In general medicine the standard for informed consent includes:
- Communicating the nature of the diagnosis
- Communicating the purpose of the proposed treatment
- Informing the patient of alternative treatments so he can make an informed and educated choice
All patients should have what is called a “differential diagnosis”. The doctor obtains a thorough history and conducts a complete physical exam, rules out all the possible problems that might cause a set of symptoms and explains any possible side effects of the recommended treatment.
In the case of electroconvulsive (ECT) treatments, make certain to have the different types of ECT explained that may be used, and the risks of each type. Discuss the extent of short and long term memory loss and the possibility of cognitive problems.
Consent for ECT is done at the onset of the first treatment for a complete series (usually 6-12 treatments). The patient is not able to give true informed consent for each individual treatment because the patient, following the first treatment, is too confused to consent further. This also decreases the risk of the patient refusing further treatments in a series, if consent is already in place at onset and no longer discussed.
You have the right to a second opinion by a psychiatrist not associated with the ECT program at the treating facility. You have the right to know if your case will be part of research and you have the right to consent to this or to refuse to be part of a study.
How much information should I be given about treatment?
You should be given ALL the information you need to enable you to make a decision.
- What the treatment is
- What it will achieve
- How long will the treatment be effective
- What are any likely side effects
- What will happen if treatment is not given
- What are the alternatives.
If you have the mental capacity and are over 18 years of age you are entitled to refuse ECT. Undue influence or threats in order to coerce you into consenting are against your legal rights. If you feel that this is happening, seek independent legal advice.
You have the right to ask for a meeting with the patient rights advocate at the treating facility in addition to legal representation. Consent, if voluntary, can be withdrawn at any time.