Shock treatment approved

Controversial electric shock treatment has been given the green light by the Royal College of Psychiatrists, which yesterday issued good-practice guidelines.

The college rejects criticisms that "pyschiatrists don't know how it works", and does not agree that its use should be banned for children.

It counters anxieties that patients who are mentally ill cannot give informed consent to electroconvulsive therapy (ECT) and says that compulsorily detained patients are protected by the Mental Health Act which requires an independent opinion be given.

However, if a patient witholds, refuses or is incapable of giving consent, "it may be necessary to proceed under the common law if the treatment is in the patient's best interest." The report advises that the psychiatrist seeks a second opinion in these cases.

"ECT is a life-saving treatment particulary in severe depression and when all other treatments . . . have failed," Dr Fiona Caldicott, president of the Royal College, said.

She said that ECT can save lives, particularly when patients are suicidal: "In these kind of life-threatening illnesses ECT has an 80 per cent success rate. It would therefore be totally unacceptable for such an effective treatment to be banned."

The guidelines produced by a committee chaired by Dr Chris Freeman say there is no evidence of ECT being used on children under 12 in Britain. They say in older children it is permissable in life-threatening conditions.