Edits: 2/16/24
Content warnings:
This post discusses:
- Coercive and forced psychiatric treatment
- Involuntary and unmodified ECT
- Links to articles that mention restraint use, physical and sexual abuse
Misleading ECT Marketing Hides Serious Human Rights Issues From the Public
Despite claims that “ECT isn’t like that anymore,” in ECT news articles and promotion of the treatment, One Flew Over The Cuckoo’s Nest-style ECT is used across many nations today.
The following quotes are common statements made about how ECT is misrepresented and stigmatized in the media:
“Many depictions of ECT in film and television have portrayed the therapy as an abusive form of control. Most famous is the film “One Flew Over the Cuckoo’s Nest,” in which an unruly patient is subjected to the procedure as a punishment. There is probably no fictional story that so haunts our consciousness of a medical treatment.“
–Electroconvulsive therapy: A history of controversy, but also of help (theconversation.com)
“For many of you reading this, the thought of ECT conjures up images of the 1975 movie ‘One Flew Over the Cuckoo’s Nest,’ with Jack Nicholson thrashing about, forced against his will to endure painful, violent seizures. This is not an accurate portrayal of how ECT is used today.“
–ect_therapy_today.pdf (hopkinsmedicine.org)
“This scene from the 1975 Academy Award–winning film One Flew Over the Cuckoo’s Nest, starring Jack Nicholson as the rebellious patient, has probably shaped the general public’s perceptions of electroconvulsive therapy (ECT) far more than any scientific description. As a result, many laypeople regard ECT as a hazardous, even barbaric, procedure.”
–The Truth about Shock Therapy | Scientific American
“‘Films such as One Flew Over The Cuckoo’s Nest did for ECT what Jaws did for sharks – the depiction of the treatment in that film is completely over the top, with the patient being held down, writhing in pain, as he is electrocuted,’ says consultant psychiatrist Dr Susan Benbow, spokeswoman for The Royal College of Psychiatrists.
‘This is not what happens. For a start, during ECT the patient is anaesthetised and given a muscle relaxant – which has been the case since the Fifties – to ensure they feel no pain at all.“
–Jack Nicholson did for shock therapy what Jaws did for sharks | Daily Mail Online
The Reality
In contrast to these claims of reformed treatment, a 2014 Human Rights Watch report on the treatment of disabled Indian women revealed disturbing practices, including the use of ECT as a form of coercion. Nurses recounted instances of threatening uncooperative patients with ECT to induce compliance:
“They fear this (ECT). We say, ‘if you don’t take your medicine, we will take you to the ECT room’ and immediately they say, ‘please don’t take me to that room, I won’t do that again.’“
Forced Unmodified ECT in Indonesia
Similarly, a 2022 Human Rights Watch report highlighted appalling abuses faced by individuals with psychosocial disabilities in Indonesia. This includes the involuntary administration of ECT, often without anesthesia or muscle relaxants; some hospitals use this method on children.
“ECT was administered in four out of the six mental hospitals that Human Rights Watch visited. In Bengkulu Mental Hospital, ECT is administered in its “modified” form (that is, with anesthesia, muscle relaxants, and oxygen), but in Grogol, Bogor, and Lawang Mental Hospitals ECT is administered “unmodified” (without anesthesia, muscle relaxants, and oxygen). In Grogol Mental Hospital, ECT is also administered to children.“
–Indonesia: Submission to the UN Committee on the Rights of Persons with Disabilities
Unmodified ECT Condemned by the Special Rapporteur of the Human Rights Council
The severity of these abuses is underscored by a 2008 interim report by the Special Rapporteur of the Human Rights Council, which condemned the use of unmodified ECT as unethical and potentially constituting torture. Such practices can result in severe physical and psychological harm, including fractures, cognitive deficits, and memory loss.
“CPT has documented instances in psychiatric institutions where unmodified ECT (i.e. without anaesthesia, muscle relaxant or oxygenation) is administered to persons to treat their disabilities, and used even as a form of punishment.“
“The Special Rapporteur notes that unmodified ECT may inflict severe pain and suffering and often leads to medical consequences, including bone, ligament and spinal fractures, cognitive deficits and possible loss of memory. It cannot be considered as an acceptable medical practice, and may constitute torture or ill-treatment.“
–Torture and other cruel, inhuman or degrading treatment or punishment
The United Nations and the World Health Organization Weighs in
Joint reports from the United Nations and the World Health Organization have echoed calls for human-rights-focused legislation.
International standards emphasize the necessity of informed consent and the prohibition of ECT on children due to its significant risks.
How Misleading Marketing Hurts Vulnerable People Throughout the World
This reality contradicts the claims of ECT supporters and the media that the treatment is never misused and suggests that only fringe groups argue otherwise. In fact, ECT is still sometimes administered forcibly, in both modified and unmodified forms, to this day.
Such marketing tactics mislead the public and undermine the urgency of addressing ongoing abuses worldwide.
To deny the ongoing practice of forced and unmodified ECT is to ignore the suffering of those subjected to it and suppress societal concern for the welfare of the most vulnerable among us.
Without practical international standards and regulations, vulnerable people will continue to endure treatments deemed cruel and inhumane by international organizations.
It’s essential to confront this reality honestly and advocate for the protection of human rights in psychiatric care.
Ways you can help
More examples of unmodified ECT use in modern times:
- Commentary: The Dilemma of Unmodified Electroconvulsive Therapy (psychiatrist.com)
- Contemporary use and practice of electroconvulsive therapy worldwide – PMC (nih.gov)
- Electroconvulsive Therapy Without General Anesthesia and the… : World Social Psychiatry (lww.com)
- Position statement and guidelines on unmodified electroconvulsive therapy https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3440905/ “The authors acknowledge with thanks the useful suggestions received from Dr. Max Fink and Dr. Vaughn McCall on an earlier version of this document.”
- https://www.bmj.com/rapid-response/2011/10/28/banning-unmodified-ect-immediately-not-necessarily-answer
- https://ctv.veeva.com/study/decreasing-the-use-of-unmodified-electroconvulsive-therapy-ect-in-an-indian-hospital
- ECT practice in Japan – PubMed (nih.gov)
- Central institute uses Electroconvulsive Therapy without sedation, though law prohibits it | India News – Times of India
- Dispatches: Stop the Forced Shocks in India | Human Rights Watch (hrw.org)
Examples of Forced ECT
- Forced ECT | HealthyPlace
- Hundreds of Mental Health Patients Given Forced Electroconvulsive Therapy (vice.com)
- Whose Finger is Taking the Pulse of America’s Shock Treatment Controversy?
- Psychiatric Hospitals Can Still Force Patients to Accept Shock Treatment. One Connecticut Patient Has Been Shocked 500 Times in Five Years. (reason.com)
- Shock therapy: court upholds appeal by patients prescribed ECT against their will | Mental health | The Guardian
- Woman died after NHS electric shock therapy was given without consent or second opinion – Mirror Online
- forced ect Archives – Mad In America
- Cancer treatment leads to involuntary ECT – forced psychiatric treatment, Scotland
