title: Patients' perceptions of the process of consenting to electroconvulsive therapy.
abstract: BACKGROUND
  The concept of valid consent has become important for electroconvulsive therapy (ECT). However, many patients feel that they do not have enough information before consenting and a significant minority feel coerced into consenting. Little is known about what factors account for these views.
  
  
  OBJECTIVE
  To explore patients' perceptions about how they consented to ECT.
  
  
  METHODS
  Twelve participants were interviewed about their experiences of consenting to ECT. Interviews were subjected to a thematic analysis.
  
  
  RESULTS
  Participants' perceptions of consenting to ECT were complex, and interpersonal factors were found to be important. Many participants felt that they had consented without adequate information from medical sources and that they had little choice to agree. Two participants consented to ECT as either a form of self-harm or hoping it would kill them.
  
  
  CONCLUSIONS
  Consenting to ECT is more complex than currently recognised and involves interpersonal and systemic factors. As a result, people may consent because they feel that they have little choice. Implications for practice are discussed.
authors.affiliation: Department of Psychology, James Cook University, Singapore. Paul.Fisher@jcu.edu.sg
authors.forename: Paul
authors.initials: P
authors.lastname: Fisher
authors.forename: Lucy
authors.initials: L
authors.lastname: Johnstone
authors.forename: Kathryn
authors.initials: K
authors.lastname: Williamson
mesh_terms: D000328:Adult; D000368:Aged; D001714:Bipolar Disorder / Q000523:psychology / Q000628:therapy; D003863:Depression / Q000523:psychology / Q000628:therapy; D004565:Electroconvulsive Therapy / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007258:Informed Consent / Q000523:psychology*; D008297:Male; D001523:Mental Disorders / Q000523:psychology* / Q000628:therapy*; D008875:Middle Aged; D019964:Mood Disorders / Q000523:psychology / Q000628:therapy; D010349:Patient Compliance / Q000523:psychology*; D011795:Surveys and Questionnaires