Martin B A, Glancy G D
ECT Service, Clarke Institute of Psychiatry, Toronto, Canada.
Convuls Ther. 1994 Dec;10(4):279-86.
A valid consent is a necessary precondition to the administration of electroconvulsive therapy (ECT). However, the assessment of mental competence to consent may be both complicated and controversial because neither case law nor statutes provide a clear description of the necessary mental abilities. The closest approximation in the literature is that derived from judicial commentary on the relevant case law and summarized into four standards. We designed a 15-item questionnaire to define and test the content or essential elements of each of these standards, and surveyed lawyers and health care professionals with known expertise or interest in the field to investigate the content validity of the questionnaire. Of the 15 items, 12 were rated important or essential to the assessment of competence to consent to ECT by > or = 67% of the lawyers and 11 were so rated by > or = 67% of the health professionals. Ten items were rated as important or essential by > or = 67% of both groups. Only two items were not so endorsed by > or = 67% of one of the groups. We conclude that the questionnaire has a satisfactory content validity and may be considered a general guideline for assessing competence to consent to ECT.
有效的同意是进行电休克治疗（ECT）的必要前提。然而，对同意的心理能力进行评估可能既复杂又具有争议性，因为判例法和法规均未对所需的心理能力给出清晰描述。文献中最接近的表述是源自对相关判例法的司法评论并归纳为四个标准的内容。我们设计了一份包含15个条目的问卷，以界定和测试这些标准中每一项的内容或要素，并对该领域具有已知专业知识或兴趣的律师和医疗保健专业人员进行调查，以研究问卷的内容效度。在这15个条目中，12条被67%或更多的律师评定为对评估同意接受ECT的能力重要或必不可少，11条被67%或更多的医疗专业人员如此评定。10条被两组中67%或更多的人评定为重要或必不可少。只有两条未被其中一组67%或更多的人认可。我们得出结论，该问卷具有令人满意的内容效度，可被视为评估同意接受ECT能力的一般指南。
