Dr. Bolam 's Voluntary Electro Convulsive Therapy

Authors Note: This paper is being submitted on the 18th of March 2013 for the winter semester of Medical Law and Ethics section 05.

He claimed that a new shift system had caused at least one death and one unnecessary operation taking place, and said that he and a small number of consultants were overworked and patient safety and continuity of care were compromised. The claimant had told the Manchester hearing he raised his concerns about the new ‘Consultant of the Day’ system with the trust clinical director Mr Watson and then the trust medical director Mrs Schram; however, he was reprimanded and told not to voice concerns again. The consultant said he was then investigated over a series of ‘malicious, vexatious and frivolous’ allegations and ‘imaginary deaths and complications had been conjured up’ to create a case against him. He believed that the investigation and the process from the beginning was about punishment for raising his clinical concerns, and he argued that the investigation did not examining the veracity’ of the allegations against

This research paper is being submitted on December 8, 2011, for Mara Pehkonen’s M230 Medical Law and Ethics Course.

Still today it is not known why ECT works but it seems to cause changes in brain chemistry that can quickly reverse symptoms of certain mental illnesses. It is also said that the shock literally shocks the person out of their illness as it is regarded as a punishment for the inappropriate behaviour. Another explanation is that the associated memory loss following shock allows the person to start afresh. They literally ‘forget’ they were suffering from a mental illness. Created in +1934 by Hungarian neuropsychiatrist Ladislas Meduna, [11]. However, ECT was not introduced in England until 1939 when Lothar Kalinowsky, observed the treatment administered in Italy and decided to use it in England due to its promising results. During this time high doses of electricity were administered without anaesthesia and muscle relaxations. This lead to memory loss, fractured bones and other serious side effects, which lead to, much of the stigma attached to ECT, because of these early treatments [12]. ECT is a treatment that is still used today, however much less brutally than in the 1930s.

What remains unknown is why electroconvulsive therapy is effective. A plethora of studies show the neurochemical correlates of this treatment and its relation to the anti-depressant effect, yet none are conclusive. Richard Abrams has studied ECT for years and discusses a wide variety of reasons for its effectiveness in his revised edition of Electroconvulsive Therapy. For a person who has studied this treatment for 50 years, he concludes

To determine the standard of care in cases of concerning issues of medical diagnosis and treatment, Malaysian judges have adopted the English common law principle which is the Bolam test since 1960s. The Bolam test got its name from the instance court case which is Bolam v Friern Hospital Management Committee.[[1975] 2 ALL ER 118] In this case, the plaintiff, John Hector Bolam, is a salesman, who was suffering from the mental illness of the depressive type. He was admitted in the Friem Hospital to undergo electro convulsive therapy as treatment. The effects of treatment such that will cause convulsion in the nature of a fit. Bolam was given an initial shock for the purpose of damping the amplitude of the jerking movements in his body where no relaxant drugs were given to him. The plaintiff suffered from a serious fractures of the pelvis on each side.[ http://oxcheps.new.ox.ac.uk/casebook/Resources/BOLAMV_1%20DOC.pdf] The plaintiff argued that the doctor neither warned him regarding the risk involved and had breached his duty by not providing relaxant drug prior to

Patient informed consent refers to the situation where the patient is fully informed on the consequences of their health care decision after which the patient gives the decision. For there to be informed consent, there are five elements that must be discussed. The first is the nature of the patient's decision then the applicable alternatives to the proposed intervention. Third are the risks, benefits and uncertainties associated with each of the alternatives. Fourth is the assessment of the patient's understanding and last is the acceptance of the intervention or an alternative by the patient. Before the patient's consent is considered to be valid, the patient's competency to make the decision must be addressed. The criteria for evaluating the patient's competency is clearly stated in section 3 of the 2005 Mental Capacity Act which states that provided the person is able to understand, retain and use information provided and to communicate their decision in any way such as talking or sign language, they are competent to make a decision. If a patient is treated against their refusal to consent, it amounts to the tort of battery or can also be considered the crime of assault. In addition to this, laws that touch on human rights reinforce the importance of the protection of the physical integrity of the individual in terms of their right to respect of their private life. Therefore, refusal of medical treatment is a human right.

