Talk:Electroconvulsive therapy/Archive 4

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intro

The structure and wording of the intro bites, it reads horribly. --scuro 11:22, 28 June 2007 (UTC)

Side effects and complications 2

The adverse effects section of this article needs to reflect a more rounded approach to Sackheim's 2007 study of cognitive effects of ECT. A careful analysis of the study shows that Sackheim found that ECT routinely increased cognitive function, except for autobiographical memory, choice reaction time, and simple reaction time, on all the major cognitive tests he devised after 6 months, compared to the patients baseline level. The simple reaction time slowing was only showed in the patients who recieved bilateral sine wave ECT, which by and large is an outdated approach and given to a very small minority of patients in the United States; almost never in private hospitals. The choice reaction time was the only test that showed a clear decrease from the baseline with no indications of improvement. More study should be taken to see how it was affected. However, it should be noticed that even simple reaction time function was improved from the immediate post-ECT time period, and can be predicted to return to baseline levels in time. One should also note that in right, unilateral pulse ECT, all major cognitive functions, including memory were increased compared to pre-ECT levels.

You are new to wikipdeia. I have moved your post down to the bottom of the page. May I suggest that you cut and paste the adverse effects section from the article, then make improvements, and finally post it here. I agree that many have misinterpreted Sackheim. But, this is a contentious topic so it would be wise to post corrections here first. --scuro 12:55, 22 July 2007 (UTC).

BTW, it's "Sackeim", not "Sackheim". It's been spelled wrong numerous times throughout this page. This person has published at least 200 papers on ECT. Everyone who's well-read with the literature should know how to spell his name. And no, he has not been misinterpreted. He has made published follow-up comments and previous video-taped comments about his study, and he does indeed believe that pulse unilateral ECT causes long-term cognitive dysfunction, and within the study itself in the concluding comments he warns people not to misinterpret the data into thinking otherwise. In a video-taped presentation, he also noted that in a professional conference with ECT researchers and ECT pracitioners that over 2/3 of the audience when polled believed that ECT can cause long-lasting cognitive dysfunction other than memory loss or confusion from around the time of treatment which he called a quote, "watershed moment". He does state that electrode placement and technique may play a role in "minimizing" the damage to cognitive function. Also, the type of cognitive battery used was more demanding on what is believed to be left-brain activity. Different tests other than what was administered would be necessary to fully evaluate right-brain function. Danrz 09:09, 23 July 2007 (UTC)

If one were to look at the actual study by Sackeim he has the data clearly mapped out on bar graphs. If you check out the bar graph for cognitive function after 6 months on unilateral ECT, you will notice that all graphs point to higher results on all of the major tests compared to pre-ECT levels. This is the evidence I have regarding unilateral ECT actually IMPROVING cognitive function.

Hello Danrz, sorry for the spelling mistake. You have exposed one of my weaknesses. The public rebuke should should be enough to burn the correct spelling into my memory banks forever.

Funny how you say he has not been misinterpreted and then 2 sentences later you quote him as warning that people should not misinterpret his data. Those who have tackled the topic in discussion have widely different viewpoints on his findings. I believe that he doesn't so much show that all ECT causes long lasting dysfunction. There are many different variables when ECT is performed. He demonstrated that older techniques do indeed cause lasting dysfunction. In a way he shed light on the proper way that ETC should be performed. But clearly he didn't make a blanket statement that all ETC causes dysfunction. Danrz can you source the points that you made in your previous post?--scuro 13:26, 23 July 2007 (UTC)

2005 Russian study and 2007 rCBF study

User 67.172.92.54, it would be nice if you could follow the conventions of Wikipedia and give yourself a name. I have provided instructions on how to do so in a welcome post on your talk page. It's nice to put a name to ideas.

Reading the summary of the rCBF study I fail to see how it relates to the previous Russian study of your addition in the article. Specifically you quote the Russian study's finding of neuron death and it looks like the rCBF study has nothing to do with that. Why should these two studies be quoted in the same paragraph? I suggest that the rCBF study be given better context be moved, or failing that, be deleted.

I have only read the summary of the Russian study. While some may see this as highly important evidence in reality it is a single study done with mice. At best the findings are a minor footnote of recent directions of research into adverse effects and consequently should receive a brief mention WP:NPOV#Undue weight such as the sentence that the previous study in that section received. I suggest that this study be trimmed to the length of the previous edit. I can access some studies at work but this is not an easy process. Could you post the conclusions of both studies and the methodology of the Russian study also? Thanks.--scuro 13:55, 23 July 2007 (UTC)

The two studies briefed in this paragraph provide examples of new evidence of organically manifested brain damage/dysfunction. That is how they relate. And although contradictory in content, it actually parallels the structure of the preceding paragraph which states in the opening sentence that a number of institutions have concluded that there is "no" evidence that ECT causes brain damage, followed by examples referring to humans/animals. The topic sentence in the new paragraph states that there IS modern evidence that ECT causes brain damage, followed by succinct examples in humans and animals of brain damage/dysfunction. The only modification I see as appropriate would be perhaps changing the wording of the topic sentence slightly; however, I think it's good as is. And I certainly do not believe the content should be trimmed whatsoever. It's already neatly compacted.

I also would like to point out that the information in this new paragraph doesn't merely contrast with the previous paragraph, it actually proves the assertions in the previous paragraph to be factually incorrect. With that said, I believe the two paragraphs should remain as they are, because despite published scientific evidence of brain damage going back over a half century, numerous institutions/researchers are indeed continuing to assert that there is "no" evidence of brain damage in humans/animals. Some researchers like Kellner and Fink argued that the modernization of ECT technique and introduction of hyperoxygenation have rendered the old evidence of brain damage in humans and lab animals to be inapplicable. However, new studies like these prevent this argument from being successfully made.

