I’m shocked: informed consent in ECT and the phenomenological-self

Springer Science and Business Media LLC - Tập 14 - Trang 1-19 - 2018
Patrick Seniuk1,2
1Södertörn University, Stockholm, Sweden
2Centre for Studies in Practical Knowledge, School of Culture and Education, Huddinge, Sweden

Tóm tắt

This paper argues that phenomenological insights regarding selfhood are relevant to the informed consent process in the treatment of depression using electro-convulsive therapy (ECT). One of the most significant side-effects associated with ECT is retrograde amnesia. Unfortunately, the current informed consent model does not adequately appreciate the full extent in which memory loss disturbs lived-experience. Through the philosophy of Merleau-Ponty, it is possible to appreciate the way in which memory loss affects a person’s self-experience, with emphasis given to one’s pre-reflective and embodied, relationship with things in the world. This paper aims to demonstrate that proper informed consent should acknowledge the extent to which repeated ECT treatments affect a patient’s sense self.

Tài liệu tham khảo

American Psychiatric Association. The practice of ECT, a task force report. 2nd ed. American Psychiatric Publishing: Washington, DC; 2001. American Psychiatric Association. The practice of electroconvulsive therapy: recommendations for treatment, training, and privileging (a task force report of the American Psychiatric Association). Second ed. Washington: American Psychiatric Publishing; 2008. Berrios G, Callahan C. Re-inventing depression: a history of the treatment of depression in primary care 1940–2004. Oxford: Oxford UP; 2004. Breeding J. Electroshock and informed consent. J Humanist Psychol. 2000;40(1):65–79. Fink M. Millinial artiucle: convulsive therapy: a review of the first 55 years. J Affect Disord. 2001;63(2001):1–15. Fink M. The electroshock riddle: effective but rejected. Br J Psychiatry. 2009;195(5):390. Geddes J, Carney S, Cowen P, Goodwin G, Rogers R, Dearness K, Tomlin A, et al. Efficacy and safety of electroconvulsive therapy in depressive disorders: a systematic review and meta-analysis. Lancet. 2003;361(9360):799–808. Henry M. In: Etzkorn TGJ, editor. Philosophy and phenomenology of the body. The Hague: Springer; 1975. Husserl E. In: Gibson TWRB, editor. Ideas: general introduction to pure phenomenology. London: Routledge; 2012. Jacobson K. The gift of memory: sheltering the I. In: Morris D, Maclaren K, editors. Time, memory, institution: Merleau-Ponty's new ontology of self. Athens: Ohio University Press; 2015. Johnstone L. Adverse Pyschological effects of ECT. J Ment Health. 1999;8(1):69–85. Karp DA. Speaking of sadness: depression, disconnection, and the meanings of illness. New York: Oxford University Press; 1996. Kellner CH, Greenberg RM, Murrough JW, Bryson EO, Briggs MC, Pasculli RM. ECT in treatment-resistant depression. Am J Psychiatry. 2012;169(12):1238–44. Koopowitz LF, Chur-Hansen A, Reid S, Blashki M. The subjective experience of patients who received electroconvulsive therapy. Aust N Z J Psychiatry. 2003;37:49–54. Locke J. An essay concerning human understanding. 27th ed. London: T. Tegg and Son; 1836. Maiese M. Embodied selves and divided minds. Oxford: Oxford UP; 2015. Mazis GA. The depths of time in the World's of Merleau-Ponty. In: Morris D, Maclaren K, editors. Time, memory, institution: Merleau-Ponty's new ontology of self. Athens: Ohio University Press; 2015. Merleau-Ponty M. Phenomenology of Perception (D. A. Landes, trans.). Hoboken: Taylor and Francis; 2012. Morris D, Maclaren K, editors. Time, memory, institution: Merleau-Ponty's new ontology of self. Athens: Ohio University Press; 2015. Parfit D. Reasons and persons. Oxford: OUP; 1984. Pestello FG, Davis-Berman J. Taking anti- depressant medication: a qualitative examination of internet postings. J Ment Health. 2008;17(4):349–60. Ratcliffe M. Experiences in depression: a phenomenological study. Oxford: Oxford Uiniversity Press; 2015. Read J, Bentall R. The effectiveness of electroconvulsive therapy: a literature review. Epidemiologia e Psichiatria Sociale. 2011;19(04):333–47. Robertson H, Pryor R. Advances in psychiatric treatment. Memory and cognitive effects of ECT: informing and assessing patients. 2006;12:228–38. Schatzberg AF, Nemeroff CB. The American Psychiatric Publishing textbook of psychopharmacology. Fourth ed. Washington D.C: American Psychiatric Pub; 2009. Sienaert P. What we have learned about electroconvulsive therapy and its relevance for the practising psychiatrist. Can J Psychiatr. 2011;56(1):5–12. Stefanazzi M. Is electroconvulsive therapy (ECT) ever ethically justified? If so, under what circumstances. HEC Forum. 2013;25(1):79–94. Svenaeus F. Depression and the self: bodily resonance and attuned being-in-the-world. In: Ratcliffe M, Stephan A, editors. Depression, emotion and the self. Exeter: Imprint Academic; 2014. Warren CAB. Electroconvulsive therapy, the self and family relations. Research in the Sociology of Health Care. 1988;7:283–300. World Health Organization. 2017 “Depression.” WHO.int. http://www.who.int/mediacentre/factsheets/fs369/en/ (Accessed December 31, 2017).