Tennessee Legislature at Vanguard of Sanity with new ECT Restrictions Passed

     The Tennessee state legislature has long been at the forefront of sane legislation for restricting the use of electroconvulsive therapy. Only Tennessee, Texas, Colorado and California have passed laws that curtail the use of ECT on children and minors. This year they have further diminished the potential for an unrestricted use of ECT by passing two new laws.

     The first is the Tennessee Medical Ethics Defense Act. It allows state healthcare providers the option of refusing to participate in any procedure that violates their conscience. Practitioners may now legally refuse to use any medical treatment because of their own moral, ethical or religious objections. While the act does not specifically mention electroconvulsive therapy, ECT is one practice more than ripe for its application. 

     The second, related legislation that Tennessee has passed this year does explicitly apply to the practice of ECT. The new law further limits the use of ECT on minors and it strengthens the existing Tennessee law by requiring a more standard and more specific application of informed consent procedures regarding giving ECT to anyone, regardless of age. 

     This new legislation now requires the testimony of an independent psychiatrist who is both trained and certified in adolescent psychiatry before any ECT can be administered to minors. In addition, that psychiatrist must now have examined the child personally and must submit a cogent rationale about why ECT is necessary for that child.

     Plus, Tennessee’s new informed consent legislation introduces three stronger aspects.

     First, written informed consent is required from either the patient or the patient’s legal guardian. That consent is also temporary. It can be withdrawn at any time.

     Second, a patient’s medical records must include proper documentation of the necessity for giving any patient ECT. That documentation must also attest to the fact that other, less intrusive therapies have been considered.

     Third, ECT must be ordered by a psychiatrist, or if the prospective ECT recipient’s attending physician is not a psychiatrist, a psychiatrist must be consulted.

     These new laws protect the citizens of Tennessee in two ways. First, they make it far less likely that indiscriminate, unjustified ECT will be given to anyone. Second, they provide a new legal framework that gives citizens more opportunity to sue ECT practitioners who have administered the brutal treatment without fully informing the patient of the consequences or of the alternative forms of help available which do not have the risk of ECT for permanent memory loss, significant cardiac problems, or higher probability for suicide.