagh
Affiliation:
Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, St. Patrick's Hospital, Dublin 8, Ireland
Declan M McLoughlin
Affiliation:
Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, St. Patrick's Hospital, Dublin 8, Ireland
*
*Correspondence Email: [email protected]
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

The Mental Health Act (MHA) 2001 has major implications for treating patients with electroconvulsive therapy (ECT), especially as those referred for treatment are among the most severely ill and often lose capacity. Under the MHA 2001, a person may only be treated without consent if they are an involuntary patient. However, there is no provision in the Act for treating voluntary inpatients whose mental state has deteriorated but who do not seek to leave hospital. Such people may lack capacity to make treatment decisions but be passively compliant.

The Wards of Court system is currently the only legal recourse but has been criticised by the Law Reform Commission and is unwieldy. Further legislation governing treatment of people lacking capacity to consent to ECT or withhold consent is required to protect and advance treatment of all concerned.

Keywords

Electroconvulsive therapyInformed consentCommitment of mentally illMental competency
Type
Editorial
Information
Irish Journal of Psychological Medicine , Volume 26 , Issue 1 , March 2009 , pp. 3 - 5
Copyright
Copyright © Cambridge University Press 2009

References

1.UK ECT Review Group. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet 2003 03 8; 361(9360): 799–808.CrossRefGoogle Scholar
2.Hotopf, M, Laird, B, Singh, Iet al.Capacity, consent and electroconvulsive therapy: A qualitative and cross-sectional study. J Mental Health 2008; 17(3): 315–325.CrossRefGoogle Scholar
3.Owen, GS, Richardson, G, David, AS, Szmukler, G, Hayward, P, Hotopf, M. Mental capacity to make decisions on treatment in people admitted to psychiatric hospitals: cross sectional study. BMJ 2008; 337: a448.CrossRefGoogle ScholarPubMed
4.Oireachtas na hÉireann, Mental Health Act, 2001, Part 1, Section 3, Subsection 1, (a) & (b). www.irishstatutebook.ie/2001/en/act/pub/0025/index.htmlGoogle Scholar
5.Appelbaum, PS. Assessment of patients' competence to consent to treatment. New Eng J Med 2007 11 1; 357(18): 1834–40.CrossRefGoogle ScholarPubMed
6.Law Reform Commission, Report – Vulnerable Adults and the Law, (83-2006) 12 2006. Section 1.63. www.lawreform.ie/Vulnerable%20Adults%20Report%20Final%20Dec%202006.pdfGoogle Scholar
7.Grisso, T, Applebaum, PS. Assessing competence to consent to treatment – A guide for physicians and other health professionals. Oxford University Press: New York, 1998.CrossRefGoogle Scholar
8.Mental Health Commission, Rules Governing the Use of Electro-Convulsive Therapy Reference Number: R-S59(2)/01/2006 www.mhcirl.ie/act/Rules%20for%20the%20use%20of%20%20Electroconvulsive%20Therapy%20MHA%202001%20S59(2).pdfGoogle Scholar
9.Decision of Mr Justice Higgins, 21st 12 2006: Q vs. St. Patrick's Hospital (respondent) and MHT, MHC (Notice Parties).Google Scholar
10. Communication from Mental Health Commission to Dr Ross Dunne specifically regarding this issue.Google Scholar
11.Oireachtas na hÉireann, Mental Health Act, 2001, Part 4, Section 56, (a) & (b).Google Scholar
12.Mental Health Commission, Code of Practice Governing the Use of Electro-Convulsive Therapy for voluntary patients. Reference Number: COP-S33/02/2008 www.mhcirl.ie/act/COP%20-%20S33-02-2008%20Use%20of%20ECT%20for%20Voluntary%20Patients.pdfGoogle Scholar
13.United Kingdom, Parliament. Mental Capacity Act 2005. www.dca.gov.uk/menincap/legis.htmGoogle Scholar
14.Law Reform Commission, Report – Vulnerable Adults and the Law, (83-2006) 12 2006.Google Scholar
15.Seanad Éireann, Mental Capacity and Guardianship Bill 2007. www.oireachtas.ie/documents/bills28/bills/2007/1207/b1207s.pdfGoogle Scholar
16. Ibid. Section 27, (1), (d).Google Scholar
17.Seanad Éireann, Mental Health (Involuntary Procedures) (Amendment) Bill 2008. http://www.oireachtas.ie/documents/bills28/bills/2008/3608/b3608s.pdfGoogle Scholar