Attitudes of Ugandan medical students toward 'straight' and 'modified' ECT

In Third World countries, limited resources of anaesthetists and resuscitation facilities mean that electroconvulsive therapy (ECT) is usually given 'straight' (i.e. without anaesthetic and muscle relaxant). This study compared the attitudes of Ugandan medical students towards ECT given straight and ECT administered with muscle relaxant and general anaesthesia (i.e. 'modified' ECT). Results confirmed the clinical impression that students regarded straight ECT as an inhumane method of treatment. However, whilst this was a major factor influencing students' preference for modified ECT as a treatment for themselves or for a close friend, it was relatively unimportant in determining their choice of ECT technique for a patient. Convenience of administration was the main criterion applied by students when deciding whether they would prefer to administer straight or modified ECT to a patient. Implications for medical education and the development of professional attitudes are discussed.