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The Practice of Consenting to Electroconvulsive Therapy in the European Union

Gazdag, Gábor MD, PhD*; Takács, Rozália MD; Ungvari, Gabor S. MD, PhD; Sienaert, Pascal MD, PhD§

doi: 10.1097/YCT.0b013e318223c63c
Original Studies

Objectives To survey major aspects of obtaining informed consent to electroconvulsive therapy (ECT) in the countries of the European Union.

Methods Leading professionals in the field of biological psychiatry in all European Union countries and Norway and Switzerland were approached by e-mail asking about the national practice of obtaining consent to ECT including the form of consent, the legality of consent by proxy, and consent to anesthesia and maintenance treatment.

Results A considerable diversity was found across Europe regarding consent to ECT. In Slovenia and Luxembourg, ECT is not available at all. Informed consent is needed in written form in most European countries except for Sweden, Denmark, Finland, and Slovakia, where verbal consent is sufficient. Italy, Ireland, and Latvia are stricter in their approach because separate written consent is required before each ECT session.

Conclusion The practice of obtaining informed consent varies from country to country reflecting the individual European Union countries’ jurisdiction and their sociocultural traditions as well as their different development of psychiatric services. In line with the increasing cooperation in health care, developing a unified way of obtaining consent for ECT is recommended.

From the *Consultation-Liaison Psychiatric Service, Szent István and Szent László Hospitals; †Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmeweis University, Budapest, Hungary; ‡The University of Notre Dame Australia/Marian Centre, Perth, Australia; and §ECT Department, University Psychiatric Center, Catholic University of Leuven, Campus Kortenberg, Kortenberg, Belgium.

Received for publication December 29, 2010; accepted April 20, 2011.

Reprints: Gábor Gazdag, MD, PhD, Consultation-Liaison Psychiatric Service, Szent István and Szent László Hospitals, Gyáli út 5-7, Budapest, 1097 Hungary (e-mail:

The authors have no conflicts of interest or financial disclosures to report.

© 2012 Lippincott Williams & Wilkins, Inc.