# Why is electroconvulsive therapy treated as a treatment of last resort? **URL:** \ **Category:** Factual Questions\ **Created:** [September 30, 2020, 7:20am UTC](https://boards.straightdope.com/t/why-is-electroconvulsive-therapy-treated-as-a-treatment-of-last-resort/921871 "2020-09-30T07:20:25Z")\ **Posts on this page:** 7\ **Page:** 2
**Author:** ![Broomstick](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/broomstick/32/246_2.png) [@Broomstick](https://boards.straightdope.com/u/Broomstick)\ **Post date:** [October 1, 2020, 9:31am UTC](https://boards.straightdope.com/t/why-is-electroconvulsive-therapy-treated-as-a-treatment-of-last-resort/921871/21 "2020-10-01T09:31:53Z")
> [@AHunter3](#): > > But they should consent as fully informed consenting people There’s the problem that, in some instances, the patient may not be able to legally consent. There are mechanisms for making treatment decisions for people in that situation for any medical need, not just psychiatric treatment, and I would definitely want a lot of oversight but that true of any medical procedure on someone in that state. I suspect ECT is more common than we realize simply because the stigma means people take great pains to conceal that they’ve had it. I’ve known several people who have had ECT. Yes, it did help their depression and they never got so bad again they were suicidal. Yes, there were some side effects. Lots of medical treatments for serious or life-threatening conditions have side effects. I don’t doubt that there have been some instances where the results were not good. I also don’t doubt that it has also very much helped some people. We can trade anecdotes all day. I don’t think it should be a first-line treatment anymore than surgery should be a first-line treatment for cardiovascular disease, you try less invasive treatments first. ---
**Author:** ![AHunter3](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/ahunter3/32/368_2.png) [@AHunter3](https://boards.straightdope.com/u/AHunter3)\ **Post date:** [October 1, 2020, 11:14am UTC](https://boards.straightdope.com/t/why-is-electroconvulsive-therapy-treated-as-a-treatment-of-last-resort/921871/22 "2020-10-01T11:14:28Z")
> [@Broomstick](#): > > There’s the problem that, in some instances, the patient may not be able to legally consent I’m aware, and of course there _has_ to be. But the mere fact of being an involuntary mental patient, by itself, utterly does not qualify. A separately competency hearing should take place and the fact of a person’s psychiatric diagnosis should not even be admissible evidence in that proceedings. If you can’t show by actual narration of empirical events and behavior elicited right there in the courtroom that the individual lacks decision-making capacity, you don’t get to treat the individual like a toddler. ---
**Author:** ![zimaane](https://avatars.discourse-cdn.com/v4/letter/z/a3d4f5/32.png) [@zimaane](https://boards.straightdope.com/u/zimaane)\ **Post date:** [October 1, 2020, 3:07pm UTC](https://boards.straightdope.com/t/why-is-electroconvulsive-therapy-treated-as-a-treatment-of-last-resort/921871/23 "2020-10-01T15:07:27Z")
Thanks for your post I really hope it works out for you. ---
**Author:** ![nearwildheaven](https://avatars.discourse-cdn.com/v4/letter/n/90db22/32.png) [@nearwildheaven](https://boards.straightdope.com/u/nearwildheaven)\ **Post date:** [October 2, 2020, 3:28am UTC](https://boards.straightdope.com/t/why-is-electroconvulsive-therapy-treated-as-a-treatment-of-last-resort/921871/24 "2020-10-02T03:28:39Z")
Here’s a book, published in the mid 1990s, by a psychologist who consented to ECT when less drastic treatments failed. It’s still in print. > **[Undercurrents: A Life Beneath the Surface: Manning, Martha: 9780062511843:...](https://www.amazon.com/Undercurrents-Beneath-Surface-Martha-Manning/dp/006251184X)** > > Undercurrents: A Life Beneath the Surface \[Manning, Martha\] on Amazon.com. \*FREE\* shipping on qualifying offers. Undercurrents: A Life Beneath the Surface “60 Minutes” recently did a piece about ECT, and the patient they profiled was Kitty Dukakis, whose husband ran for president in 1988 on the Democratic ticket. She’d long been known to have struggled with alcoholism, and it sounds like she was using that to self-medicate. It does seem to work especially well in senior citizens whose depression is so severe, they appear to have dementia. ---
**Author:** ![Melbourne](https://avatars.discourse-cdn.com/v4/letter/m/b5e925/32.png) [@Melbourne](https://boards.straightdope.com/u/Melbourne)\ **Post date:** [October 2, 2020, 6:37am UTC](https://boards.straightdope.com/t/why-is-electroconvulsive-therapy-treated-as-a-treatment-of-last-resort/921871/25 "2020-10-02T06:37:32Z")
> [@SenorBeef](#): > > an inaccurate portrayal in One Flew Over the Cuckoo’s Nest. That was an inaccurate portrayal of Lobotomy, not ECT. Psychosurgery is _much_ less common than ECT, and approval is _much_ more restrictive: psychosurgery would never be approved for depression, and lobotomy would never be approved at all. (Note that when I say, never approved for depression, those rare cases who get approval for psychosurgery might _also_ have depression. As well as some other really depressing mental condition) ---
**Author:** ![BippityBoppityBoo](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/bippityboppityboo/32/5745_2.png) [@BippityBoppityBoo](https://boards.straightdope.com/u/BippityBoppityBoo)\ **Post date:** [October 2, 2020, 7:25am UTC](https://boards.straightdope.com/t/why-is-electroconvulsive-therapy-treated-as-a-treatment-of-last-resort/921871/26 "2020-10-02T07:25:03Z")
> [@Melbourne](#): > > That was an inaccurate portrayal of Lobotomy, not ECT. ECT also was depicted in “One Flew Over The Cuckoo’s Nest”, in a very horrifying portrayal of the procedure. Lobotomy after effects were also part of the drama but the actual surgical procedure was not filmed-it is the ECT treatment that is unforgettable and has set ECT back decades. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [October 2, 2020, 1:45pm UTC](https://boards.straightdope.com/t/why-is-electroconvulsive-therapy-treated-as-a-treatment-of-last-resort/921871/27 "2020-10-02T13:45:41Z")
A more modern portrayal of ECT for shock effect (sorry) appears in the 2018 novel _City Of Endless Night_ by Douglas Preston and Lincoln Child. The plot features an experimental ECT procedure gone wrong. Excessive current burns out a patient’s supramarginal gyrus, eliminating his capacity for empathy and compassion, eventually unleashing a serial killer on New York. [Previous page](https://boards.straightdope.com/t/why-is-electroconvulsive-therapy-treated-as-a-treatment-of-last-resort/921871.md?page=1)