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Bu sayfa, 26. Dünya Psikiyatri Kongresi'nde sunulan çalışmanın yapay zekâ desteğiyle hazırlanmış Türkçe özetidir. Çalışmanın sahibi sunan yazarlardır; atıf için orijinal kaynağa başvurun.

ECT in Patients Who Lack Capacity to Consent

Ect in patients without capacity to consent

Patients who lack decision-making capacity should not be denied evidence-based ECT solely because they cannot provide informed consent; evidence shows that efficacy in this group is at least as good as in other patients and that successful treatment often restores capacity.

The talk addresses the use of ECT in patients who lack decision-making capacity. ECT is one of the most effective treatments for severe depression, bipolar disorder, schizophrenia, and catatonia, and can be lifesaving in severe psychiatric illness. It emphasizes that ECT is a safe treatment associated with reduced all-cause mortality, and that its generally transient side effects should be assessed in the context of the severity and risks of the underlying illness. A substantial proportion of patients requiring ECT temporarily lack decision-making capacity; these patients may receive treatment through substitute decision-making or on the basis of advance directives, in accordance with the applicable legal frameworks. Evidence shows that ECT is at least as effective in patients who lack capacity as in other patients, and more effective in some patient groups, without compromising safety; successful treatment often restores decision-making capacity, thereby supporting patient autonomy. Compulsory (involuntary) ECT is described as a distinct and exceptional clinical situation, to be considered under strict legal and ethical safeguards only when a patient who lacks capacity actively opposes treatment, serious harm is imminent, and no less restrictive option is available; favorable clinical outcomes and high rates of retrospective acceptance following recovery are reported for this practice. In conclusion, ensuring equitable access to ECT for all eligible patients, including those who lack capacity, is presented as both a medical and an ethical imperative.

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