It's usually used only in SEVERE cases of depression where the danger of suicide is very, very high. It is considered a FAST & EFFECTIVE treatment (generally one has + results in 3-4 treatments). Although, as you said, there is memory loss, the efficacy cannot be disputed, especially when even the best anti-depressants take usually 3-4 weeks to have ANY effect.
So, on a pure risk assessment level, the risk is considered to be acceptable when the alternative may very well be suicide.
On Edit: There are some interesting guidelines in California about obtaining informed consent from patients who undergo ECT. See below.
State of California - Health and Human Services Agency Department of Mental Health
ELECTROCONVULSIVE TREATMENT (ECT), INFORMED CONSENT FORM
MH 300 (11/90)
DO NOT SIGN THIS FORM UNTIL YOU HAVE ALL THE INFORMATION YOU DESIRE
CONCERNING ELECTROCONVULSIVE TREATMENT (ECT).
The nature and seriousness of my mental Condition, for which ECT is being recommended, is
RECOMMENDATION: I understand that ECT involves passage of an electrical stimulus across my brain
for a few seconds, sufficient to induce a seizure. In my case the treatments will probably be given
________ times per week for _______ weeks, not to exceed a total of ________ treatments and not to
exceed 30 days from the first treatment. Additional treatments cannot be given without my written consent.
Reasonable alternative treatments (such as psychotherapy and/or medication) have been considered and
are not presently recommended by my doctor because
IMPROVEMENT: I understand that ECT may end or reduce depression, agitation and disturbing thoughts.
In my case there may be permanent improvement, no improvement, or the improvement may last only a
few months. Without this treatment my condition may improve, worsen or continue with little or no change.
SIDE EFFECTS AND RISKS: I understand there is a division of opinion as to the effectiveness of this
treatment as well as uncertainty as to how this procedure works.
I also understand this treatment may have brief side effects: headaches, muscle soreness and
confusion.
There may be some memory loss which could last less than an hour or there may be a permanent
spotty memory loss. Memory loss and confusion may be lessened by the use of unilateral (one-sided)
electrical brain stimulation rather than bilateral (two-sided) stimulation.
Anesthesia and muscle relaxants will be used during these treatments to prevent accidental injury.
Oxygen will be administered to minimize the small risk of heart, lung, brain malfunction or death as a
result of the anesthesia or treatment procedures.
My physician states I have the following medical condition(s) which increase the risk in my case, as
follows:
I HAVE THE RIGHT TO ACCEPT OR REFUSE THIS TREATMENT. IF I CONSENT, I HAVE THE
RIGHT TO REVOKE MY CONSENT FOR ANY REASON AT ANY TIME PRIOR TO OR BETWEEN
TREATMENTS.
Dr. _____________________________ has explained the above information to my satisfaction. At least
24 hours have elapsed since the above information was explained to me. I have carefully read this form or
had it read to me and understand it and the information given to me.
I HEREBY CONSENT TO ECT
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