Harvard's views on the case:

Subject: Re: Action Alert - stop the forced ECT of a man in MN
Date: Sun, 9 Nov 2008 14:24:35 -0500
From: bd_colen@harvard.edu

To: m.holford@hotmail.co.uk

Please remove me from this list.
------Original Message------

"If anyone would like to defend involuntary ECT, let me hear from you. If you make a good argument, I might even post it."

I'll gladly do so. Just give me a few hours to type it up.

I have no comment on this particular case - until you've met a patient you're not an informed commentator, in my opinion - but I'll defend involuntary ECT in general.

Go here: http://health.groups.yahoo.com/group/criticalpsychiatry/ and check this group out and you will find out why they do it, there are plenty of people that say that they want it to stop, and then they will do just about anything to keep it going!

let's all not loose sight of the fact that Prof David Healy is a keen exponent of ECT !

here is a link to his book -

http://books.google.co.uk/books?id=RvXzXnskJB4C&pg=PA120&lpg=PA120&dq=david+healy+electroconvulsive&source=web&ots=bT98-1cKLz&sig=roE6E8M8QRJ7rVWCnUFOV4FCi08&hl=en&sa=X&oi=book_result&resnum=2&ct=result

Sara XXX

Involuntary ECT scares the crap out of me, especially since a psychiatrist told it was the only thing left for me. He was wrong.

I didn't have ECT & have been off all meds since 2002, and I'm doing a lot better. I'm very glad my psychiatrist didn't decide to force it on me & considering it was supposedly the only hope for me I suppose he very well could have.

Dear Philip:

If someone is going to make the intellectual argument for forced ECT; could they make an argument for forced frontal lobotomies while they’re at it please? I could really use the belly laugh as treatment for their insanity.

Stan

I am officially neutral on voluntary ECT--if someone wants it, it's their brain--but involuntary ECT...

Philip,
I'm not very sure about "voluntary" ECT.
I want to remember the post you did on July 13, 2007:
http://www.furiousseasons.com/archives/2007/07/a_readers_ect_experience.html

“Mr. and Mrs. S” went my doctor – “We’ve tried everything on your daughter but she is extremely depressed and still suicidal. We’ve tried several different drug therapies and nothing is working, and we are left with two things. She has ten days left on her insurance and if she is still like the way she is now, we will be forced to put her in a state hospital. Or we can try ECT”.

ECT was then explained to my parents, and they saw a video. And with the State’s leading expert on ECT who told them he would be personally administering it, papers were signed, I was convinced by mom and dad “ do this to make your mother happy”, and the next day woken up at 5 am to be driven to the local teaching hospital for my first round.

Is it a voluntary treatment? Was the patient informed of everything that is at stake doing this procedure?
What does it really means voluntary ECT?

Stan: Well yes, I'm about to make the argument for ECT but if you ask very nicely I might do one for lobotomy as well!

I remember (shockingly, lol) my ECT, and how they way underestimated the amount of time I would be be having memory problems. It was unilateral, and they told me this would cause less memory problems. Later another psychiatrist informed me that unilateral ECT doesn't cause any memory problems, and therefore I had been given bilateral rather than unilateral. She was full of shit, it was unilateral, but either way somebody would be either mininformed or lying to me or both. Whenever I get any medical procedure it seems that I am never informed in a way that a lay-person can understand the details of the procedures that are being done to me, the whole process seems anathema to informed consent. But then that would proletarianize the whole process, which is why Loren Mosher's Soteria House was forced to close its doors.

"It's not clear to me what psychiatric condition Sandford is allegedly being treated for."

Does nobody Google anymore?

Victory House is an assisted living residence for seniors with Alzheimer's, and an adult foster care home.

"[Sandford] says it's causing poor memory for names such as of friends and his favorite niece." Maybe so, but he was mentally--legally, severely--incapacitated by dementia to begin with so it's hard to substantiate something like that.

Not defending the ECT, but people shouldn't take press releases from *anyone* at face value. You know that, Phillip.

interesting point sandra, however the 'evidence' you offer is supposition. the reality is adult care facilities around the country house ppl with alzheimer's, schizophrenia, depression, anxiety, bipolar disorder, etc. they are step down mental health units for lack of a better term.

i have inquired what dx sandford is being treated for with ect but have not received any answer.

man, some of you readers are getting super chippy with me these days. wtf is that about?

I think regular readers here and of my blog KNOW I am against forced ECT. As i said in my piece you published here a year or so ago, ECT is a serious medical procedure. If you want it, fine. If you don't, fine. But to force it on another human being, that is wrong, wrong, wrong. Ir is clear that Ray DOES NOT want this procedure done anymore, so STOP IT for heaven's sake!

I had mine forced on me back in December 2002. I was pretty much suicidal, and semi- catatonic. I was in the hospital for 20 days and was due to be discharged at 30. I wasn't getting any better, so my parents, as my next of kin, were called in, and it was explained I had 2 options- State hospital (a nightmare) or ECT. The leading psychiatrist in the state at that time, sat down with my parents for over an hour and explained it to them. I couldn't hold a pen in my hand and sign my name, so my parents signed and I basically signed with an X.

The next day it started. And again, to make a long story short, it
DID NOT make things better. I use to be a vibrant, intelligent woman. I was once a contestant on Jeopardy! I saw a drop in IQ points, I lost both long term and short term memory.... the list goes on and on. The only good thing about ECT? The cranberry juice I got after.

I advocate against ECT but my position is this- if you want it, fine. If you don't that is fine too. It's your choice. But to force it on someone seems to be more Middle Age thinking than the 21st Century.

And yes, i am signing with my surname this time because I am upset over this whole issue. My thoughts and prayers are with Ray.

Thank you Philip for having the cajones to bring this topic up, and let us discuss this.

