Past attempts by policy experts and scholars to synthesize the legal policy considerations behind a general limited right to refuse treatment and specific legislative efforts to regulate the use of electroconvulsive therapy (ECT) have met with considerable controversy, confrontation, and misunderstanding. It will be argued on the basis of the following legal analysis that the parameters of the law of informed consent and substituted decisionmaking, as articulated in the leading court decisions and state legislation, provide a reasonable framework upon which to develop sound policy judgments about the right to refuse electroconvulsive therapy.
The components of the law that form the basis for this conclusion, from the most general to the most specific, are: the decisionmaking rights of mentally disabled persons; the principle of informed consent; the law of substituted consent for mentally incompetent persons; and informed consent as applied to ECT. Together, these interrelated and pyramidal legal concerns provide a framework that defines what the law requires before mentally disabled persons may accept or refuse ECT.
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Submitted on: 17-Oct-2003