Posted by boBB on May 18, 2000, at 18:33:42
In reply to Re: ECT, bob, posted by Adam on May 17, 2000, at 23:07:19
I have a question of purely editorial concern. It seemed your post offered two conflicting assessments of the available, peer reviewed literature regarding ECT.
You wrote:
> Nearly every major journal in psychiatry has published at least a couple of review articles on it, and ALL OF THEM (emphasis added), not for want of looking, claim unequivocably that there is no credible evidence in support of permanent harm from ECT.> I do find myself being afraid of THE FEW REPORTS, PUBLISHED (emphasis added) in peer-reviewed journals, that suggest ECT is not so benign.
Maybe I damaged my memory some other way, like falling off my skateboard while improperly acting like a teenager, and comparing your two apparently contradictory assessments does require that I remember the one while I read the other. Are you saying that peer reviewed suggestions "that ECT is not so benign" do not undermine unequivocable claims that there is "no credible evidence in support of permanent harm from ECT"? If so, I guess your assessment is consistent, at least with itself.
I understand that reports from people who awake from anesthetized ECT experiences with broken bones, or reports of long-lasting post-ECT memory loss do not carry water, scientifically, unless they are verified and published in peer reviewed literature. The question remains, however, whether informed consent implies only information published in peer reviewed publications, or whether it also implies access to case record of malpractic litigation, summaries of practitioners' records in adverse cases and access to reports compiled by public health agencies and other governmental bodies.
The discussion of informed consent can also include discussion of the potentially prejudicial role of an authority figure who is supplying the information. If the clinical caregiver stands to gain from collection of Medicaid payments with little oversight concerning the efficacy of the treatment, which often seems to be the case, at least in the administration of ECT, we might want to consider whether the caregiver themself can be relied upon as a fair arbitrer of what information is sufficient to qualify the consent of the ECT subject. My perception of informed consent is that it refers to information provided to the subject of a therapy, who then consents, rather than information shared by scientists who then consent to allow or require a particular therapy.
Anyway, I agree that waking from anesthesia ROCKs. (but that is a subjective, un-peer-reviewed assessment). AND, my sister had pretty good luck dressing up cats, but I have experienced ferocious resistance attempting to put pajamas on feline subjects.
poster:boBB
thread:33082
URL: http://www.dr-bob.org/babble/20000517/msgs/33944.html