Rogerian Argument: The Case of Electroconvulsive Therapy - Essay Example

Harris Kamran English Language Argumentative Paper 7 April Rogerian Argument: The Case of ECT ECT, or Electroconvulsive Therapy, isa technique used in the psychiatry department for the treatment of mental illnesses like manic depression, severe chronic depression, psychosis, schizophrenia, and many other mental disorders (Mayo Clinic Staff). It was first developed in 1938 by Ugo Cerletti, an Italian psychiatrist, while observing the slaughtering of pigs (Behrman). He noticed that before the pigs were cut open, they were made unconscious by administering electric shocks to them (Behrman). Further experiments proved that this technique could be useful for patients of mental disorders (Behrman). Soon afterwards, it was approved and introduced into general practice by the New York State Psychiatric Institute. Since then, it has been the topic of constant debate over its use (Behrman). The procedure has been much improved over the years. The patient now is sedated through administration of general anesthesia, such as Brevital, through an IV line along with a muscle relaxant such as succinylcholine (Behrman). One of the ankles or hands is not relaxed so that the physician can monitor the effect of therapy (Mayo Clinic Staff). The vital signs of the patient are constantly monitored during the procedure which lasts for ten to fifteen minutes (Mayo Clinic Staff). A gel is applied to the temples of the patient and electrodes, unilaterally or bilaterally, are placed on the temples, and an electric current of around 220V is passed through the patient’s head to induce a grand-mal seizure for thirty to sixty seconds (Mayo Clinic Staff). This procedure is repeated three times for two to four weeks, for a total of six or twelve sessions as needed, depending upon the patient’s condition (Mayo Clinic Staff). There is no denying that this treatment has some risks and side effects attached to it and it is important to analyze those. The very idea of passing electric current of such a high voltage through the brain is unacceptable to some critics and it is thought of as a primitive, rudimentary and archaic technique (Behrman). It is a surprise for some specialists that this technique is still practiced in today’s medicine (Behrman). The first side effect is that of confusion experienced by the patients (Behrman). This confusion is expected to last for a few minutes to a few hours, but it can go on for days too. However, it does subside. This is associated with nausea and headache which also might last for some time (Mayo Clinic Staff). The biggest problem, however, is that this practice is associated with transient memory loss which, in some cases, might become permanent (Hyphenbird). For most patients, it is retrograde amnesia, that is, they can not remember anything from the time that the treatment starts to the time it is finished (Mayo Clinic Staff). However, it can span more months before and after the treatment and, although, it is expected to subside and the patient to recover after some time, it may be a couple of weeks (Mayo Clinic Staff). In some patients it lasts longer and may become permanent (Hyphenbird). Some psychiatrists associate it with brain damage and some patients have also companied of brain damage (Behrman). Other than the memory loss, the risks include muscle damage and broken bones owing to the lack of administration of anesthesia and muscle relaxants (Hyphenbird). As the patient undergoes convulsions, his bones and joints are shaken due to the shock and so he might develop fractures or bruises (Hyphenbird). There are complaints of jaw clenching and pain in the jaws almost with all the patients after ECT (Hyphenbird). Some of the medicines that are delivered during the procedure to prevent heart stoppage and the spasm of respiratory muscles actually increase the heart rate and , hence, the cumulative effect can be lethal (Hyphenbird). Even if the patient is not given those medicines, the effect of ECT on heart itself can induce, in some cases, heart failure and serious complications (Mayo Clinic Staff). Therefore, it is vital to keep the patient under observation throughout the process and to take physical and medical history and examination beforehand (Mayo Clinic Staff). Psychiatrists like Peter Breggin feel that the healing effects of ECT are nothing but short-lived consequences of exposing the brain to such high voltage (Behrman). It is as if the person with a headache is slapped on the head; he feels transient relief, but is not cured, and there may be more damage to the brain than healing (Behrman). There are also numerous cases where the patients were not completely informed about the technique and their side effects or proper precautionary measures were not taken so that the patients later developed many psychological and physical traumas (Behrman). Some patients have reported permanent memory losses for significant periods in their life, like, a woman missing out on a complete year of her memories after ECT (Hyphenbird). The majority develop psychological fear of hospitals after undergoing ECT (Hyphenbird). There is, nevertheless, a positive side to this argument as well. ECT made a bad impression on the public initially when it was used without much understanding, and often caused more damage than cure. However, over the past thirty to fifty years, much improvement has been made in this practice and so it has made a positive comeback (Behrman). In the recent years, more ECT has been practiced in the United States than tonsillectomy (Behrman), which shows its acceptance in the society, and especially among the physicians who understand its pros and cons better than the laymen. According to the American Psychiatrist Association, ECT has a success rate of a surprising eighty percent, whereas the use of anti-depressant medications has a success rate of between fifty and sixty percent (Behrman). This makes it one of the most practiced and most successful psychiatric treatments in the medical profession (Behrman). Another benefit of this technique is that it is useful in patients on whom the traditional medicines cease to have effect, either due to a lack of biologic response, or tolerance (Behrman). Therefore, it is often the last resort for most patients. Although it is true that doctors have not yet come to a unified decision as to exactly how ECT works, they do have several theories about its mode of action (Behrman). ECT might effect the way the neurons respond to the neurotransmitters released in the brain changing the perception of the individual and elevating the mood (Behrman). Another view is that since ECT is essentially an artificial seizure induced under controlled settings, it is useful in order to teach the brain to counter natural seizures produced within the brain (Behrman). The electric shock might also cause the hypothalamus to secrete hormones and other peptides which effect the general body chemistry uplifting mood and inducing hunger and sleep (Behrman). Whatever the procedure might be, the end result is promising and quite helpful to the patients. This discussion also shows that the doctors are not just shooting in the dark; studies for the effect of ECT are underway, and physicians have a general idea about the effect ECT effects the body chemistry. Therefore, they are aware of the extent of side effects that this technique has on the body and have determined that the effects are within a safe range. ECT can prove to be a very successful and sometimes the only therapy to treat someone with suicidal tendencies, severe mania, or a refusal to eat (Mayo Clinic Staff). More precisely, it is used in cases of severe depression especially when accompanied by psychosis, medicine-resistant depression, catatonia with or without schizophrenia, and schizophrenia itself (Mayo Clinic Staff). It is also beneficial in cases of obsessive compulsive when it is medicine-resistant, epilepsy, Parkinson’s disease, and Tourette syndrome (Mayo Clinic Staff). A great benefit of this treatment is that it can be given in circumstances where other medication may actually be contraindicated, for example, it can be given in old age to people who are intolerant to traditional medication, during pregnancy when there is a danger of harming the fetus through the use of medication, and to people who would rather use ECT than have medicines, since anti-depressants themselves have quite a lot of side effects (Mayo Clinic Staff). Given both the sides of the argument, it is evident that the proponents and the opponents both have strong motives and lines of argument to defend their position, and both can equally be justified. The decision, at the end, rests upon the patient and his guardian or family if they want to choose this method of treatment. The conclusion, then, can be this: if all else fails, the end resort can safely be ECT, which has proven to be successful in treating cases where medication has failed despite the side effects that it has. But then again, all medications have side effects if they are not taken according to the proper instructions, and the anti-depressant medicines themselves have side effects that at times can put the patient at more discomfort than he was at before. Therefore, ECT cannot be ruled out as a viable and relatively safe treatment for psychiatric illnesses, given than all the safeguards for the procedure and the protocol is duly followed, and the patient is given detailed information about the procedure, with both the pros and cons, and alternate options, so that they can truly make an informed decision. Works Cited Barnes, Dr. Richard. “Information on ECT.” RC Psych. Royal College of Psychiatrists, Jul. 2010. Web. 7 Apr. 2012. Behrman, Andy. “Electroshock Therapy.” Electroboy. Andy Behrman, 2005. Web. 7 Apr. 2012. Darton, Katherine. “Making Sense of Electroconvulsive therapy (ECT).” Mind. Mind Publication, 2010. Web. 7 Apr. 2012. “Electroconvulsive Therapy.” Sane. Sane Australia, 2010. Web. 7 Apr. 2012. Mayo Clinic Staff. “Electroconvulsive therapy (ECT).” Mayo Clinic. Mayo Foundation, 2 Aug. 2011. Web. 7 Apr. 2012. Hyphenbird. “Electric Shock Treatment for Mental Illness- Therapy or Torture?” Hub Pages. Hubpages Inc., 2011. Web. 7 Apr. 2012. Read More