ECT and special problems of informed consent

The authors examine the question of whether severely depressed patients can validly consent to ECT, indeed whether anyone should be asked to consent to a treatment that some have held is disabling and beyond the range of rational choice. They suggest some clarification in the use of the terms "competent" and "rational." The authors present examples of cases where ECT may appropriately be used with and without a patient's consent. They conclude that except in cases in which patients may die without ECT, physicians will not err morally by respecting patients' informed decisions about treatment.