Minnesota law governing the use of involuntary electroconvulsive therapy (ECT) is undergoing a review by a work group led by the Mental Health Consumer Survivor Network of Minnesota (CSN) and the Minnesota Disability Law Center (MDLC). The group’s goal is to propose legislative changes that will strengthen individual’s rights in the process.
The use of involuntary ECT in Minnesota became an issue of public debate this year when a Minnesota man challenged a court order that subjected him to a lengthy course of ECT treatments against his will. Ray Sandford’s plight drew international attention and was widely publicized by groups including Mindfreedom. Recently Sandford’s involuntary treatments ended but only because the doctor ordering the treatments withdrew from his case.
Many people voluntarily choose ECT as a form of treatment. However, under Minnesota law ECT is considered an intrusive treatment that cannot be forced on an individual without a court order. A legal guardian cannot consent to ECT, and court orders authorizing involuntary ECT must contain reasonable time limits. The key Minnesota Supreme Court case of Price v. Sheppard sets out other requirements as well.
Although Minnesota provides fairly robust protections compared to other states, the work group’s review of the law indicates that more could be done to ensure that individuals’ rights are protected before they receive this intrusive medical procedure against their will. A definite time limit for court orders would provide greater protection for individuals. Five other states have laws that specify a time limit for court orders for involuntary ECT, ranging from 45 days to one year.
The work group is also examining the procedures governing involuntary ECT in the event of an emergency. Current law allows medical directors to administer involuntary ECT without a court order if they declare an emergency situation. But the statutes provide little detail regarding procedures or limitations for ECT in the event of an emergency. The issue of what emergency conditions would justify the immediate use of forced ECT is an initial focal point for the work group’s discussion.
Other issues under discussion include the need to clarify the definition of incompetency to give or withhold consent for ECT; the need for clear limits on when ECT can be forced on individuals who have developmental disabilities; and the clinical basis for balancing the benefits and harms of ECT as compared to other treatments for mental health and other conditions.
The Minnesota Legisla-ture’s House Health Care and Human Services Policy and Oversight Committee heard testimony from work group participants on the topic in August. The work group agreed to provide legislators with suggested legislative changes in November.
In addition to CSN and MDLC, work group participants include representatives of the Office of Ombudsman for Mental Health and Developmental Disabilities, the Mental Health Association of Minnesota, NAMI Minnesota, the Department of Human Services State Operated Services, Allina, MindFreedom (Minnesota branch), WellMind Association of Minnesota, Lutheran Social Services, the Governor’s Council on Developmental Disabilities, the Office of the Ombudsman for Long Term Care, and the Hennepin County Commitment Defense Project.
As of Access Press deadline, the work group had met and was planning to have proposals ready by mid to late November. If the public would like to weigh in before then, they should call or email Pamela Hoopes at 612-746-3711, phoopes@midmnle gal.org. Or contact the work group co-chair, Maureen Marrin at CSN, 651-637-2800, firstname.lastname@example.org
The group will be posting some more detailed information such as summaries of current law on the MDLC Web site (www.mndlc.org) so watch the site for further information.
Pamela Hoopes is the Legal Director at the Minnesota Disability Law Center.