Maudsley ECT debate: two questions for each side
(See also my highly critical piece on John Read posted 10 days later)
‘Electroconvulsive Therapy (ECT) has no Place in Modern Medicine’
I have a ticket and will be voting against, because I know that many people have ECT on a voluntary basis, and it would cause them distress if it were withdrawn overnight.
However, I am quite sceptical about ECT: in ten years as a higher trainee and consultant in Learning Disability (LD) Psychiatry I only ever heard of one person with LD needing it in the UK. I went to national LD conferences regularly and often asked about ‘treatment resistant depression’, partly because as a student in 1984 part of my psychiatry placement was at the Brook Hospital, which was the last major centre for psychosurgery in the UK.
Two Questions for John Read (proposing to abolish ECT):
- You have compared ECT to ‘lobotomy and the rotating chair’: https://twitter.com/ReadReadj/status/1033636959502008325 This seems close to the Scientologists who say that ECT is a deliberate form of torture, and point to early twentieth century history to support that view. As a psychologist, would it not be more honest to acknowledge that your profession has a dark history just as psychiatry does? Intelligence testing was central to eugenics (including deliberate killing in its most extreme form) in the early twentieth century, and more recently American psychologists have designed torture techniques for the US government: https://twitter.com/peterkinderman/status/542425928773541889
- You have recently stated that you want a larger, better quality, randomised controlled trial (RCT) for ECT. You have also stated that you do not accept the concept of diagnosis, and propose an ‘alternative’, but as diagnosis (including a notion of severity) are necessary for an RCT of a treatment for severe depression how is this possible? https://twitter.com/NMacFa/status/1034063327847239680
Two Questions for Sameer Jauhar (against abolishing ECT):
- As a Maudsley Hospital consultant psychiatrist, and a researcher at the ‘world-leading’ Institute of Psychiatry, Psychology & Neuroscience, is not your professional and academic credibility undermined by an apparent culture of minimising ‘bullying, harassment and misogyny’ in those organisations?
- Given that the previous RCTs of ECT showed a significant placebo effect, do patients deserve more honesty about this to be able to give proper ‘informed consent? And is there a case for offering randomised sham or real ECT in clinical practice?