I would also like to point out that the claim in the preceding paragraph that "all" of the recent scientific reviews have concluded that there is no evidence that ECT causes brain damage, is false. It's factually incorrect. You see, it only takes one published review to render this claim incorrect. And, for example, Breggin has published a recent scientific review that details a laundry list of published studies from the last half century showing that ECT can cause brain damage and lasting cognitive deficits.

Patients considering ECT very likely on a web search will visit websites like Wikipedia, Mayo Clinic's page, or the APA's website. Websites run by medical organizations have a tendency to stress that there is "no" modern evidence that ECT causes brain damage, and also omit mention of the recent Sackeim study with regard to cognitive function. Often they even suggest that such claims are myths. This may be very misleading to readers who, when they read that there is "no" evidence of brain damage/dysfunction in humans/animals at such sites, may very well believe it. Readers should know that there are continuing claims by certain researchers and organizations that there is no empirical evidence of lasting harm from ECT. They should also know that yes, yes THERE IS some evidence of organic brain damage/dysfunction. The claim of "no" evidence needs to be changed to read that there is "limited evidence".

With regard to the paragraphs under the subheading of "Adverse Effects", it's the second paragraph which most needs revision, because it needs to be broken into two paragraphs. The topic and bulk of the paragraph deal with ECT and memory, but torwards the end it starts trailing off and touching on other subjects dealing with other types of cognitive dysfunction and IQ reduction that should be discussed in another paragraph in this section.

In summary, it's often claimed by the ECT industry and medical organizations that there is "no" evidence of organic brain damage/dysfunction and this is conspicuously detailed in this article. So if there IS such evidence, and especially given that this is a factual assertion, it's only proper to mention and provide a couple succinct examples of such evidence to avoid BIAS. This paragraph does this in a compact and efficient manner. Danrz 16:38, 23 July 2007 (UTC)

A single study performed on systematically inbred mice (which are acknowledged to behave physiologically abnormally) showing, in the author's own words, a "moderate" decline in neurons in the hippocampus without evidence of apoptotic activity tells us next to nothing about the effect of ECT on neurons in human beings. I'm not discounting the study which has a place in the article, but it cannot be the basis for the long paragraph in currently struggles to support. Until and unless this is replicated in at the very least other mouse strains, it's trivial. Nmg20 18:01, 23 July 2007 (UTC)

No. I added this paragraph to show that there ARE studies providing direct evidence that ECT can cause brain damage or abnormal brain function in animals or humans. The paragraph was intended to make this point and then provide a couple quick and recent examples, one in lab animals and one in humans. The paragraph is already of good length and only gives the amount of detail necessary to prove the point and to make the gist of the studies clear to the reader. I also consider it to be of utmost importance. The paragraph immediately preceding this one states that a number of mental health institutions have concluded that there is NO evidence that ECT causes brain damage. "No" evidence is a strong assertion, and it is completely and entirely false, and this can be stated as a fact and proven. The relevance of this new paragraph for inclusion in this section does not rest upon the precise details of the studies, such as whether the best choice was made for rodent strain (which was the choice of the expert neuroscientists whom most editors here are not). I'm not going to get into a lengthy debate with you on rodent strain, etc, because I feel you've completely missed the boat as to the reason this paragraph was even added. I could have substituted other studies in their place. As far as I'm concerned, this paragraph is crucial in this section and cannot be ommitted while maintaining neutrality. And if you think about it, for patients considering ECT or doctors looking for information, it's really not fair for them to read this page and see that institutions and researchers have concluded there is "no" evidence that ECT can cause brain damage or abnormal brain function in either animals or humans when it simply isn't true. But given that this statement is made in many other places on the web other than Wikipedia, it should be included nonetheless along with evidence disputing this claim. I guess I don't understand what's so hard to understand about this. It's already been explained above more thoroughly and clearly. Justin997 20:31, 23 July 2007 (UTC)

Doh!!!! Not Breggin again. Please, he is not a reliable source for any conclusion that requires scientific support. Breggin is usually cited in articles published in distinguished journals as a social critic. Eg Some social critics like Peter Breggin contend that ADHD does not exist. No one ever uses his research because he doesn't do any original research. Nor does Breggin do a systematic review of the literature. He is a cherry picker who finds data and other tidbits to support a forgone conclusion. He is about the worst source one could use with regards to science.

Like it or not, the APA and the Mayo clinic are totally reliable sources. If you believe that the article has bias then I suggest that you find other reliable sources to support the minority view you believe certain sections should have. I agree with Nmg20. We have great sources and numerous reviews using sophisticated technology and methodology to conclude that there is no evidence that ECT causes brain damage. The unreplicated mouse study is a footnote, if that. It's methodology may have no bearing what so ever on Human ECT. Of prime importance is the parameters of the shock given. Can someone post the methodology?

Finally you can't just go on Pubmed and hobble together a few studies to support an idea. No one has shown how the rCBF study supports the notion that ECT causes brain damage in humans. Folks it's not about being "fair" it's about good solid and reliably supported information. We went to great lengths ( again look at the archive ) to find the best sources on this topic. Had a reliable source such as the Mayo clinic stated that ECT causes brian damage, the article would be different. What was remarkable was how the best sources all came to the same conclusion. Find us an institution some where in this world that supports the minority viewpoint you believe should be in the article. If you add material to an article it is your responsibility to support it. Without that support I will chop that paragraph down to it's previous edited version.--scuro 22:04, 23 July 2007 (UTC)

There either "is" evidence that ECT may cause abnormal structural and functional changes in the brain of animals or humans, or there "is not". It's that simple. It only takes one study to disprove such an assertion. However, there are many such studies. The Russian study is just "one" of them in animals. A person cannot overcome such evidence by referring to secondary sources claiming that no such evidence exists when there is direct primary sources proving that it DOES that we are looking at right now! For that matter, the Russian study reviews the literature and cites other studies showing that ECT causes abnormal structural changes in the brains of animals. The question here is not whether a minority or majority of studies conclude that ECT can cause brain damage. The assertion that was made is that there is "NO" evidence that ECT causes brain damage in humans or animals. This is just plain false, and this has been proven to be false.

