Electroconvulsive Therapy in Pediatrics
Submitted by Stacey Kast, RN, BSN
Electroconvulsive Therapy (ECT) previously known as Electroconvulsive Shock Therapy is a procedure initiated in patients with mental illness so as to spur reprieve. The process involves the passing of a small quantity of electric current through the brain in a bid to create a brief seizure by altering the brain chemistry in order to reverse some symptoms of mental distortion. Although ECT is associated with some side effects like memory loss its application for about 6 months or more results to changes in the symptoms in some patients. Dr. Bour Heuyer first carried out ECT application on young ones who had varied psychiatric conditions in the early 1940s. Later on in 1947, Dr. Lauretta Bender performed the first American cases of ECT application and noted a remarkable improvement on patients ailing from childhood schizophrenia (Kellner, 2014). The therapy is used to alleviate instances of mental disorders like, mania, catatonia, schizophrenia, and depression. ECT is applicable to both minors and seniors although it is widely carried more on adults. The performance of ECT on young ones is a sensitive matter that requires the utilization of relative medical ethics to a high extent.
Importance of Medical Ethics in ECT Young Patients
The performance of ECT on patients is a matter that has resulted to criticism and contradictions due to the side effects that are associated with its application in a substandard way (Lima et. al., 2013). Therefore, ECT experts are indeed under duress to ensure that they follow the correct procedures as well as ensure that they are no essential processes omitted. Failure to observe the dictums of professional medical ethics, the patients are at a risk of suffering from the side effects which include; confusion, memory loss, heart rate and blood pressure increase, muscle ache, nausea, and headache. Medical expatriates who initiate the ECT process must endeavor to uphold professional medical ethics, especially, when performing ECT on young ones below the age of eighteen years. Some of the tenets of ethical brilliance in ECT performance by professionals include; beneficence, justice and respect to the law of the land, and autonomy.
This refers to the choice of acting in the best interest of the patient. ECT experts uphold this ethical guideline by ensuring that the young ones whom are subjected through the Electroconvulsive Therapy are safe from any possible complication. According to the data available on ECT application, no pediatric patient has died due to the performance of ECT (Kellner, 2014). The existing data seeks to point that they are little risk matters regarding ECT performance on the pediatric population. In accordance to this, ECT professionals are ethically aligned by seeking to arouse seizures through ECT on young ones suffering from psychiatric cases. Similarly, in accordance to the same medical ethical doctrine that demands that doctors and physicians should not harm patients, it s necessary for ECT experts to ensure that they keenly initiate the process in order for it to remain harmless as it is supposed to be.
Justice and Respect to the Law of the Land
ECT application on infants and teenagers has a number of restrictions by law that ECT experts ought to be aware of when administering ECT on pediatrics. It is important for ECT professionals to be cognizant of the fact that individual states have different guidelines for the application of ECT on the pediatric generation. For instance, it is illegal in California for one to conduct ECT for a patient below 12 years of age (Van et. al., 2014). Texas also has its own stipulations regarding ECT application on infants. In essence, despite the fact that justice stipulates that every individual has a right to fair distribution of resources and services, ECT experts are required to ensure they stick to the guidelines of the law in order to avoid being charged for violating the available doctrines.
The patient has an inalienable right to choose the type of treatment that he/she prefers without being coerced into a specific treatment therapy. In line with the requirements of the 2004 AACAP Practice Parameters, ECT experts are required to ensure that the parents and the teenage are made aware of both the benefits and side effects of ECT. After elaborating vividly on both the consequences and benefits of ECT it is upon the individual and parent to decide if he/she is to go through the ECT process or not. On the same note, all patients that are to go through ECT are required to obtain an evaluation from another psychiatrist other than the one treating the patient. The autonomy of the ECT patients is protected by the above procedures. Other American states have gone further to put stringent measures to strengthen the patient’s right to autonomy by providing a waiting period of 72 hours after consent that one has in case there is a change of mind before commencement of the process (Lima et. al., 2013).
In summary, the use of ECT for the pediatric population requires significant application of professional ethics in order for the process to be smooth and successful. Experts who administer ECT on psychiatric patients ought to consider the right of the patient to choose the type of treatment they want after being equipped with all the pros and cons related to the process. At the same time, it is important for doctors to ensure that they conduct ECT for pediatrics after ensuring that the procedure is aimed at achieving the interest of the patient. In essence, ECT professionals should ensure that they keep abreast of the different legal amendments and developments in various states in order to be found on the right side of the law now, and in future.
- Kellner, C. (2014). Electroconvulsive Therapy in Children and Adolescents, Neera Ghaziuddinand Garry Walter, Editors. The Journal of ECT.
- Lima, N. N., Nascimento, V. B., Peixoto, J. A., Moreira, M. M., Neto, M. L., Almeida, J. C., & Reis, A. O. (2013). Electroconvulsive Therapy in Adolescents: A Systematic Review. Annals Of General Psychiatry.
- Van DaalenSmith, C., Adam, S., Breggin, P., & LeFrançois, B. A. (2014). The Utmost Discretion: How Presumed Prudence Leaves Children Susceptible to Electroshock. Children & Society