This letter refers to the article by Chittaranjan Andrade regarding the use of unmodified ECT (1). The author has discussed the obvious advantages of modified ECT over unmodified ECT. He also highlights the ground realities and difficulties in practice of modified ECT. The author concludes that the use of unmodified ECT may be preferable to no ECT, as in the case when ECT is indicated but anaesthesiological facilities are unavailable or unaffordable.
Though I agree in principle with the points raised and this discussion may be scientifically correct, we need to know the views of the people who are going to be recipients of such treatment. It has been seen that doctors show remarkably little interest in their patients’ views of the procedure and its effects on them (2). I think that in this discussion on the ethical issues of administering unmodified ECT, a patient’s perspective is not being considered.
Though no data are available, most of the patients who refuse ECT do so because of the fear associated with the procedure. This fear may be attributed to the gruesome and barbaric picture of ECT projected by the media in which patients are shown screaming and refusing ECT and later on convulsing.
The use of unmodified ECT would only increase this fear and lead to rejection and disrepute of this really effective modality of treatment for psychiatric disorders at the hands of the media and anti-ECT lobbies.
Nischol K Raval, Lecturer in Psychiatry, Maharashtra Institute of Mental Health, Department of Psychiatry, Sassoon Hospital, Pune 411001, India. e-mail: nischolraval@hotmail.com