Here's another new study. What was that about "no" evidence of brain damage again?

Neurochem Res. 2007 Mar;32(3):389-94.

Effects of maintenance electroshock on the oxidative damage parameters in the rat brain.

Jornada LK, Feier G, Barichello T, Vitali AM, Reinke A, Gavioli EC, Dal-Pizzol F, Quevedo J.

Laboratorio de Neurociências, Programa de Pós-Graduação em Ciências da Saúde, Universidade do Extremo Sul Catarinense, 88806-000 Criciuma, SC, Brazil.

Although several advances have occurred over the past 20 years concerning refining the use and administration of electroconvulsive therapy to minimize side effects of this treatment, little progress has been made in understanding the mechanisms underlying its therapeutic or adverse effects. This work was performed in order to determine the level of oxidative damage at different times after the maintenance electroconvulsive shock (ECS). Male Wistar rats (250-300 g) received a protocol mimicking therapeutic of maintenance or simulated ECS (Sham) and were subsequently sacrificed immediately after, 48 h and 7 days after the last maintenance electroconvulsive shock. We measured oxidative damage parameters (thiobarbituric acid reactive species for lipid peroxidation and protein carbonyls for protein damage, respectively) in hippocampus, cortex, cerebellum and striatum. We demonstrated no alteration in the lipid peroxidation and protein damage in the four structures studied immediately after, 48 h and 7 days after a last maintenance electroconvulsive shock. Our findings, for the first time, demonstrated that after ECS maintenance we did protocol minimal oxidative damage in the brain regions, predominating absence of damage on the findings.

Publication Types: Research Support, Non-U.S. Gov't

PMID: 17268857 [PubMed - in process]

A secondary issue here is whether any modern published reviews of the literature have found evidence of brain damage in animals or humans, because there is also a claim in this article that none have. The answer is "Yes". Aside from Breggin, there are other published papers reviewing the literature and finding evidence of abnormal structural changes in the brain of animals after ECT (case in point, the Russian paper that reviews the literature). And while I am not going to defend Breggin's motives, like it or not your claim that he hasn't done a systematic review of the literature is false. In a recent published review he cites over 170 references, a good chunk of them by the opposing side.

The material is supported. They are primary sources of information from published, peer-reviewed studies, and references and references were provided along with study abstracts. The material should stay as is. Danrz 23:46, 23 July 2007 (UTC)

"There either "is" evidence that ECT may cause abnormal structural and functional changes in the brain of animals or humans, or there "is not". It's that simple. It only takes one study to disprove such an assertion". That is not the way that science works. One study proves or disproves nothing. Several studies also can mean squat. Studies can be flawed in their methodology, their conclusions, or...as you see in Wikipedia often...someone uses a study or more to wrongly support their own conclusion. Science looks for a body of evidence. This body isn't hobbled together with a google search or Pubmed search. When scientists do a review of the literature to assess a body of evidence they look at all the relevant studies about one topic and then draw conclusions from this body of evidence. All the recent major reviews on this topic all support that there is no evidence that ECT causes brain damage.

Simply giving us more studies doesn't support a conclusion. It's not a case of I have more studies so this means it is so. You still have yet to explain how the rCBF study shows how ECT causes brain damage in humans. I have yet to see the conclusion or methodology posted from the Russian mouse study. Please start here first because this is the first bit of support given. Also please don't confuse conclusions from animals studies as evidence that the same thing will happen with humans.

Currently there is no support for the rCBF study in this subsection and it will be deleted without further support. The mouse study also warrents no more then a sentence. Neither study is majority or minority opinion on this topic. Please take the time to read WP:NPOV#Undue weight Wikipedia is clear on this issue. Also I strongly disagree with the way these studies have been used to create bias in the article. Please don't post further studies without seeking concensus in discussion first.--scuro 01:55, 24 July 2007 (UTC)

These studies have been used to prevent bias in the article. The paragraph immediately preceding the new paragraph in the article states that there is no evidence that ECT causes brain damage in humans or animals, and also states that there is no evidence of recent reviews pointing to any such evidence. Both of these claims have been most thoroughly debunked with direct evidence to the contrary and I find your arguments to be specious at best. It is very appropriate to follow-up such sweeping claims with an example from primary sources pointing to brain damage in mice given ECT, and the functional brain scan study in humans showing significantly increased abnormal cerebral blood flow in post-ECT patients. It is not only appropriate, it is necessary for the sake of balanced and unbiased presentation. I might also point out that there are other studies aside from these that could substitute for what's here. These two were chosen because they are so recent and utilized advanced technologies. No undue weight has been placed here by any stretch of the imagination, especially given the preceding paragraph making very bold claims that there is no evidence, no evidence, no evidence, and that the title of the subheading is ADVERSE EFFECTS! I dismiss your assertion as false that there "is no support" for the new human SPECT scan study showing abnormal, compromised cerebral blood flow in post-ECT patients under the heading of "Adverse Effects." In my opinion, it's strange logic to maintain a full paragraph incorrectly professing no evidence when such assertions have been completely debunked with direct evidence, and then attempt to argue that any possible evidence to the contrary "warrents[sic] no more than a sentence." The new paragraph will remain. Justin997 04:21, 24 July 2007 (UTC)

You have got to be joking. The past reviews being, "thoroughly debunked"? I'll say that starkly because it is such a startling statement. Antispsychs like Breggin use that term often and they are always talking through their hat. What a dubious assertion. Really...have you read the reviews? Do you know what a proper scientific review is? You can't simply negate several reviews with a mouse study. These reviews span decades of research plus there is Rudorfer's thorough medical encyclopedic entry on this very subject. The mouse study doesn't "balance the scales" of "bias". Really. The "direct evidence" claim is also out in left field. This study was done with mice. We have one Russian mouse study that no one is even willing to post the methodology of in discussion. The other piece of "direct evidence"? We have the rCBF study which is about blood flow. Wikipedia doesn't work in the way that you envision it to. Wikipedia states in the undue weight policy that, "views held only by a tiny minority of people should not be represented as significant minority views, and perhaps should not be represented at all". What reliable source states that ECT causes brain damage in humans? Post one reliable source that makes that statement. None has been posted so far in discussion. We have Russian scientists but do they extrapolate their findings to human ECT and if they do how do they qualify that? These are very important questions that you need to answer.

