Involuntary ECT: a “Proper” Torture in the UK?

     Far fewer residents in the UK receive electroshock therapy per capita than in America, but the percentage there of those who are forcibly given the procedure is far higher than in the New World. Of the 2500 people who receive ECT annually in the UK, almost 40 percent are given it involuntarily. In America “only” 8.5 percent of ECT recipients are administered ECT involuntarily.

     UK’s National Health Service has a severe staffing shortage. More than 100,000 vacancies are reported today, mostly for doctors and nurses. Consequently, about one third of British doctors are now foreign born and educated and are used to more easily fill these vacancies.

     However, almost half of the psychiatrists in the UK are foreign educated, mostly in India or Greece.
In America only 23 percent of doctors are international medical graduates, but 30 percent of US psychiatrists are, and most of them were educated in India or Pakistan.

      Some foreign psychiatric programs allow entry directly from high school and place more emphasis on initial exam scores than on academic background. Many foreign psychiatric certification programs can be completed in six years rather than the standard eight — four pre-med college and four medical school – of American and British schools.

     Does the high percentage of UK forced ECT deliveries equate to the high rate of NHS psychiatrists trained elsewhere?

     It is at least a coincidence worth investigating, both in the UK and in America. The legal requirements for involuntary ECT are similar in both countries, so there’s another variable than that behind the much higher rate of UK’s forced ECT sessions.

     Both the US and the UK have medical exams that need to be passed in order to practice in each country, but the current US USMLE test is more rigorous by far than the older UK PLAB exam and is also more thorough than the recently upgraded UK medical exam, the UKMLA.

     There may also be cultural influences on foreign trained psychiatrists that prompt them to more quickly force ECT on someone. For instance, it is only recently that India has banned the use of “unmodified” ECT in the country…that is, administering the 460 volts without any anesthetic.

     The World Health Organization (WHO) has stated that electroconvulsive therapy (ECT) without the free and informed consent of the patient constitutes a violation of human rights and can be considered torture or other cruel, inhuman, or degrading treatment. Along with the UN Office of the High Commissioner for Human Rights, the WHO calls for the prohibition of any involuntary ECT.

     Isn’t it about time to add that to the curriculum of all psychiatric medical schools anywhere?