United Nations Report Recognizes Enforced (Involuntary) ECT as Torture, Yet State Laws Sanction Psychiatrists Committing this Abuse

In the fourth part of a series of public awareness articles about electroshock treatment, Jan Eastgate, the president of Citizens Commission on Human Rights International continues to explore the cover up of the dangers of electroshock (ECT).

The American Psychiatric Association (APA) and Food and Drug Administration (FDA) report (without current evidence) that 100,000 Americans are administered electroshock treatment (ECT) every year. Despite serious risks such as permanent memory loss and brain damage, ECT can also be forced onto involuntary patients without their consent. This includes minors who have parents or guardians that are misled into believing that inducing a grand mal seizure, which ECT does, is vital for a child’s mental health, and consents for them. Nothing could be further from the truth and several United Nations reports determine that coercive ECT is torture.

ECT consent does not mitigate that torture. When a patient is committed to a psychiatric facility, their right to consent may be waived, which by international human rights standards can constitute torture:

  • In 2013, the Report of Juan E. Méndez, then UN Special Rapporteur on Torture, that ECT (even given with anesthetic and muscle relaxants) may cross a threshold of mistreatment that is tantamount to torture or cruel, inhuman or degrading treatment or punishment. Specifically, he called for “an absolute ban on all forced and non-consensual medical interventions against persons with disabilities, including the non-consensual administration of psychosurgery, electroshock and mind-altering drugs….”[1]
  • A July 2018 UN Human Rights Council report on “Mental health and human rights,” also called on governments to recognize that forced psychiatric treatment, including ECT, “as practices constituting torture or other cruel, inhuman or degrading treatment or punishment….”[2]

Statistics on the rate of involuntary committed patients receiving ECT in the U.S. is not publicly available and often requires requests through State and Federal Freedom of Information Acts (FOIA). In CCHR’s submission to the FDA in 2016, CCHR pointed out the dearth of official statistics on ECT’s usage throughout in the U.S. and lack of oversight over such a potentially damaging practice.

CCHR filed FOIA requests for stats on ECT usage, with 27 states responding and 19 admitting they allow the use of electroshock to children, including seven states using it on those aged “zero to five.” This is despite four U.S. states banning the use of ECT on minors. The World Health Organization’s Resource Book on Mental Health, Human Rights and Legislation also says: “There are no indications for the use of ECT on minors, and hence this should be prohibited through legislation.”[3]

In December 218, the FDA reduced the risk classification of the ECT device without knowing how many people may have been damaged by it.[4] In 2015, the agency deferred to a 1995 study that reported 100,000 Americans are given ECT every year. It cited the U.S. Surgeon General report in support of this—a report that is 20 years old.

The figure appears to be an extrapolation from Richard Abrams, co-founder the ECT device manufacturer, Somatics LLC. Abrams reviewed a study, where authors estimated in 1986, that 36,658 patients had received approximately 300,000 ECTs. The psychiatrist then extrapolated the figure for 1995 (100,000) which is the figure still used today.[5]

In 2018, electroshock enthusiast, Dr. Charles Kellner, asserted, “While an exact right-sized figure is hard to come by, we speculate that closer to 250,000 ECT patients per year (resulting in about 1.5 million ECT procedures)” would be a more appropriate number to deliver in order to obtain “optimal outcomes and reduce suicides.”[6] [Emphasis added]

Although there is evidence that ECT does not prevent and can actually induce suicide, Dr. Kellner’s speculation means more people could be subjected to ECT damage and torture.  Yet “Memory is special, even sacred to some people, because it defines one’s sense of self and identity”[7]is often equated with the very essence of a person’s ‘being.’”[8] However, he then dismisses memory loss as “a temporary nuisance.” [9]

The thousands of patients who have reported adverse memory effects from ECT have never referred to them as a “temporary nuisance.” In fact, according to a study published in Proceedings of the National Academy of Sciences, an extensive long-term follow-up study indicates that “most ECT patients will never recover from the damage in the form of persistent severe mental deficits.”[10]

Even Kellner’s colleague, ECT researcher, psychologist Harold Sackeim admits that “virtually all patients experience some degree of persistent and, likely, permanent retrograde amnesia” (memory loss of events prior to ECT.)  In a study published in Neuropsychopharmacology, Sackeim and colleagues acknowledged that ECT may cause permanent amnesia and permanent deficits in cognitive abilities, which affect ability to function.[11]

The FDA’s Final Order on ECT in 2018 specified that the ECT device should be reduced in risk classification for treatment of major depression, bipolar, schizophrenia, and catatonia. FDA’s response to the UN’s report equating coercive ECT with torture was that the UN hadn’t specified these disorders and, as such, FDA disregarded the underlying message these human rights reports provide.

