Patients' perceptions of the process of consenting to electroconvulsive therapy

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.
Aim. To explore patients' perceptions about how they consented to ECT.
Method. 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.
Conclusion. 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.