Feargal Quinn (Independent)

I am in an area in which I am out of my depth inasmuch as I do not know a great deal about this. However, I have spoken to some people who have had involuntary treatment and it has had a very severe affect on their lives. One is torn between the disastrous personal experiences of people and the professional advice.

I have checked up on this. It is very interesting that a much refined version of lobotomy, to which Senator Boyle referred, called neurosurgery for mental disorder is still carried out in the United States and in the United Kingdom in Cardiff and Dundee hospitals for persistent severe depression, anxiety and obsessive compulsive disorders. In 2006 a neurosurgeon in Cardiff described the practice as not a panacea but added that in patients for whom all other treatment has failed, it transforms their lives if it works well. Many professionals in the area still see a place for the treatment. Nobody is disagreeing with the treatment as such.

There is an oft held perception that ECT is a high risk with little benefit but we must look beyond those pure assumptions or perceptions as to what ECT is and whether it can bring benefit to those suffering, even if they are unable to agree to the therapy at that time. It is worthwhile noting a report published in the Lancet medical journal by researchers at the University of Edinburgh and the University of Aberdeen who found that ECT to be the most effective treatment for depression, particularly when the condition is accompanied by psychotic symptoms or hallucinations. However, they pointed out that there are some risks associated with ECT, including having greater anaesthesia and memory impairment. The researchers said that all effective treatments for depression, which is by nature associated with the most profound suffering, must be welcomed.

In another report in the Lancet in 2003, the United Kingdom ECT review group found ECT to be one of the most safe and effective treatments in medicine. I am going to some pains to remind Members that it is a very effective treatment. As the Irish Journal of Psychological Medicine highlighted in its editorial published this year, this proposal is meant to promote the use of advanced directives made by patients early in the course of their illness when they have capacity. The assumption is that advanced directives will prevent paternalism and promote the rights of the patient. However, the authors of the article state that a ban on involuntary ECT would render them unable to treat some of the most mentally ill people in society. They state it would lead to medical deterioration and subsequent general hospital treatment for some. It would mean a basic violation of the treatment contract because the detention in hospital of involuntary patients should be based on the principle of reciprocity for which they state they must aim to restore decision-making capacity to patients.

I agree with this view that medical practitioners must be able to have the ability to restore this decision-making capacity to involuntary patients. That is why I find it difficult to divide between the personal experiences of those who have spoken to me and the medical experience and the professionalism of the experts in that area of medicine. I am not saying we should not go ahead with this but I am expressing the concern that we should not jump into it without giving serious consideration to the very definite medical advice we have been given before we assume it is the correct thing to do.