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Electroshock. Restoring the Mind

By Max Fink

Carisbrooke Resource Centre, Wenlock Way, Gorton, Manchester M12 5LF

Oxford: Oxford University Press. 1999. 148 pp. £22.00 (pb). ISBN 0-19-511956-8

This book is subtitled Guide for Patients and their Families, so my first impulse was to get the opinion of a user. However, I changed my mind after reading it.

I have met Max Fink in the past and he is given to bullish statements, so I was not surprised at the tenor of the book. However, I cannot suggest to my patients or their relatives that they should read a book that states that a course of electroconvulsive therapy (ECT) usually takes at least 6 months and that appears to condone using ECT to treat patients without informed consent. Fink describes the mechanism whereby treatment can be given without written consent in the USA, pointing out that it can be slow and expensive. He then describes several case histories in which this mechanism was circumvented and treatment appears to have been given without either informed consent or the appropriate order from a State Court. We must be grateful that the current Mental Health Act procedures in the UK provide an effective mechanism to allow appropriate timely treatment of these very ill people. On behalf of these vulnerable individuals we must be vigilant regarding proposals for reform.

This is a small, slim and eminently readable volume, but I cannot recommend it to patients and families. I did find it instructive in terms of practice and attitudes in the USA and I urge psychiatrists who prescribe ECT to read it and to reflect upon our own practice in the UK. Those who campaign against the stigma associated with psychiatry might also find it interesting. ECT in the USA has faced relentless opposition from anti-ECT groups, and there is always a temptation to combat extremism by going to the other extreme. The real challenge, of course, is to recognise legitimate concerns at both poles of opinion and to negotiate a middle course.

This Article Full Text (PDF) Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Benbow, S. M. Search for Related Content PubMed Articles by Benbow, S. M.