Inquiry call over doctor's work at Broadmoor: Patient 'was held down for shock treatment': Unmodified ECT was used by a Broadmoor doctor years after it was rejected by psychiatrists

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The Independent Online
COLM BYRNE, who was a student nurse at Broadmoor in 1979, says he saw Dr Loucas give unmodified ECT - ECT given without muscle relaxant or anaesthetic - to a disturbed patient who was being kept in isolation and was behaving violently. A charge nurse had spoken to Dr Loucas about the noise the patient was making.

Mr Byrne helped bring the patient into a room for ECT and to hold him on the bed. He says: 'Dr Loucas came in, applied the electrodes and gave him the shock. Although there were four of us holding him down, holding his hips and his shoulders, his back arched and he rose about six inches off the bed and he seemed to be in a great deal of pain.'

When Dr Loucas saw that Mr Byrne was 'visibly shocked', he told him: 'What we're seeing here, Student Nurse Byrne, is the use of ECT in an emergency.'

Twenty-Twenty Television, which made 'Special Treatment', the Cutting Edge programme, has spoken to a nurse who was on the ward that day who confirmed Mr Byrne's account. The nurse does not consider that there was any emergency.

The programme makers have also obtained a signed statement from a patient, Roger Packham, who was given unmodified ECT by Dr Loucas. Mr Packham said: 'Dr Loucas got the staff to hold me down and then he would shout 'let go' at the last minute and throw the switch. The straight ECT hurts a lot for a second after they throw the switch. It scrambles your brains and for days you can't remember anything. I had 17 lots of ECT like this.'

Mr Packham, who is now in Ashworth Hospital, Merseyside, also said he was kept in a 'strip room' which had no furniture other than a mattress on the floor and a bucket. 'The window was covered by wooden boards, so no light came in. I was kept in this room for 24 hours a day. I was in there from 1980 to 1982.'

Mr Byrne says he was interviewed by two senior officials from the Department of Health and Social Security in September 1979, after speaking publicly about the use of unmodified ECT and assaults he had witnessed by nurses on patients.

Mr Byrne and the nurse who backed up his account also gave a sworn statement to the mental health charity, Mind.

According to press reports at the time, the Department of Health and Social Security declined to comment because the allegations were the subject of a police investigation, but it added: 'The Secretary of State is aware of the allegations.'

Later the DHSS said it would not hold an inquiry into the use of unmodified ECT at Broadmoor. Patrick Jenkin, then the Secretary of State, said: 'The choice of drugs and the dosage and the application of any medical treatment is essentially a matter for the professional clinical judgement of the doctor.

'Unless there is prima facie evidence of substantial professional misconduct or malpractice (as distinct from generalised ill-defined allegations or complaints) management ought not to seek to concern itself in such matters as clinical judgement.'

A debate raged in the medical and national press about whether unmodified ECT should ever be used. Anthony Clare, then of the Institute of Psychiatry, and Larry Gostin, then legal director of Mind, quoted a letter written by Desmond Pond, then president of the Royal College of Psychiatrists, which concluded: 'By and large, unmodified ECT is not acceptable and any psychiatrist who does it would find it hard to justify his action with his peers.'

The Lancet, the medical journal, said Professor Pond's letter suggested some circumstances in which unmodified ECT might be given: where anaesthetic was medically contra-indicated in a patient in urgent need of ECT, or where an anaesthetist was not available when a patient urgently needed ECT.

The Lancet editorial concluded that: 'It is difficult to imagine the circumstances in which ECT could be administered to a recalcitrant patient and yet an intramuscular injection of a major tranquilliser was impossible.'

Ten psychiatrists, including Dr Clare, wrote to the British Medical Journal, saying that further use of umodified ECT was indefensible.

Dr Donald Johnson, a consultant psychiatrist in Manchester, says that in common clinical practice, unmodified ECT was no longer used by the 1960s. In tonight's programme he says: 'After 1960 at the very latest, it would be totally unjustified to use unmodified ECT in any circumstances.'