Indian Journal of Social Psychiatry (Jan 2015)
Mental Health Care Bill 2013: The Place of Electroconvulsive Therapy
Abstract
Electroconvulsive therapy (ECT) is one of the oldest medical treatments in psychiatry. The practice has evolved over the years, and the indications have become better defined now. Notwithstanding these, it remains a highly regulated and scrutinized practice. Indian laws specifically related to ECT do not exist till date though this would change if the purported mental health care bill 2013 becomes the law of the land. ECT gets both direct and indirect mention at various places in the bill with far-reaching consequences impacting patients, families, and the professionals. Ban on “ECT as an emergency treatment option” and on “unmodified ECT” is being sought. In addition, ECT in minors is slated to come under stricter regulation. ECT could also get implicated under the “advance directives” provisions of the bill. This naturally has triggered vociferous debates throughout the country between the supporters as well as detractors of ECT. A number of ethical, professional, logistic, and clinical concerns are being discussed. In this background, we attempt to critically evaluate the bill with regard to ECT in the background of the existent scientific and legal literature. We provide possible future directions with regard to ECT practice and its regulation.
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