Mankad Mehul
From the Duke University Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC.
J ECT. 2015 Sep;31(3):143-6. doi: 10.1097/YCT.0000000000000241.
Informed consent underpins all medical decisions, including the decision to undergo electroconvulsive therapy (ECT). Written informed consent remains the standard before the initiation of ECT and requires the inclusion of several components to be considered valid. Prospective patients must be aware of risks and benefits of ECT as well as risks and benefits of alternate, and potentially less effective, interventions. Patients must also possess adequate decision-making capacity to make an informed choice about treatment. Consent for ECT may present unique issues, such as the interplay between potential cognitive adverse effects and informed consent. Options to address this concern include thorough explanation of this topic before the initiation of ECT, continued reassessment of consent during ECT, or some combination of approaches.
知情同意是所有医疗决策的基础，包括接受电休克治疗（ECT）的决策。书面知情同意仍然是ECT开始前的标准，并且需要包含几个要素才能被视为有效。未来的患者必须了解ECT的风险和益处以及替代干预措施（可能效果较差）的风险和益处。患者还必须具备足够的决策能力，以便对治疗做出明智的选择。ECT的同意可能会出现一些独特的问题，例如潜在认知不良反应与知情同意之间的相互作用。解决这一问题的方法包括在ECT开始前对该主题进行全面解释、在ECT期间持续重新评估同意情况，或采用某些方法的组合。
