Decisional Capacity of Depressed Elderly to Consent to Electroconvulsive Therapy

Maria I. Lapid, Teresa A. Rummans, V. Shane Pankratz, Paul S. Appelbaum

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


The purpose of this article is to determine the abilities of severely depressed elderly to consent to electroconvulsive therapy (ECT) and to investigate the impact of educational intervention on their capacity. Forty severely depressed adults referred for ECT, with Mini-Mental State Examination scores greater than 20, were recruited. Using the MacArthur Competence Assessment Tool for Treatment (MacCAT-T), decisional capacities were assessed at baseline and reassessed after education. Between the 2 assessments, all subjects received standard education, and half of the group was subsequently randomized to receive further education. At baseline, the geriatric group scored lower on understanding, reasoning, and choice and higher on appreciation. After education, all MacCAT-T scores increased for both age groups. Depressed elderly in the sample, as a group, had adequate decisional capacities to consent to ECT. They showed greater improvement in decisional capacity with education. The findings highlight the importance of providing education to the elderly to optimize their ability to give informed consent.

Original languageEnglish (US)
Pages (from-to)42-46
Number of pages5
JournalJournal of Geriatric Psychiatry and Neurology
Issue number1
StatePublished - Mar 2004


  • Decisional capacity
  • Electroconvulsive therapy
  • Geriatric depression

ASJC Scopus subject areas

  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health


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