REVIEW ARTICLE


Psychological and Medico-Legal Perspectives on Electroconvulsive Therapy and Patient-Centered Care: A Short Review of Cross-Cutting Issues



Valeria Tullio1, 2, Stefania Zerbo2, Antonietta Lanzarone2, Salvatore Procaccianti2, Antonina Argo2, *
1 Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy.
2 Department of Health Promotion, Mother and Child Care, Internal Medicine, and Medical Specialties (PROMISE) – Medico Legal Section, University of Palermo, Palermo, Italy.


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Creative Commons License
© 2020 Tullio et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: (https://creativecommons.org/licenses/by/4.0/legalcode). This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to Department of Health Promotion, Mother and Child Care, Internal Medicine, and Medical Specialties (PROMISE) – Medico Legal Section, University of Palermo, Palermo, Italy, E-mail: antonella.argo@unipa.it


Abstract

Electroconvulsive therapy is a treatment that, since its first administration, has been a major topic for debate within the scientific world. In recent years, the debate has become increasingly focused on the short- and/or long-term efficacy of electroconvulsive therapy, its appropriateness in clinical settings, its mechanism of action, the impact evaluation of transient and/or persistent adverse effects, and the drafting of international guidelines, etc.

From the authors’ point of view, these themes are inevitably crossed by three other fundamental issues of significant psychological, relational, ethical, and medico-legal impact. Still, they are less studied than purely biomedical issues in recent times. Therefore, the aim of this article is to focus on the following cross-cutting issues: the therapist-patient relationship, the patient’s perspective, the attitude on electroconvulsive therapy, and informed consent.

This short review refers to the international literature on ECT published since 2000. Analyses of the three previously listed topics are, in part, made within the context of Italian medical settings.

Keywords: Electroconvulsive therapy, Psychological perspective, Medico-legal perspective, Patient’s perspective, Therapist-patient relationship, Patient-centered care model.