Susan,
You are an amazing woman.
Thank you.

Is forced ECT being done in other states besides Minnesota & New York?

I just read this and followed a link near the bottom to your page. He is being treated for severe depression. It is extreme. I have suffered from depression for over 20years. At times I would say it was severe. People with depression are suffering day to day without having to undergo electroshock therapy with or without consent.

Forced ECT is Wrong in Minnesota, World
by John M. Grohol, Psy.D.
November 11, 2008
I can’t believe I’d ever had to write an entry like this. It turns my stomach.

On Friday, MindFreedom, a non-profit human rights organization for people labeled with psychiatric illnesses, published the disturbing story of Ray Sandford, a 54-year-old resident of Columbia Heights, Minnesota.

Sandford’s sad story is amazing and haunting. He is undergoing electroconvulsive therapy (ECT) for severe depression. We don’t know the full back-story, but the fact that he lives in a sheltered living home called Victory House suggests he’s had a rough life of it so far.

Lots of people undergo ECT, although I’m not a big proponent of it. I believe that because of the unpredictable memory loss associated with this “treatment,” it is not only a treatment of last resort in depression, it should probably be done away with as a treatment altogether except in extreme cases. Proponents of ECT claim the memory loss associated with ECT is always around the time of the ECT itself, yet there are thousands of documented cases (many of which appear in the published literature) that show that the extent and severity of memory loss is random and unpredictable. You could lose memories associated with your childhood, or best friend, or even a spouse. No one can tell you what your experience will be. So in effect, the treatment can be nearly as painful as the disease itself.

Which isn’t to say that ECT hasn’t helped people. But so did amputations prior to the 1800s, because medical science had no understanding of infection, bacteria, or sterilization. I would humbly suggest our understanding of the brain is about where medical science was 200 years ago. And to apply electrical shocks to it to combat depression is akin to amputating your leg because you suffered from a scratch while walking in the woods, which later got infected. It works, but it’s the crudest method imaginable. (Frankly, I put it a small step up from trepanation.)

So ECT is a treatment option and since science has shown it works (just as science once showed that leeches applied to the body “worked”), it’s available to anyone who is informed of its risks and chooses it as a treatment for depression.

But ECT is rarely administered against a person’s will in modern science. Most professionals and states recognize that a person’s Constitutional rights would likely be violated if they were to be forced to undergo a controversial treatment procedure that even the scientific community doesn’t agree upon. Sadly, Ray Sandford lives in Minnesota, and apparently Minnesota doesn’t much care about a person’s Constitutional rights if they’ve been relieved of them by a court. Ray Sandford doesn’t want the ECT treatments, but he no longer has a choice or say in the matter.

Ray Sandford has a legal guardian — a court-appointed conservator — whose name is Tonya Wilhelm. Wilhelm works for Lutheran Social Service of Minnesota and it is Wilhelm who authorized the forced treatment of the person she is legally bound to protect and look out for his best interests. Of course she didn’t do this on her own, a doctor experienced with ECT treatments recommended it to her (or the courts), and she agreed (on behalf of her client). And why not? What does Wilhelm have to lose since it’s not her brain they’re treating?

The transcript with MindFreedom’s David Oaks is chilling:

Ms. Wilhelm said, “We are following the letter of the law.” She said the State of Minnesota had secured a variety of court orders that require Ray to have forced electroshock against his expressed wishes. Ms. Wilhelm says it’s all legal and she can’t do anything about it.

Well, of course you can do something about it — you’re charged with protecting the person that you agreed to act as conservator to!

Lutheran Social Service of Minnesota is the largest, statewide non-profit social service organization in Minnesota with over 2,200 employees who serve in 300 communities. It has an annual budget of $90 million. So this is not some mom-and-pop organization, but rather a far-reaching Christian-based organization that should know better. And, you’d think, would be against forced-treatment of this nature.

Agree or disagree with me about ECT. Agree or disagree with me about forced treatment. But I think most of us can agree that if that were our loved one who was being forced to undergo a controversial treatment with questionable and sometimes disturbing side effects, we’d take a step back and ask such treatments to stop. I thought the barbaric practice of forced electroshock treatments went out in the 1960s, as we began to better understand the human dignity and rights of people with mental illness and close down the huge public psychiatric hospitals. Nobody should undergo a forced medical procedure that they don’t want, regardless of the outcome. That is a right embodied in our rights to “life, liberty and the pursuit of happiness,” the foundation of our Constitution.

We don’t know all of the details of this case (like Sandford’s previous history, other treatments, and why he has a conservator). So perhaps an important piece of the puzzle hasn’t been provided. But I can’t imagine what additional information would make forced ECT treatments “okay.”

We call on the good people at Lutheran Social Service — Mark Peterson, Jodi Harpstead, Joyce Norals, Kenneth Borle, Ember Reichgott Junge, Jeri Schoonover, and Rod Brown, all of whom are the executives of Lutheran Social Service — to look into this matter more closely and determine whether Tonya Wilhelm is indeed acting in the best interests of her conservatee, and reply to the allegations that Ray Sandford is being forcibly made to undergo ECT treatments he does not want.

* * *
By the way, Minnesota is one of those states that agrees with forced outpatient treatment and has codified it into law. The Treatment Advocacy Center calls such forced treatment as “assisted outpatient treatment.” That’s like calling prison an “assisted living community.” According to TAC’s site, the forced treatment has to be court-ordered because the person has a high likelihood of being a danger to himself or to others.

* * *
Read the two articles on Furious Seasons (hat tip!) about this: Help Stop Forced, Involuntary ECT In Minnesota and Neuroscientist Defends Forced ECT

Read MindFreedom’s article which has a call to action in it: If it’s Wednesday, then Ray Sandford is Getting Escorted from His Home for Another Forced Electroshock