The wikipedia undue weight policy states:

• If a viewpoint is in the majority, then it should be easy to substantiate it with reference to commonly accepted reference texts;
• If a viewpoint is held by a significant minority, then it should be easy to name prominent adherents;
• If a viewpoint is held by an extremely small (or vastly limited) minority, it does not belong in Wikipedia (except perhaps in some ancillary article) regardless of whether ::it is true or not; and regardless of whether you can prove it or not.

From my reading of the policy the studies shouldn't even be in the article. It was an olive branch to allow the mice study in the article. It demonstrates paths in recent research. Also the undue weight policy states, "undue weight applies to more than just viewpoints. Just as giving undue weight to a viewpoint is not neutral, so is giving undue weight to other verifiable and sourced statements. An article should not give undue weight to any aspects of the subject, but should strive to treat each aspect with a weight appropriate to its significance to the subject. Note that undue weight can be given in several ways, including, but not limited to, depth of detail, quantity of text, prominence of placement, and juxtaposition of statements". This means the sentence about the mice study should be at the end of the section and of minimum length.

I have first posted and now quoted Wikipedian policy with regard to this section. We have no reliable source, majority or minority opinion, that states that ECT causes brain damage in humans. Time has been given to other editors to demonstrate these standards and it hasn't been done. I see no justification for the new paragraph to stand as is. --scuro 13:58, 24 July 2007 (UTC)

Justin997, you say that the choice of mouse strain is not relevant, and that criticising the expert neuroscientists who chose it is not for us to do. In so doing, you misunderstand the target of my criticism - I'm criticising those who seek to take a piece of research which is looking at the effects of electric currents on specific brain regions at a subcellular level in mice, and look to extrapolate from that to ECT in humans. The mouse strain the researchers is used is not even normal for a mouse, and was probably - I'm speculating - selected because it would give the researchers the best chance of showing the changes they were looking for. Not only does the study have no bearing on humans, it's not even currently applicable to normal mice. My point is that the researchers didn't attempt to claim that it was, and that for you to do so is therefore incorrect.

Put it this way - for you to use this study to say "ECT causes brain damage", you have to be able to cite the authors saying exactly that - and they don't. They say something like, convulsions cause moderate neuronal death in the mouse strain we looked at.

The second study you cite - Jornada et al - I'm very happy to see included. If we include it of course, we must represent it properly - so we should include the following direct quotes from the article:

"M-ECT is a reliable and safe option for patients with psychiatric disorders who are resistant or intolerant to medication" (p.1)

"In our previous studies involving ECS and brain oxidative stress parameters, we are unable to find a significant oxidative stress damage after ECS in rats that received a traditional ECS protocol." (p.2)

"There are a series of reported cases with long periods which were successful, including for instances a 77-year old lady who was given M-ECT for more than 7 years or/and another patient who underwent 1,250 treatments with no clinical evidence of cerebral damage. The findings of this study showing absence of M6 and M7 (greater intervals between sessions) back up this aspect@ (p.4)

"The animal brain is especially sensible to oxidative damages in virtue of its high consumption of oxygen. Virtually, all living organisms can suffer from oxidative damage. In this work, we demonstrate that after maintenance ECS oxidative damage can occur in some regions of brain depending on the time and number of ECS sessions, but oxidative damage after maintenance ECS is not a universal finding in the rat brain." (p.4)

"These results, when observed along with our findings, may suggest that the ECS mobilizes not only glial but also neuronal trophic activity. Its greater efficiency in comparison to other antidepressive treatments may be the result of its capacity to mobilize other cerebral mechanisms." (p.5)

The paper is stuffed with data showing not only that the "damage" they found was trivial, but also with explanations of how this "damage" may in fact explain the greater clinical efficacy of ECT.

I find it staggering that anyone who had actually read this paper could interpret a paper which doesn't look at humans, doesn't look at ECT, and concludes that if found minimal oxidative damage and predominantly an absence of damage as supporting the idea that ECT causes brain damage in humans. Nmg20 16:10, 24 July 2007 (UTC)

Hi. The issue here is very simple. The article currently states there is "NO" evidence that ECT causes brain damage in humans or animals. The article also states that there are "NO" recent reviews that found such evidence. Both of these claims in the article have been proven to be grossly incorrect. Yet a paragraph is devoted to it. Because such fallacious claims are made often however, a paragraph was written pointing out an example of a mouse study pointing to the contrary, and also cited a new study that found that ECT compromises normal cerbral blood flow in humans, possible evidence pointing to brain dysfunction. The information is sound, supported, and appropriate given the subheading and the preceding paragraph that promotes gross misstatements of fact by saying that there is "NO" evidence of brain damage in humans or animals, and "NO" modern reviews pointing to such evidence. (And yes, there are reviews, as has been proven.)

