House Bill 100 has been introduced in our state Legislature and would effectively ban electroconvulsive therapy (ECT) in minors, except in cases of catatonia — a condition that represents only a small minority of pediatric patients who receive this treatment. The public deserves to understand the implications of this proposal.
ECT involves passing a controlled electrical current through the brain to induce a brief seizure. It is an invasive treatment. It can cause headaches, nausea, muscle aches and short-term memory impairment. Some patients report longer-lasting, and in some cases permanent, changes to memory and cognition following the procedure. These risks are real, and any physician who minimizes them is failing their ethical duty.
I know this because I am one of the doctors who performs ECT.
ECT is also the most effective treatment we have for severe, life-threatening depression, including in adolescents who have failed other available interventions. Many of these patients are at imminent risk of suicide. I have attended the funerals of patients I have treated who died by suicide when their illness proved stronger than the options available to them at the time.
Medicine often asks patients and families to accept significant harm in order to prevent far greater loss. Chemotherapy and radiation therapy can permanently damage fertility, bones, organs and cognition, yet we do not ban these treatments for young people. Instead, we rely on rigorous safeguards and informed consent so families can weigh serious risks against the alternative — often death.
The most troubling experiences I have encountered with ECT involve patients who received it without adequate informed consent. That is a tragedy. But denying families and physicians the ability to make careful, case-by-case medical decisions in moments of extreme risk is not a solution.
House Bill 100 would replace medical judgment with political mandate, and in doing so would remove a last-resort, evidence-based treatment from minors whose lives may depend on it.
Jeremy Kendrick, Salt Lake City