Ruling on boy’s ECT treatment

Press, 21 May 1977, Page 3

Ruling on boy’s ECT treatment

PA Wellington; A Commission of Inquiry I into electro - convulsive: therapy treatment on a 13-1 year-old Niuean boy at Lake' Alice Hospital last year has! found that there was no express authority for the treat-! ment, either bv the family! or the Department of Social! Welfare, although this could be inferred. ; The inquiry was conducted! by an Auckland magistrate.! Mr W. J. Mitchell, S.M.,j earlier this year. His report; was tabled in Parliament yes- 1 terday by the Minister of; Social Welfare (Mr Walker). 1 The Magistrate had been! asked to inquire into allega-l tions concerning the treat-! ment of the bov while he was! under the guardianship of the Director-General of Social Welfare; and specifically by whose authority the treatment was administered at Lake Alice. The Health Department’s Director of Mental Health (Dr S. W. P. Mirams) said the report showed that there had been no impropriety on the part of the department. Dr Mirams said that Lake Alice hospital had taken the boy in because no other resources anneared to be available for him. A medical officer of health at Auckland. Dr T. C. Becroft, who an-anged for the boy’s | admission, had “gone to more; than the ordinarv amount of! trouble to help, and the <om-’ mission has decided that she! acted with the full confidence! of the boy’s family,” said Dr' Mirams. ! The Magistrate said in hisj report: • “1 consider that authority! for the boy’s treatment can he inferred from the conduct ■of the people concerned, both the family and the Department of Social W’elfare. This rested in the trust imposed (on all sides in Dr Becroft. who made the placement. ■ “At the same time it must J>e acknowledged that there was no express authority for the act either from the family or from the officers from the Department of Social Welfare.”

The Magistrate said: “I think, however, the department should examine its procedures so as to ensure that where a child under the guardianship of the department has to have medical treatment, the medical practitioner talks to someone—preferably the family if they!

are available—and obtains any necessary consents. “Perhaps the legislature ought to define the positions of the parents and the department for the purposes of consent to treatment.” When the boy entered Lake Alice in November, 1975, the Magistrate said, there could be no doubt that his condition called for elec-tro-convulsive therapy. He was suffering from acute psychotic depression, and evidence made it clear that his age did not rule the treatment out. “ECT is uncommon for 13-year-olds, but the reason is that they seldom show the symptons which call for it,” he said. The view that age itself was no reason to withhold treatment was shared by all the medical witnesses in his inquiry. “T can therefore say that ECT for the boy was warranted in terms of accepted medical practice in psychiatric hospitals in New Zealand.” The Magistrate said the discussion on whether anaesthetic should be used during treamtment took him out of his depth. But he added: “1 was not persuaded that the treatment was administeied in such a way as to cause unnecessary suffering, physical or mental.” The Magistral- said he was certain that ECT was not used at Lake Alice as a punishment.

' During the hearing, there’ were several references to I i the film “One Flew Over the; ! Cuckoo’s Nest.” | “Clearly this film had some bearing on recent public interest in electro-con-vulsive therapy,” said the Magistrate, who added that he had seen the film at a private screening. Dr Mirams said that the report showed the need.for professional staff to clarify whether social workers were merely just involved with a patient or whether they had a statutory responsibility to a patient. “A medical officer, or doc-! tor, or private practitioner will commonly’ get a child coming to him with a social worker. “There will be situations where it is proposed to do something like this (the j treatment of the Niuean : boy) when doctors do not) aiways remember that the.

.Social Welfare officer is the child’s guardian and should be consulted.” Asked why Lake Alice jHosp \al had attracted so 'much criticism, Dr Mirams i said this was partly a result of a conflict between certain i psychological and psychiatric opinions. He added that rhe hospital also tended to concentrate difficult problems. As well as having a security unit for the mentally disturbed. it had an adolescent unit which responded to requests from all over New Zealand to take children whom other people could not, or would not. handle. “Any mental hospital is likely to find itself in the cftre of controversy at some time. 1 would like to think one reason is that we have always encouraged ! completely free access to the place,” said Dr Mirams. |