The progression of arguments to the contrary here is quite odd and revealing:

_{1) First the paragraph was too long and was trimmed down and a study removed.
2) Then there's an argument that the two studies don't directly relate to one another and shouldn't therefore be in the same paragraph, even though it's abundantly obvious why they are (to contradict previous paragraph finding "NO" evidence in humans or animals, and provide an example of study finding brain damage in mice, and an example study finding compromised, abnormal cerebral blood flow in humans)
3) Then an argument that this mouse study should only be a minor footnote that no one will read (even though the reason it's there is to provide an example that yes, there IS evidence)
4) Then an attack is made on the design of the study, apparently suggesting that it isn't evidence because of the mouse strain chosen. (which I disagree with, and regardless it's not a wiki editor's place to challenge the mouse strain choice of expert neuroscientists who make this stuff their life's work -- it's their study. Moreover, it isn't the superiority of the study that got it here, it was listed as an "example" that YES THERE IS EVIDENCE IN ANIMAL MODELS OF BRAIN DAMAGE).
5) Then the claim is made that the mouse study struggles to support the paragraph.
6) Then the mouse study is called trivial until it's replicated (even though again it was added as an "example" that YES, there is evidence, not because of overriding importance)
7) Then I pointed out in the talk page that one of the "NO" evidence claims made in the preceding paragraph in the article is that there are no modern reviews finding evidence of brain damage. I proved this claim to be false, and cited to Peter Breggin, a very well-known MD who has written a book on the topic and a recent comprehensive review of the literature citing close to 200 references and finding numerous evidence of brain damage in animals.
8) Then Breggin is personally attacked, apparently suggesting that his published review isn't good enough to disprove the "no evidence in recent reviews" claim, because he's not a "reliable source." (I also point out that there are other reviews finding evidence, including one done in the Russian mouse study).
9) Then in response to me writing that there there either IS evidence of brain damage in animals or humans or there is not, and that a single study stating that brain damage was found in a modern study can defeat the harsh claim of "NO" evidence of brain damage in animals, it's argued that "that's not the way that science works", and "several studies also can mean squat".
10) Then it's argued I can't negate "secondary" sources that found no evidence of brain damage in animals or humans with direct "primary" sources of published experimental studies which found such damage as part of their experiment. (This is not to mention that there are also other published reviews finding evidence of brain damage in others' work).
11) etc.}

In addition to this, it's claimed that this single paragraph briefly showing a couple studies pointing to possible adverse effects (the subheading IS Adverse Effects, btw), violates the Wikipedia policy of undue weight. This is incredibly strange as the paragraph immediately before the new paragraph is entirely devoted to multiple claims of "No evidence" of brain damage in humans OR animals. If a paragraph can be devoted to "No evidence" stating untruths, then one can and should be added afterwards to give a couple of examples of this evidence which is claimed not to exist.

Of course, the real problem here is the paragraph boldly asserting "NO EVIDENCE" with regard to studies in humans OR animals of brain damage. This has been proven to be false. The paragraph also asserts that "NO" modern reviews of the literature have found such evidence by others. This is also false. Ideally, this paragraph should be deleted and both paragraphs should be re-written to point out that the majority of studies find no objective evidence of organic brain damage or dysfunction in humans OR animals, but there are a minority of studies that have found this, including recent studies, and then references should be given. At this point, there is a unreasonable refusal to acknowledge that there is ANY published evidence pointing to brain damage or organic brain dysfunction in animals OR humans. And a whole paragraph is devoted to multiple claims of "no evidence." Because of this, the new paragraph will remain for the time being in order to preserve the quality of the article and educational value of the "Adverse Effects" section. It will also be retained to maintain neutrality, fairness, and balanced perspective. Danrz 20:56, 24 July 2007 (UTC)

I agree the issue is very simple.

(1) Changes in regional cerebral blood flow are not brain damage. They are a perfectly normal part of human (and rodent) physiology, and occur every time you read a letter, turn the TV on, get upset or happy, etc. They are not "brain damage".

(2) Neuronal loss can be brain damage. The sort of neuronal loss you get from a concussion, or from drinking too much alcohol is measurable, but I don't think anyone would look to suggest that getting a minor bang on the head or getting drunk once causes brain damage. Because ECT is an emotive subject in which various groups and individuals are emotionally invested, they may seek to do this.

(3) Neuronal loss in rats or mice which is caused by ECS and described by the authors as being essentially trivial is not evidence that ECT causes brain damage in humans.

Turning to your thoughts on the progression:

(1) I think the paragraph was (per WP:Weight) originally too long and probably still is given the very minor relevance of the rodent studies (which aren't even about ECT) to the topic at hand.

(2) The study on rCBF and rat neuron loss are on different things. Blood flow isn't brain damage and doesn't involve neuronal loss. One study's on humans, one's on rodents. One kills its subjects, one doesn't. One has a control, one doesn't. Etc.

(3) I think the mouse study, for the reasons given above, is trivial to the article, and more to the point it doesn't prove ECT causes brain damage - not in rodents, certainly not in people.

(4) As I have already explained once, I wasn't criticising the design of the study - I was criticising whoever included it here for attempting to use it to prove something it wasn't designed to prove.

(5) I've already covered this - it doesn't.

(6) Proving that A causes B requires replication. You're trying to use a single study to say "ECT causes brain damage in rodents" - there are dozens of studies which haven't found brain damage, and one that does. You would expect 1 in 20 to find brain damage by chance; that's why you need replication (which reduces the risk of a chance finding to 1 in 400, and 1 in 8000 with a third replication, etc). In addition, ECS isn't ECT, so a study looking at ECS can suggest things about ECT, but "ECS causes X" can't be used to say "ECT causes X".

(7) We've dealt with Breggin here before. He's a quack, and is not a reliable source. Scuro has explained why already on this page, and the article on Peter Breggin on wikipedia describes him repeatedly as controversial, part of the anti-psychiatry establishment, and as having been regarded as a crank by courts on several occasions.

(8) Where is Breggin's "review" published? If it's not in a respected, peer-reviewed scientific journal, it's not good enough - and probably not even a review. Can we have a medline link to it, please?

