The article ?Shock therapy for mental patients will be reviewed?
continues the ignorant tradition of demonizing electroconvulsive
therapy (ECT) in the media (the very use of the anachronistic
and misleading phrase ?shock therapy? is unwarranted) without
5 presenting the compelling reasons for its continued use. Most
of the facts and quotations in the article, including the
gratuitous final paragraph about pigs in an abattoir, are
simply taken from an article by Davar in ?Issues in Medical
Ethics?, without questioning whether Davar?s presentation of
10 the issue is an unbiased and scientifically accurate one. What
Ms. Davar, and by extension Ms. Jain, has done is simply cite
authorities who agree with her point of view, quote statistics
without context, use an abundance of negative adjectives, and
ignore outright the empirically proven benefits (often
15 life-saving) of ECT in many categories of mentally-ill
patients. This is shabby and irresponsible medical journalism.
While this is not the place to dispute, point-by-point, Ms.
Davar?s presentation of her position and Ms. Jain?s repetition
of it, I would like to quote, to counter their negative
20 emphasis, from Andrew Solomon?s widely read, intensively
researched, highly respected book, The Noonday Demon: An
Anatomy of Depression. Solomon writes: ?Antidepressants
are effective [against major depression] about 50 percent of
the time, perhaps a bit more; ECT seems to have some
25 significant impact between 75 and 90 percent of the time...
Many patients feel substantially better within a few days
of having an ECT treatment ? a boon particularly striking
in contrast to the long, slow process of medication response.
ECT is particularly appropriate for the severely suicidal ?
30 for patients who repeatedly injure themselves and whose
situation is therefore mortally urgent ? because of its
rapid action and high response rate, and it is used in
pregnant women, the sick, and the elderly, because it does
not have the systemic side effects or drug-interaction
35 problems of most medications.?
There are, indeed, problems with the administration of ECT,
especially in a country like India with its poor health
infrastructure. It would be foolish to deny that the
practice is subject to abuse (as Solomon and numerous
40 Indian writers report). The continued use of ?direct? ECT
(without the use of an anesthetic) is certainly a matter
of concern ? and a concerted effort to implement national
guidelines making ?modified? ECT (using an anesthetic)
mandatory is as necessary as it is laudatory. But we can
45 all do without more pieces of journalism which perpetuate
the myth that ECT is a medically unjustified, indeed barbaric
practice, tantamount to torture. This ignorant view, equally
prevalent in the West as it is in India, has more to do with
movies like One Flew Over The Cuckoo?s Nest than
50 with scientific fact.
