The Regulation of Professional Behavior: Electroconvulsive Therapy in Massachusetts

Abstract

This study concerned the regulation of professional behavior. Several sources of regulation were examined to see if and how they succeeded in directing psychiatrists' administration of electroconvulsive therapy (ECT). Archival data from the Massachusetts Department of Mental Health were used to compare professional behavior with scientific evidence and professional consensus in four areas of ECT administration. Results show that approximately 90% of ECT patients received treatment inappropriately, suggesting that the regulation of ECT administration is ineffective. A survey of psychiatrists suggests that some forms of regulation have not been implemented while those regulations which do exist convey little information to inform the behavior of psychiatrists and are, consequently, ineffective. Psychiatrists' behavior was, however, related to their attention to the medical literature.