Forced treatment is not a new topic here on World of Psychology, nor is this the first time we’ve discussed the unusual case of Ray Sandford. What did Mr. Sandford do wrong?
Nothing. He’s simply mentally ill, the medications and prior treatments over his lifetime have failed him, and his legal guardian is a social service agency in Minnesota. The convergence of those three characteristics means he was a prime candidate — in the court’s eyes — for ECT treatment.
The only problem? He opposes his electroconvulsive therapy (ECT). And despite experts’ insistence that Mr. Sandford is not competent to make such decisions for himself, his case has galvanized the “mad pride” movement and those who opposed any type of forced treatment.
Last week, Minneapolis’ City Pages wrote a nice in-depth piece about Mr. Sandford’s case. They describe the bizarre reason court-ordered ECT treatments are on the rise in Minnesota:
In 1976, just as ECT was at the nadir of its popularity, a 14-year-old Minnesota boy was shocked against his and his mother’s objections. The mother filed suit and went before the Minnesota Supreme Court. The resulting decision held that legally competent patients were immune from being shocked against their stated objections. Moreover, the case made clear that even incompetent patients were entitled to a court proceeding before being administered electroconvulsive therapy.
On its face, the Price-Sheppard decision appeared to bolster patients’ self-determination—after all, the requirement for guardians to get court-approval before administering the volts is one that didn’t exist before.
But in practice, court-ordered ECT has been on the rise since the ruling, for a number of reasons. The ruling assumed that a committed person is—by very virtue of being committed—incompetent. Second, attaining the court order is more of a bureaucratic formality than a serious deliberation.
The good news is that this abusive treatment may be joining the dinosaurs in a few years. The FDA is requiring the manufacturers of ECT machines to, after 70 years, conduct clinical trials research to show the treatment is both safe and effective. What, you say, there’s no such clinical trials on record? Nope. Lots of case studies and small-scale studies, but since the FDA grandfathered the machines in, they never required the same kind of rigorous scientific data psychiatric drugs do. Until now.
New research into ECT may have trouble meeting the FDA requirements, since the positive effects of ECT are short-lived (”maintenance treatments” are often required for the rest of your life), while the long-term adverse effects — unpredictable memory loss — are non-reversible.
Which is good news for folks like Mr. Sandford, although it’ll still be years in coming.
In the meantime, we hope Mr. Sandford finds a way to stop the treatments he doesn’t want. Because if Mr. Sandford were my brother, I’d do everything within my power to find him more appropriate and least restrictive care.
Read the full article: Minnesota mental health patient Ray Sandford forced into electro-shock therapy
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What if Ray Sandford Were Your Brother? | World of Psychology (5/24/2009)
7 Comments to
“What if Ray Sandford Were Your Brother?”
There is a local hospital that routinely practices administration of ECT. I was not aware that there have been no clinical trials at all.
It is in noones vested interest to do clinical trials if the technique has been grandfathered as approved. It would be expensive to do the trials and if they were not positive, it would effectively put the clinics out of business. The proceedure is I understand quite lucrative with the repeat business.
What if Ray Sandford were YOU?
This article shows quite clearly how, when shielded by secrecy, the mental health agencies and the courts will abuse peoples’ rights to “life, liberty and the pursuit of happiness” and self determination. Ray had no rights at all; not even the right to keep his brain from being destroyed.
Mentally ill does not equal mentally incompetent.
It’s well past time that the mental health industry is made to provide evidence, (as opposed to anecdotes), that ECT works. People I have known that have had it done have been far far worse as a result of the “treatment.” And, yes, they need the “maintanance” treatment — the very proof of its failure.
My friends have lost many of their memories. Let me ask the mental health community a question. Just who are we without our memories?
Don’t get me wrong, ECT does have evidence that it works. But I’d characterize most of that evidence being not up to today’s expected research standards for such treatments. Specifically, ECT research has often used and studied in inconsistent (and often suboptimal) ways, making comparisons between studies difficult. And ECT research often suffers from small sample sizes — I don’t think there’s been a single large-scale clinical trial ever done for ECT. ECT treatments consistently show a high risk of relapse across studies (higher than seen with similar depressed patients on medications, but this may also be an effect of the severity of depression, as ECT patients tend to have the most severe depression). There have virtually no long-term studies done on ECT.
All of these research issues can be readily corrected and ECT machine manufacturers now have incentive to do so as soon as possible, before the FDA deadline.
It concerns me when patients refuse treatment when they have an ongoing mental disease. I am also concerned about “mad pride” which promotes the idea that patients can lead normal lives without treatment. I suffer from depression and I would certainly want to access any and all treatments which would make me better. I research depression treatments on line to check for improved medications and emerging therapies. I have been hearing about a new treatment known as Brain Stimulation Therapy which does not cause the memory issues associated with ECT and has produced good results. Mr Sandford and his care givers should look into this option.
This is fundamentally a civil rights issue, not a medical one. What has been happening to Ray could happen to anyone, because there is no defense against a mental health professional declaring you to be “incompetent” or “insane”. The expert needs offer no evidence beyond his or her own professional opinion, and nothing that can be said disputing that opinion by the person being judged needs be considered valid by the person doing the judging.
One of the foundations of psychiatric abuse is to dehumanize people by reducing them to a label — a so-called “diagnosis” — and to ignore the significance of their individual life experiences. Problems that could be just a temporary setback in a person’s life if treated in other ways can end up forever altering the course of their life for the worse if treated according to the “medical model” of institutional psychiatry.
I am a victim of ect treatments and i was forced into having them against my will and the side effects i have experianced from them leave me believing i was better off without them!!! now here we are 6 years after the treatments and i am back to where i was before i had them again! dont let them fool you they are a horrible thing to go through and now i can such huge memory loss i cant remember some of the happiest times in my life which make me even more depressed. Stay away from ect im warning you all.
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Last reviewed: By John M. Grohol, Psy.D. on 24 May 2009
