Model Legislation Prohibiting Electroconvulsive Therapy (ECT)
on Children

FOR THE STATE OF _______ LEGISLATIVE SESSION
PROHIBITING ELECTROCONVULSIVE THERAPY (ECT) ON CHILDREN, 16 YEARS OF AGE OR YOUNGER; ENACTING FURTHER
 PROTECTIONS WITH REGARD TO INFORMED CONSENT FOR ECT

Background: 

State laws provide inadequate protection for children against electroconvulsive therapy, also known as “electroshock” and “ECT” (hereinafter referred to as “ECT”). The procedure administers up to 460 volts of electricity through the brain causing a grand mal seizure. The World Health Organization’s Resource Book on Mental Health, Human Rights and Legislation 2005, advised: There are no indications for the use of ECT on minors, and hence this should be prohibited through legislation.”[1] 

State laws in California, Colorado, Tennessee and Texas  have enacted laws prohibiting the use of ECT in children at various ages, from under the age of 12 to under the age of 16.[2] The 2014 Western Australian Mental Health Act prohibits the use of ECT on children 14 years or younger and makes it a criminal offense for any psychiatrist or other doctor to administer ECT to any child in this age group.  Violation of this law results in a 2 year imprisonment, along with a fine.[3] In 2017, India also prohibited the use of ECT on children.

In the U.S., Freedom of Information Act (FOIA) requests show children as young as 0-5 are currently being electroshocked.

Despite its use for almost 80 years, it remains unknown how ECT “works.” A Psychiatric News article in 2016 stated: “We don’t know exactly how electroconvulsive therapy works” and “At least a dozen theories have been proposed as mechanisms of action for ECT but few, if any, have found much acceptance.” One theory is that “ECT caused a good kind of brain damage.”  Since 1976, the Food and Drug Administration (FDA) has failed to obtain clinical studies from the ECT device manufacturers proving device’s safety and efficacy.[4]

The Food and Drug Administration lists the adverse effects of ECT to include:

  • Cardiovascular complications
  • Cognition and memory impairment
  • Dental/oral trauma: Dental fractures, dislocations, lacerations…
  • Physical Trauma
  • Prolonged or tardive seizures
  • Skin Burns
  • Death may result from various complications of ECT such as reactions to anesthesia, cardiovascular complications, pulmonary complications, or stroke (impairment of blood flow to the brain or bleeding in the brain).[5]

There can be 40 to 70% failure (relapse) rate within six months of receiving ECT, requiring more electroshock, called “continuation” and “maintenance ECT,” along with antidepressants and/or other psychotropic drugs continuing to being administered.[6] ECT is not a cure. Furthermore, a Texas ECT Annual Report that recorded six deaths in 2014 shortly after ECT administration, four of which were suicide.[7] Suicide was the leading cause of death within two weeks post ECT.

An article published in Advances in Psychiatric Treatment in 2006 stated the “newer methods of ECT have not resulted in an appreciable decrease in adverse effects.”[8]

Section 1: Prohibition of Electroconvulsive Therapy on Children 16 Years Old or Younger.

  1. Electro-convulsive Therapy, also known as “ECT,” electroshock or “electroshock therapy” (“ECT”), is prohibited for use on any child who is 16 years of age or younger.

Section 2: Criminal Penalties:

  • A person commits an offense under this Act, if the person intentionally causes, conspires with another to cause, or assists another to cause a person aged 16 or younger to be administered ECT.
  • An individual who commits an offense under Section 3(1) is subject to criminal penalties of at least:

(i)  A fine of not more than $100,000

(ii)  Confinement in jail of two years or both

(iii) An individual and the psychiatric facility shall be liable for compensation to the patient violated under this section.

References:

[1] Benedetto Saraceno, M.D., “WHO RESOURCE BOOK ON MENTAL HEALTH, HUMAN RIGHTS AND LEGISLATION WHO 2005,” p. 64.

[2] http://www.healthyplace.com/depression/articles/pediatric-ect-electroconvulsive-therapy-in-adolescents-and-children/.

[3] “Electroshock therapy on under-14s banned in WA after law passes Parliament,” ABC News, 17 Oct. 2014, http://www.abc.net.au/news/2014-10-17/mental-health-bill-passes-wa-parliament/5822874.

[4] Jonathon Emord & Associates, Citizens Petition filed with the FDA Commissioner, 14 Aug. 2016, http://emord.com/blawg/wp-content/uploads/2016/08/1-ECT-Citizen-Petition.pdf.

[5] FDA Docket, FDA-2014-N-1210-0815; This is a Comment on the Food and Drug Administration (FDA) Proposed Rule: Neurological Devices; Reclassification of Electroconvulsive Therapy Devices Intended for Use in Treating Severe Major Depressive Episode in Patients 18 Years of Age and Older Who Are Treatment Resistant or Require a Rapid Response; Effective Date of Requirement for Premarket Approval for Electroconvulsive Therapy for Certain Specified Intended Uses, https://www.regulations.gov/;#!documentDetail;D=FDA-2014-N-1210-0815.

[6] Ana Jelovac, et al., “Relapse Following Successful Electroconvulsive Therapy for Major Depression: A Meta-Analysis,” Neuropsychopharmacology, Nov 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799066/.

[7] Texas Department of State Health Services. Electroconvulsive Therapy (ECT) Reports, FY 2014 ECT Annual Report, page 1. http://www.dshs.texas.gov/mhsa/bhmd/ect/.

[8] Harold Robertson, Robin Pryor, “Memory and cognitive effects of ECT: informing and assessing patients,” Advances in Psychiatric Treatment, May 2006, 12 (3) 228-237; DOI: 10.1192/apt.12.3.228, http://apt.rcpsych.org/content/12/3/228.full.