10A NCAC 28D .0202      ELECTROCONVULSIVE THERAPY

(a)  The treatment/habilitation team may recommend the use of electroconvulsive therapy.

(b)  Before electroconvulsive therapy can be utilized two licensed physicians, one of whom shall be clinically privileged to perform electroconvulsive therapy, shall approve a written plan, which includes indication of need, specific goals to be achieved, methods for measuring treatment efficacy, and indications for discontinuation of treatment. In addition, electroconvulsive therapy shall not be administered to any client under age 18 unless, prior to the treatment, two independent psychiatric consultants with training or experience in the treatment of adolescents have examined the client, consulted with the responsible state facility psychiatrist and have written and signed reports which document concurrence with the use of such treatment. For clients under the age of 13, such reviews shall be conducted by child psychiatrists.

(c)  The internal client advocate shall be informed at the time of the decision to utilize electroconvulsive therapy whenever the legally competent client requests such notification or when proposed for use with minor clients or adults adjudicated incompetent.

(d)  Electroconvulsive therapy shall not be initiated without prior consent in accordance with G.S. 122C‑57(f).

(e)  If the adult client is determined to be de facto incompetent by the treatment/habilitation team and is determined to need electroconvulsive therapy, legal guardianship procedures shall be initiated and consent requirements of Paragraph (d) of this Rule shall be met.

(f)  All electroconvulsive therapy shall be administered in accordance with generally accepted medical practice and shall be documented in the client record.

(g)  The State Facility Director shall maintain a statistical record of the use of electroconvulsive therapy which shall include, but not be limited to, the number of treatments by client, unit or like grouping, responsible physician, and client characteristics. The statistical record shall be made available to the Division Director on a monthly basis.

History Note:        Authority G.S. 122C‑51; 122C‑56; 122C‑57; 131E‑67; 143B‑147;

Eff. October 1, 1984;

Amended Eff. July 1, 1989;

Pursuant to G.S. 150B-21.3A, rule is necessary without substantive public interest Eff. May 1, 2018.