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<p>Severe psychiatric disorders are often associated with a&#xa0;lack of capacity to consent. Electroconvulsive therapy (ECT) is an evidence-based treatment for treatment-resistant and severe affective, psychotic and catatonic syndromes. Studies show that patients lacking capacity respond to ECT at least as well as or even better than, those with capacity to consent. Based on the available literature and clinical experience, ECT also demonstrates good efficacy and tolerability when administered against the patient’s will. In addition to reducing symptoms, ECT can help restore the capacity to consent and the majority of patients initially treated against their will consent in the course of the therapy. Nevertheless, in the absence of consent ECT is often associated with structural and legal hurdles that can delay or even prevent the initiation of treatment, to the detriment of patients. This applies to general psychiatry, but to an even greater extent to forensic psychiatry. Here, ECT is used particularly rarely despite frequent indications. Improved structural conditions and clear legal frameworks are therefore necessary for its appropriate use. For medical and ethical reasons it is essential that patients have access to a&#xa0;form of therapy indicated for them, regardless of the treatment setting.</p>

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Elektrokonvulsionstherapie bei fehlender Einwilligungsfähigkeit als Maßnahme gegen den natürlichen Willen und im Maßregelvollzug

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月30日

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  • Isabel Methfessel,
  • David Zilles-Wegner,
  • Alexander Sartorius,
  • Lena Machetanz

摘要

Severe psychiatric disorders are often associated with a lack of capacity to consent. Electroconvulsive therapy (ECT) is an evidence-based treatment for treatment-resistant and severe affective, psychotic and catatonic syndromes. Studies show that patients lacking capacity respond to ECT at least as well as or even better than, those with capacity to consent. Based on the available literature and clinical experience, ECT also demonstrates good efficacy and tolerability when administered against the patient’s will. In addition to reducing symptoms, ECT can help restore the capacity to consent and the majority of patients initially treated against their will consent in the course of the therapy. Nevertheless, in the absence of consent ECT is often associated with structural and legal hurdles that can delay or even prevent the initiation of treatment, to the detriment of patients. This applies to general psychiatry, but to an even greater extent to forensic psychiatry. Here, ECT is used particularly rarely despite frequent indications. Improved structural conditions and clear legal frameworks are therefore necessary for its appropriate use. For medical and ethical reasons it is essential that patients have access to a form of therapy indicated for them, regardless of the treatment setting.