The practice of consenting to electroconvulsive therapy in the European Union

To survey major aspects of obtaining informed consent to electroconvulsive therapy (ECT) in the countries of the European Union.

Leading professionals in the field of biological psychiatry in all European Union countries and Norway and Switzerland were approached by e-mail asking about the national practice of obtaining consent to ECT including the form of consent, the legality of consent by proxy, and consent to anesthesia and maintenance treatment.

A considerable diversity was found across Europe regarding consent to ECT. In Slovenia and Luxembourg, ECT is not available at all. Informed consent is needed in written form in most European countries except for Sweden, Denmark, Finland, and Slovakia, where verbal consent is sufficient. Italy, Ireland, and Latvia are stricter in their approach because separate written consent is required before each ECT session.

The practice of obtaining informed consent varies from country to country reflecting the individual European Union countries' jurisdiction and their sociocultural traditions as well as their different development of psychiatric services. In line with the increasing cooperation in health care, developing a unified way of obtaining consent for ECT is recommended.