The medicinal experts on staff for the 12 hours that the patient was in painful distress while she was being drowned by the feeding solution, neglected to perceive that she was in trouble until it was past the point of no return. While this is obviously a blatant case of medicinal negligence, not all medical malpractice cases are quite so obvious, and not every single medical procedure with a troublesome result can be viewed as medical malpractice negligence. The essential prerequisite for medical malpractice is that the doctor or other medical expert has breached the acknowledged standard of care for their specialty in their geographic area, and that the breach caused harm to the patient. Doctors, as human beings, commit errors consistently, yet in the event that their mistake does not bring about injury or harm to the patient, there are no grounds for lawful

This essay will argue that the decision reached in Cattanach v Melchior [2003] was the correct one. Supporting this argument is the courts departure from the principles established in McFarlane v Tayside Health Board [1999].Additionally, Cattanach extends itself by attempting to address and give legal clarity to the idea of compensable harm in relation to negligence of medical practitioners. This has ultimately led to Cattanach establishing a positive framework, previously not recognised by the courts, to award damages for the torts of wrongful birth and wrongful life. Finally, the reaction to Cattanach on the judicial and executive branches of government have had significant impact on shaping public policy in relation to these complex issues.

When ECT “hit” the medical scene in the 40s and 50s, it was unsafe and gruesome (Dahl, 2008). Treatment was often performed while the patient was awake, and their convulsions were not controlled at all – they were often strong enough to break bones. ECT hit its peak in the 1960s when three tenths of a million US citizens underwent the therapy yearly (Dahl, 2008). At that point, however, it was still “absolutely a cruel procedure” (Dahl, 2008). It is still yet to recover from its ghastly past, the general public still thinks of ECT as how it was portrayed in One Flew Over the Coocoo's Nest, and more recently, Requiem for a Dream (Fitzgerald, 2011). A psychiatrist summed up the current status of ECT very well saying, “Quite frankly, the stigma pushes people away from it, and it pushes some psychiatrists away from even recommending ECT, but most of the stigma related to ECT really is related to misconception” (Dahl, 2008).

After researching electroconvulsive therapy (ECT), I have decided that if a close family member or even myself were severely depressed I would not support the use of ECT. Electroconvulsive therapy consists of an electrical shock, which is used to produce a seizure. Many people experience seizures due to some other type of illness or illnesses, and in these cases there is medicine taken in order to prevent these occurrences. In deciding my opinion on the topic of ECT I asked myself would I want to put myself or a loved one through what others are trying to avoid; a seizure. Although ECT has proven to be effective in some cases of depression, it has many risk factors involved and it does not ensure a lifetime with out the reoccurrence of

Electroconvulsive therapy (ECT) is a treatment for severe mental illness in which the brain is stimulated with a strong electrical current which induces a seizure. The seizure rearranges the brain's neurochemistry and results in an elevation of mood. This essay asks: Is ECT any safer and more effective in treating mood disorders than drug therapies? This treatment has a controversial history ever since it was first introduced in 1938. I intend to argue that electroconvulsive therapy is indeed a safe treatment of mental disorders when other treatments have failed. Due to the development of safer and less traumatic ways of administering ECT, the treatment has made a comeback, is greatly used, and proves to be

Within healthcare, practitioners often have to make difficult decisions regarding the care of their patients. This could be to do with giving or withdrawing treatment, or as simple as sharing risk information (Glover, 1997). Ultimately, the practitioner must be able to rationalise any decision they have made (Morrison, 2009). With this in mind, the following assignment will draw upon an ethical dilemma and explore how theoretical perspectives can be utilised within the decision making process. Therefore it will also be pertinent to draw upon the law, and how this influences actions within health care. To facilitate this discussion, I will identify a scenario from practice that

For the purpose of this assignment the experience of attending Electro-Convulsive Therapy will be discussed. It will include rationale for the procedure, an account of the procedure and the student nurses reflection on the experience using Gibbs’ model of reflection (Jasper 2003). Electroconvulsive therapy (ECT) is a medical treatment for severe mental illness in which a small, carefully controlled amount of electricity is introduced into the brain. This electrical stimulation, used in conjunction with anaesthesia and muscle relaxant medications, produces a mild generalised seizure or convulsion (Mankad et al 2010).

In Gregg v Scott, Mr. Malcolm Gregg (‘the claimant’), the House of Lords examined the law of negligence in the area of personal injury. In order for the claimant to have a successful claim in court, the onus to shifts to the claimant to demonstrate that a duty of care owed by the doctor, there was a breach of that duty, an injury was sustained, and the negligence on behalf of the doctor Dr. Andrew Scott (‘defendant’) was a cause of the ‘injury’. If these elements are not satisfied, the claimant may lose its entitlement to full compensation.