(9) I am not clear who you feel has said this. You only have one study which actually suggests brain damage - rCBF isn't brain damage, and I'm afraid it was a horrible misrepresentation of Jornada et al to claim it did. (In passing, would you care to respond to my extensive quoting from that article to explain why it doesn't support the uses you tried to put it to? This is important in the context of an article where studies have repeatedly been summarised erroneously by those opposed to ECT).

(10) I think the objection here is not to your finding primary sources - it's to your giving one study finding trivial brain damage as much weight in the article as essentially every other one from the past 15-20 years, as summarised in the secondary sources.

(11) etc? ok, etc.

I'd appreciate a response to the above points - please don't just relist your claim that there are published studies showing brain damage as a result of ECT. Could you also cite the specific parts - sections and pages - from the articles which you feel support your claim so I can check what we're reading, as I've done with the Jornada study above? I think that'll help in that we'll both be working from the same specific parts of the text, not just from pieces of the abstract. Nmg20 22:12, 24 July 2007 (UTC)

With regard to the re-draft, I'm going to point out some of the problems. First of all, the studies finding adverse effects in animals have not been tallied, and when quantified with the number 2, it may give the impression that these are the only ones, and there are more. Also, I see no reason to expand beyond the two original studies that were included, aside from providing references for them in brackets. For instance, at the end of the paragraph we can include a sentence like "Other studies have also documented brain damage or dysfunction in humans or animals", followed by numbers in brackets that can bring the reader down to the reference section.

It was complained earlier that this section was too long, with undue weight, etc. Moreover, a number of misrepresentations were made with regard to the study finding oxidative damage. Where it was written that "the animal brain is especially sensible to oxidative damages in virtue of its high consumption of oxygen", this was actually one of the reasons WHY they checked for this type of damage. Oxidative damage to cells actually involves the transfer of electrons, and hyperoxygenation is known to increase oxidative stress. Also, people are animals. When they said the animal brain is especially sensible to oxidative damage, this was inclusive to humans, not exclusive. What they were talking about is the animal brain vs. other organs in the body. For example, when people stop breathing, the major concern is brain damage and death, because it starts to occur several minutes after cessation of oxygen whereas other areas of the body can endure for much longer intervals and recover where the brain often cannot. The animal brain is particularly ill-equipped to fully heal from many types of damage. It's been argued that evolution led to the blood-brain barrier and extra thick skull rather than a brain that is more resistant to assaults and/or has better regenerative capabilities. Furthermore, when I mentioned this study on the talk page, I was not demanding that it be included in the article, nor did I think it was the best choice for an example to contradict the claim of "No evidence." The point of it was that brain damage was documented in this study, whether minimal or not. Again, it's all about the preceding paragraph that states over and over again that there IS NO EVIDENCE. This is false.

Finally, the original draft was much better written and more accurately respresented the findings of the studies in a concise and easy-to-read format. So, I restored it while editing the topic sentence and specifying the mouse strain used in the spirit of cooperation and collaberation with other editors. Danrz 22:58, 24 July 2007 (UTC)

Thanks, Danrz. I'm frankly not interested in repeating myself over and over again a thousand times, especially in response to circular, specious arguments which have already been responded to with very lengthy screeds, and most all of the claims in the criticisms being debunked. In addition to what was written above about the proposed new redraft, I might also mention that the SPECT scan study was ALSO misrepresented in the new draft. The researchers explicitly stated that rCBF was quote "largely normalized" in patients responding to medication but that ECT-treated patients showed significant increases in abnormal rCBF and followed a different path, and the original draft used their own words. The timeline posted above by Danrz really does tell a lot about all this. I'm glad it was posted. When editing material on Wikipedia it is possible for critics to "shoot themselves in the foot" so to speak, by throwing up a thousand different arguments to counter one paragraph, and then expecting hard-working contributors to spend hours and hours responding to never-ending arguments, many of which are nonsensical and not worthy of response. Justin997 23:36, 24 July 2007 (UTC)

(1) "With regard to the re-draft, I'm going to point out some of the problems. First of all, the studies finding adverse effects in animals have not been tallied, and when quantified with the number 2, it may give the impression that these are the only ones, and there are more"

I will ask again - prove it. If you have these studies, post them. Claiming they exist is utterly spurious - and the reason you keep repeating the claim rather than posting links to these studies is that they do not exist.

(2) You claim "Where it was written that "the animal brain is especially sensible to oxidative damages in virtue of its high consumption of oxygen", this was actually one of the reasons WHY they checked for this type of damage." Please prove this by citing where they say this in the paper, including the section and page number.

(3) As I explain above, you cannot use this study to support the idea that ECT causes brain damage in humans or animals, because it doesn't look at ECT. It also repeatedly states - as I have directly quoted above - that it supports the idea ECT does not cause brain damage!

(4) Justin - you may find my arguments "circular and specious" - but they are supported by the studies you have cited, and your claims are not. I defy you to provide evidence - as I asked for above, quoting section and page - from these studies which supports your claims. Please - do ahead and do it.

(5) Regarding the rCBF study, my summary of it was accurate - your gloss attempts to put words into their mouths - they concluded that "Perfusion changes after a response to electroconvulsive therapy may follow a different course", not that they did - in other words, the authors didn't feel their findings supported the claim you are trying to use it to make. That's mispresenting the study.

(6) I've responded to the timeline in detail. Take the plank out of your own eye before going after the speck in mine, please.

(7) If you don't like the idea of hard work, please don't waste the time of those who, like me, are willing to read the actual sources and quote from them rather than misinterpreting pubmed abstracts. I will ask again that you put in the hard work rather than merely talking about it - I am assuming you have read these studies and have access to the full text of them - so please quote from them to support your claims, giving section and page numbers.

The current version of the page is a misrepresentation of the studies it cites for reasons I have outlined above which you continue to fail to address, and is against WP:Weight. Nmg20 15:09, 25 July 2007 (UTC)

Reliable sources for adverse effects addition, where are they?

