Cal. Code Regs. Tit. 15, § 3999.348 - Electroconvulsive Therapy
(a)
Shock therapy is the only form of organic therapy, as defined by law, which may
be used in the treatment of persons committed to the custody of the Secretary.
No patient who is competent and capable of giving informed consent will be
administered any form of shock therapy without having given his or her consent.
Prior authorization of a superior court is also required before shock therapy
may be administered for any treatment purpose other than as an emergency
lifesaving measure.
(1) Shock therapy as a
lifesaving emergency medical measure may be administered to a patient who is
competent and capable of giving informed consent and who has given consent, or
a patient who is incompetent or incapable of giving informed consent, without
prior court authorization. However, all pertinent clinical data relating to the
nature of the emergency and the treatment given will be presented to the court
for review within ten days of the first instance of emergency shock
treatment.
(2) When a patient is
competent and capable of giving informed consent and has done so, and the court
has authorized such treatment, shock therapy may be administered in a
nonemergency course of treatment. No form of shock therapy may exceed three
months of continuous treatment nor more than three months in any 12-month
period.
(b) Informed
Consent. The term, "Informed Consent," means that a person must knowingly and
intelligently, without duress or coercion, and clearly and explicitly consent
to the proposed shock therapy. The patient's consent must be given in writing
and in the presence of the attending physician. It must be preserved and be
available to the patient, the patient's attorney, guardian, or
conservator.
(c) Determining need.
If the attending physician determines that shock therapy is required for the
health and safety of the patient, permission may be requested of the warden or
superintendent to administer the therapy.
(1)
The warden or superintendent will appoint a committee of physicians, two of
whom are board certified or eligible for board certification in psychiatry or
neurosurgery, to review the patient's treatment record and the determination of
the attending physician. At least one of the attending physicians must not be a
full-time employee of the Department.
(2) Before shock treatment may be
administered, this committee must unanimously agree with the attending
physician's determination that it is required and, if it is to be performed
under the provisions of subsection (b), that the patient has the ability to
give informed consent and has in fact given informed
consent.
(d) Withdrawal
of consent. Any patient who has given informed consent may withdraw it at any
time. The shock therapy must cease immediately.
(e) Court petition.
(1) A patient, or patient's attorney,
guardian or conservator may file a petition with the superior court of the
county in which the patient is confined for an order to prohibit the
administration of shock therapy upon the patient. This petition must be served
by the county clerk upon the warden or superintendent on the same day it is
filed and constitutes a refusal of consent or withdrawal of any prior
consent.
(2) The warden or
superintendent has ten days to file a response to the petition. The superior
court may grant a continuance of ten additional days. The response must be
served upon the patient, and upon the patient's attorney, guardian or
conservator on the same day it is filed with the clerk of the superior
court.
(f) Correspondence
regarding shock therapy. The patient is entitled to communicate in writing with
his or her attorney, and by writing or visits with his or her parents, guardian
or conservator regarding any proposed administration of shock therapy or
organic therapy. Any mail regarding shock therapy will not be prevented from
leaving the institution.
(g)
Incapable of informed consent.
(1) If the
patient is incapable of giving informed consent to a program of shock therapy,
and the attending physician believes that such treatment is required for the
health and safety of the patient, the attending physician may request the
permission of the warden or superintendent. If the warden or superintendent
agrees with the request and the committee, appointed pursuant to subsection
(c)(1), also unanimously agrees that such therapy is required, the warden or
superintendent will forward the request to the Chief, Medical Services, for
review and recommendation to the Secretary. If the Secretary concurs in the
course of treatment, the warden or superintendent will petition the superior
court for permission to conduct the hearing. No treatment will be conducted
until after a hearing at which the patient is represented by counsel and after
a court order authorizing the treatment is issued.
(2) In an extraordinary case, the attending
physician may determine that shock treatment is required for a longer period of
time than three months, or more frequently than three months in the period of
one year. The same procedures as in subsection (g)(1) will be followed before
any further shock therapy will be administered.
(h) Patient rights. If the attending
physician determines that a patient should be administered shock therapy, the
patient will be informed of his or her rights under this article. A copy of
Penal Code sections
2670 through
2680 will be
made and will be given to the patient at that time.
Notes
Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code.
State regulations are updated quarterly; we currently have two versions available. Below is a comparison between our most recent version and the prior quarterly release. More comparison features will be added as we have more versions to compare.
No prior version found.