Many harmed by electroconvulsive therapy (ECT) want to protect themselves from involuntary ECT in the future.
One way to do this is by creating a psychiatric advanced directive (PAD), which is a document that outlines their wishes regarding psychiatric treatment.
How do Psychiatric Advanced directives work?
PADs are legal documents that allow people to state their wishes for medical care in advance in case they are unable to communicate those wishes later on.
However, current state laws allow doctors to ignore patient advance directives if they conflict with their view of what the best medical care should be. Insurers may also refuse to pay for alternative treatments requested in a patient advance directive.
Unfortunately, psychiatric advance directives cannot guarantee that a person will not be subjected to involuntary shock therapy.
The 2006 article “Superseding Psychiatric Advance Directives: Ethical and Legal Considerations,” published in the Journal of the American Academy of Psychiatry and the Law, explains how care providers can easily override them.
- What psychiatric advance directives are
- How PADs work in theory vs practice
- The mental health system and laws at play in these scenarios
- Philosophical, ethical, and legal reasons for overriding PADs
- Incentives for interested parties to override PADs
- a_practical_guide_to_psychiatric_advance_directives.pdf (samhsa.gov)
- NRC PAD | National Resource Center on Psychiatric Advance Directives (nrc-pad.org)
- Advance directives in mental health care: evidence, challenges and promise – PMC (nih.gov)
- Ulysses pact – Wikipedia
- The Choice to Limit Choice: Using Psychiatric Advance Directives to Manage the Effects of Mental Illness and Support Self-Responsibility (umich.edu)