First, most cases of depression are diagnosed and treated in primary care (Berrios and Callahan, 2004), which effectively limits the volume of patient contact with clinical psychiatry. There are perhaps two obvious reasons why ECT remains contentious. Given the APA’s confidence in the efficacy of ECT treatment, as well as the World Health Organization’s projection that depression will soon be one of the most significant sources of disability globally ( 2017), it is curious that a treatment touted to be more effective than any antidepressant (Geddes et al., 2003). In fact, according to the American Psychiatric Association (APA), “electroconvulsive therapy has the highest rates of response and remission of any form of antidepressant treatment, with 70%–90% of those treated showing improvement” (APA 2010, 88). Yet, for contemporary psychiatry, ECT is one of the four positively indicated treatment modalities to treat major depression. These representations have, perhaps, encouraged beliefs that ECT is a cruel and anachronistic practice. Much to the chagrin of contemporary psychiatric clinicians, the less than flattering aspects have been portrayed in narratives such as The Bell Jar and One Flew Over the Cuckoo’s Nest. The 70-year history of ECT is marked by abuse and misuse. Accordingly, in addition to treatment benefits, a properly informed patient is a patient who not only “understands” the potential risks and harms of ECT, but who can also appreciate that the risks and harms will necessarily interfere with lived-experience, and by default, self-experience. In particular, the main impetus for this discussion is precisely that an overly scientific attitude takes for granted that the depressed patient – the soul that is sick – is first and foremost a self. For, if psychiatric imperative is to treat “sick souls”, then clinicians would be remiss in over privileging a scientific attitude to the exclusion of all others. Instead, using phenomenological philosophy as an analytical framework, my intention is to investigate the risks and harms associated with ECT, and the way patients are informed about the potential side effects. Footnote 1 Unlike most appraisals of electroconvulsive therapy (ECT), this paper is not primarily concerned with statistically analyzing ECT data produced by research trails. The sciences of both health and behavior continue to attract so-called “phenomenological research” into their orbit of praxis, and while we have good reason to welcome new avenues of inter-disciplinary research, we must also be cautious about stipulating what one can or cannot do with phenomenology.
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