The authors examine the question of whether severely depressed patients
can validly consent to ECT, indeed whether anyone should be asked to
consent to a treatment that some have held is disabling and beyond the
range of rational choice. They suggest some clarification in the use of the
terms "competent" and "rational." The authors present examples of cases
where ECT may appropriately be used with and without a patient's consent.
They conclude that except in cases in which patients may die without ECT,
physicians will not err morally by respecting patients' informed decisions