Individual on Death Row Receiving Electroconvulsive Therapy (ECT) for Catatonia: A Case Report

Area of Science:

• Neuroscience
• Psychiatry
• Medical Ethics

Background:

• Electroconvulsive therapy (ECT) is underutilized and presents challenges for justice-involved populations.
• Ethical considerations surround ECT for individuals on death row.
• A case of persistent altered mental status in a long-term inmate is presented.

Purpose of the Study:

• To describe a case of successful ECT administration for catatonia in a justice-involved individual.
• To address the ethical considerations and logistical challenges of providing ECT in a carceral setting.
• To demonstrate a method for balancing patient safety and institutional policies during ECT.

Main Methods:

• A patient with catatonic stupor, unresponsive to lorazepam, was treated with ECT.
• A modified procedure involving temporary removal and reapplication of restraints during ECT was implemented.
• Seven ECT treatments were administered over five days.

Main Results:

• The patient's catatonic symptoms significantly remitted within five days of ECT.
• The modified restraint procedure was successfully implemented without compromising safety or carceral policies.
• ECT improved the patient's quality of life without restoring competency for execution.

Conclusions:

• ECT can be a safe and effective treatment for catatonia in justice-involved individuals.
• Modified restraint protocols can facilitate ECT administration in carceral environments.
• Psychiatrists should prioritize patient suffering reduction and quality of life, independent of legal system goals.