Page 3302 - Week 10 - Friday, 26 August 2005

Next page . . . . Previous page . . . . Speeches . . . . Contents . . . . Debates(HTML) . . . . PDF . . . .

As the Minister for Health has said, electroconvulsive therapy remains a controversial treatment. Nevertheless, electroconvulsive therapy is an effective treatment for episodes of severe depression and medication-resistant mania. It is not appropriate for a society to base its decisions about medical treatment on fear or innuendo. Treatment decisions should be made according to the best available evidence of clinical effectiveness. This is the standard our community applies to all medical treatments.

This bill will amend the Mental Health (Treatment and Care) Act 1994 to remove the three-day statutory time delay for authorising the administration of ECT on an emergency basis. The delay associated with this notification period has put the lives of a small number of patients at risk. These amendments will remove this limitation to enable the tribunal to make involuntary emergency ECT orders where such treatment is necessary to save a person’s life.

The medical literature indicates that ECT can be the most effective treatment in cases of severe depression, especially those that do not respond to other treatments. That said, there is no question that any form of involuntary treatment is a serious matter and raises very significant human rights concerns. Members of the Assembly can be confident that this bill has gone through a rigorous process to ensure that it is fully compliant with the Human Rights Act. It has benefited from the valuable input of the human rights commissioner, who was consulted throughout its development. All of the commissioner’s concerns were met in finalising the bill.

An extensive public consultation process was held to ensure that stakeholder consensus could be reached as far as possible and, because of the public interest generated by the bill, I requested my department to take the unusual step of providing a detailed statement of reasons, which was tabled in support of the compatibility statement under the Human Rights Act.

Mr Speaker, significant changes were made to the original bill to ensure that the limitations on rights were strictly proportionate. The membership of the Mental Health Tribunal was expanded from just the presidential member to a full, three-member tribunal; the lower threshold criterion of irreparable harm was removed, so that the emergency treatment can only be made where it is necessary to save the life of a person; a second doctor’s opinion is required prior to seeking an application; the administration of ECT must be recorded as either voluntary or involuntary; the public advocate must be informed prior to an emergency ECT decision being made; the number of emergency ECT treatments is capped at three in accordance with international standards; and there is a blanket prohibition on emergency ECT treatment for people under 16 years of age because of lack of data supporting the safety and need of this form of treatment in minors. The safeguards contained in the amended bill set an exceptionally high standard or threshold for the provision of ECT in emergency situations.

Today, we see yet again the Human Rights Act at work, providing a standard to hold our behaviour up against and to measure our decisions against. This bill is an excellent example of how the Human Rights Act can help legislators work out human rights issues in a spirit of cooperation between stakeholders. It demonstrates the value of the human rights dialogue that is taking place in the ACT.

Next page . . . . Previous page . . . . Speeches . . . . Contents . . . . Debates(HTML) . . . . PDF . . . .