Consent procedures and electroconvulsive therapy in South Africa: Impact of the mental health care act

Abstract

The introduction of the new Mental Health Care Act (MHCA) No 17 of 2002 has highlighted the ethical treatment in least restrictive environments for patients suffering from mental illness. The legislation has highlighted several shortcomings in the consent procedures that were previously utilised for psychiatric patients. Electroconvulsive Therapy (ECT) is a controversial treatment modality hence consent procedures for its use are particularly important. The use of ECT is a highly regulated and legislated treatment in most countries, but not in South Africa. Up until the introduction of the MHCA, and its implementation in December of 2004, legislation and monitoring of the use of ECT in South Africa had been conspicuous by its absence. The MHCA will potentially have an impact on the practice of ECT in a variety of ways. This paper is intended to highlight, for the ECT practitioner, both the implications of these changes as well as propose new consent procedures for ECT.