Electricity doesn’t differentiate a mental condition when it charges through the brain and body: Physical damage is damage no matter what the state of mind or labeled condition, no matter whether consent is given or not. Torture is torture.

When the FDA was questioned about the number of patients that are subjected to electroshock involuntarily, the agency claimed that “involuntary ECT treatment is uncommon and, when it occurs, requires a judicial proceeding.” However, including the District of Columbia and Puerto Rico, a Journal of the American Academy of Psychiatry and the Law report said there are 33 geographical jurisdictions where the state laws and administrative codes do not even comment on the use of ECT.[12]

In its more than 80 years of use, the amount of torture committed in the name of electroconvulsive “therapy” comprises millions. The UN Convention against Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment (CAT), which the US signed in 1988 and legally ratified in 1994, requires signatory parties to take measures to end torture within their territorial jurisdictions. For purposes of the Convention, torture is defined as an extreme form of cruel and inhuman punishment committed under the color of law.

Under involuntary commitment laws, psychiatrists, as agents of the State, are being allowed to torture with impunity.

The late Dr. Thomas Szasz, a professor of psychiatry and CCHR’s co-founder said, electroshock is “torture called therapy. This is dehumanization called therapy, which is exactly what we blamed the Russians for when they put so-called dissidents into mental hospitals.”

The FDA should be brought before Congress over its defiance of the UN recommendations; instead of protecting citizens, it is allowing electroshock torture to be passed off as “standard” medical care. More importantly, the evidence against ECT indicates a clear-cut case for abolishing it completely.

Tens of thousands of people have signed CCHR’s online petition to ban electroshock. More are encouraged to sign this and also to report any incident of ECT damage to CCHR.

References:

[1] A/HRC/22/53, “Report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, Juan E. Méndez,” United Nations, General Assembly, Human Rights Council, Twenty-second Session, Agenda Item 3, 1 Feb. 2013, p. 1, Summary.

[2] “Mental health and human rights:  Promotion and protection of all human rights, civil, political, economic, social and cultural rights, including the right to development,” Annual report of the United Nations High Commissioner for Human Rights and reports of the Office of the High Commissioner and the Secretary-General, Human Rights Council, 10-28 Sept. 2018, p. 14, point 46..

[3] “WHO RESOURCE BOOK ON MENTAL HEALTH, HUMAN RIGHTS AND LEGISLATION WHO 2005,” p. 64.

[4] https://www.federalregister.gov/documents/2018/12/26/2018-27809/neurological-devices-reclassification-of-electroconvulsive-therapy-devices-effective-date-of.

[5] Richard Abrams, M.D., History of Electroconvulsive Therapy,  Fourth Edition, (Oxford University Press, 2002), pp. 13-14.

[6] Charles Kellner, “The Role of ECT in the Suicide Epidemic,” Psychiatric Times, 24 Aug. 2018, https://www.psychiatrictimes.com/electroconvulsive-therapy/role-ect-suicide-epidemic/page/0/2.

[7] Charles H. Kellner, “Electroconvulsive Therapy: The Second Most Controversial Medical Procedure,” Psychiatric Times, Vol. 28, No. 1, 8 Feb. 2011, http://www.psychodyssey.net/wp-content/uploads/2011/02/Electroconvulsive-Therapy-The-Second-Most-Controversial-Medical-Procedure.pdf.

[8] http://www.psychrights.org/Research/Digest/Electroshock/PBregginCites/CgntvEffctsECTBrdggGpBtnRsrhCP.pdf.

[9] https://www.mdedge.com/psychiatry/article/150463/depression/ect-patients-do-better-when-families-attend-sessions.

[10] https://www.huffingtonpost.com/dr-peter-breggin/electroshock-treatment_b_1373619.html.

[11] John Breeding, Ph.D., “Electroshocking Children: Why It Should Be Stopped,” 11 Feb. 2014, https://www.madinamerica.com/2014/02/electroshocking-children-stopped/, citing, Sackeim, “Memory Loss: From Polarization to Reconciliation,”  The Journal of ECT, Sept. 2001, Vol. 17, Iss, 3, p 229, Letters to the Editor and Sackeim et al., “The Cognitive Effects of Electroconvulsive Therapy in Community Settings” Neuropsychopharmacology, Vol. 32, Number 1, 2007.

[12] http://www.jaapl.org/content/34/3/406.full.pdf.

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