Words...I happen think NMG20 is bang on once again but what does it matter if others don't agree. There is no consensus here but more importantly there is no reliable source that states that ECT causes brain damage in humans or animals. That request has been made several times and has been consistently ignored. Lets keep it simple. A quotation from a study would have to explicitly link brain damage to all the different forms of ECT to make the blanket statement that ECT causes brain damage. I have seen no citation to an institution, major newspaper, journal on the topic...etc... from anywhere in the world that states that ECT causes brain damage...with or without qualification. Nor do we have a citation from a reliable authoritive individual source. Without that, the whole paragraph must go or drastically be altered. NMG20 gave an excellent account that gave undo weight to experimental findings and it was rejected.

No more, the ball is in your court. The addition is yours and has been strongly contested. Where are the reliable citations?

For the time being I have stuck a POV section tag on this part of the article while we wait for the reliable source. Wikipedia states that only a short time should be granted for these sources to be found, and if none are found the entry should be deleted. I would also strongly suggest that people stop editing this section of the article without first seeking consensus in discussion as also stated in Wiki policy about contentous issues.--scuro 02:58, 25 July 2007 (UTC)

Well, I'm not fooled by any of this. I've visited the ECT page numerous times over the last few months and just noticed the neutrality-disputed banner in the "Adverse Effects" section and then saw the new paragraph. I just spent almost two hours of my time examining this excellent new paragraph, looking at the full text of the studies referenced, and going through the endless sophistry on this talk page. Somehow I doubt many others will be willing to actually go through this endless charade of an exchange on this talk page to see what really transpired here behind the scenes. And that's too bad. Because if they did, there's a good chance they would be as disgusted as I am. Every imaginable (and unimaginable) type of attack has been made on this new inclusion, and a lot of the criticism makes no logical sense whatsoever. I can't believe people actually took the time to respond to all of this empty and perpetual rhetoric. It kind of reminds me of how small children like to play a game by asking a parent "why", and when the parents carefully explain and respond, the child asks "why" again and giggles and the process keeps going..... Only this is MUCH WORSE!! The saying "if you can't win, confuse the issue" comes to mind. Far be it from anyone to actually take a step to make at least a small portion of this article fair, balanced, and truthful.

With regard to the new material itself as added by Danrc, I wouldn't change a thing. And I wouldn't change the studies, either. The real controversy here is with the paragraph preceding the new one which makes multiple claims that there is zero studies showing brain damage in humans or animals, and zero published reviews saying so. People here have went out of their way to show these claims are completely and utterly false. And they have won the argument. The evidence is right in front of us. I've looked at it. So have others. And there's nothing wrong with the sources. The debate is whether there is "any" evidence showing brain damage in animals or humans, and there is. And the mouse study is a good one, and very recently published, and very clear in its conclusion that brain damage was caused by the procedure. Someone actually had the audacity to claim that this study by Russian neuroscientists is not a good source and therefore doesn't constitute evidence. The researchers were accused at one point of intentionally picking a bad rodent strain, etc. It is the opinion of the experts who conducted the study that evidence reveals brain damage. And as far as the false statement that there are no modern reviews finding brain damage in animals or humans, that's also false. Breggin is all that's necessary (even though there are others), and he has published in professional journals and has a doctorate and Harvard education. No one cares what someone's "personal opinion" is of him. The debate is whether or not there is evidence of brain damage in animals or humans, and whether or not there are any recent reviews pointing to any such evidence. And there are multiple studies, and more than one review. These are proven facts at this point. And as far as the SPECT study goes, the paragraph doesn't directly state that the study shows definitive proof of brain damage. It states that it shows a type of brain dysfunction (rCBF) considered to be abnormal by the expert researchers. They DID use the word "normalized" in reference to the medicated patients responding, and said that ECT patients went in the opposite direction. And the whole reason why brain damage is relevant to begin with is because it can cause "brain dysfunction". So, if there is a study showing that abnormal cerebral blood flow can be significantly elevated in patients after a course of ECT, it belongs here in this paragraph as an example. The new text should remain as submitted most recently by Dan.

This article has historically been accused of being grossly biased, and the topic itself is controversial. Looking over the history of contributions and edits to this topic, I can see that there has been possible over-domination by two or three users in particular. Without naming anyone, I'm going to have to put a watch on certain editors to watch what they're doing here and elsewhere. Someone has to. Ali del mundo 05:36, 25 July 2007 (UTC)

Keep your eye on the ball. Where are the reliable citations that flat out state that ECT causes brain damage? WP:RS Everything else at this point diverts our attention from this key pillar of Wikipedia.--scuro 06:04, 25 July 2007 (UTC)

Nor are you fooling me, Ali del Mundo. Your flustered reaction contains no substance or evidence for your position, but plenty of upset rhetoric. It's too bad splinters in the mind's eye aren't reflective. 83.226.251.48 (talk) 21:06, 24 February 2008 (UTC)

You're not fooling anyone. The questions as to your query requesting proof of reliable sources have already been answered, making this query inappropriate. The "reliable sources" for the new inclusion are studies from professional, peer-reviewed medical journals and have been listed in the references from the very beginning with inline citations linking to the list of references at the bottom of the page. Moreover, you yourself contributed to a sloppy, misrepresentative rewrite of this same paragraph posted by NMG20 utilizing the same two sources!!! In effect, you republished these sources for the same purposes yourself! So what you are claiming right now doesn't make the slightest bit of sense, and once again you and NMG20 (as Justin put it) "shot yourselves in the foot", so to speak, by republishing the same two sources for the same purpose. This really is ridiculous. This is not to mention that earlier the two of you were making complaints about undue weight, and then preceded to add yet another study to the two that were already there and make the paragraph even longer! Yet again, you shot yourselves in the foot, contradicted yourselves, and as if that is not bad enough, you forced people to once again respond to nonsensical criticisms. Danrz 11:07, 25 July 2007 (UTC)

Very well put. LOL! Look, Dan, there's really no reason to continue responding to these two. They no longer have any credibility. And every time you or I or someone else thoroughly responds to one of their typically fallacious arguments and debunks it, they just ask it back over again. There never was any central argument to their criticisms. They basically threw up a thousand different arguments to try and keep one small chunk of text out of the article, hoping that at least one of their arguments would stick. I'm tired of this silliness. Justin997 11:42, 25 July 2007 (UTC)

There are two issues here. One being the relevancy of citations to the question that ECT causes brain damage. The second issue is of undo weight. Lets see if we can't move forward in at least one direction. The first paragraph that concludes that there is no evidence that ECT causes brain damage is about half the size of the second paragraph that describes two scientific studies. The first paragraph lets readers know what national institutions such as the Surgeon General and Britain's National Institute for Clinical Excellence think about the question of brain damage. Next we learn what the two most recent major reviews on the question of brain damage have to say. The second longer paragraph mainly contains findings from the two independent studies.

Here is Wikipedia's statementment on undo weight WP:UNDUE:"Undue weight applies to more than just viewpoints. Just as giving undue weight to a viewpoint is not neutral, so is giving undue weight to other verifiable and sourced statements. An article should not give undue weight to any aspects of the subject, but should strive to treat each aspect with a weight appropriate to its significance to the subject. Note that undue weight can be given in several ways, including, but not limited to, depth of detail, quantity of text, prominence of placement, and juxtaposition of statements". Clearly the opinion of national institutions and the authors of the two most recent major reviews on the topic are much more significant than two unrelated studies that don't even assert that ECT causes brain damage. Can we agree on this much?--scuro 14:00, 25 July 2007 (UTC)

Hi, Scuro. I have not read completely all the comments about the controversial recent edition to this article. My speciality is philosophy, such as ethics, rather than the science of electroshock. So, I'm not sure exactly what you guys are arguing about. However, Scuro, your claim that the opinion of national institutions and authors of recent major reviews on the topic are more significant than the opinions of [allegedly] unrelated [and apparently minor?] studies seems to be an appeal to authority, a belief that a claim is true because of the expertise of the claimant, rather than the validity of the claim itself. When I added the citation of Barbara C. Cody, I also was accused of making an appeal to authority, which is a significant accusation. Anyway, I don't know what's happening here, but if you are making an appeal to authority, you should consult the Wikipedia article on "appeal to authority" and understand that that type of belief tends to be a logical fallacy, because the validity of a claim does not depend on the expertise of the claimant. Chris Dubey 15:58, 25 July 2007 (UTC).

Whoa, whoa. Don't use blindly use logical fallacies to discuss the correctness of science or reports of scientific literature. Our entire legal system as well as all of Wikipedia could be debunked as an appeal to authority. Also, if a bum on the street tells me the best way to earn money is in clothespins, I would dismiss him ad hominem. These are both logical fallacies because a DNA analysis expert claiming the semen belongs to the Hugh Heffner and my claim that clothpins aren't lucrative aren't necessarily true, yet they are exceedingly likely, which is why peer-reviewed journals are accepted when somebody's blog isn't on wikipedia. That notion of metaphysical certainty that logical fallacies break is too far divorced from the practical certainty we care about in a wikipedia article.--Loodog 16:15, 25 July 2007 (UTC)

Loodog, I was not discussing the validity of any of the specific scientific studies involved here, which I'm not familiar with anyway. Merely, I was explaining that a person should not base their judgment of the truth or falsity of a claim on the supposed knowledge or skill of the claimant. You are right that probability depends on the situation, which includes the expertise of the claimants, but the truth or falsity of a claim remains independent of how much knowledge is possessed by the person who makes the claim. A claim made by a relatively unknowledgable source can still be true and a claim made by a relatively expert source can still be false . What matters is that people judge the claim itself, rather than the source, whether they judge the source by appeal to authority or ad hominem or whatever other false prejudgment. Chris Dubey 19:46, 25 July 2007 (UTC).

If a person "should not base his judgement of the truth or falsity of a claim on the supposed knowledge or skill of the claimant", then I have no reason to listen to my doctor when he tells me to exercise. Read my last two sentences again.--Loodog 04:18, 26 July 2007 (UTC)

Loodog, you seem to be continuing to engage in a flawed defense of logical fallacies. Your example about your doctor is misleading vividness. But, philosophy aside, you are making overgeneralizations. By the way, accordant to my knowledge, if you were a slave in the United States of America prior to the American civil war, your doctor might have diagnosed you with drapetomania, an allegedly irrational desire for freedom, which is documented in a Wikipedia article at present, and he probably would have called it "science," too, as if that made it rational. What people call science is not always science. As for your suppostion that a person could cite appeal to authority as part of a claim to debunk an entire government, their claim would probably be wrong. Yes, a person could claim that every statement made by a particular government is false merely because the claimant is the government, but such a claim would itself be ad hominem. However, in converse, not every statement made by a government is true merely because the claimant is the government. Examples of governmental leaders who probably lied to their citizenry include Adolf Hitler, Joseph Stalin, and Bill Clinton, as well.

Before the American civil war, slavery was already practical for the government, by the way, but its practicality did not ensure the validity of arguments in favor of it. But we are not debating arguments about slavery. As for "practical certainty," I'm unsure if that's a goal I would want in an encyclopedia, even though it's not a scientific journal. However, I was only making a comment about the logic of a belief about the validity of sources, not the logic of the sources themselves, and, in the end, you and the other full editors should do whatever Wikipedian rules state and what you believe is correct. Chris Dubey 18:27, 26 July 2007 (UTC).

My claim that national institutions and authors of major institutions was needed had nothing to do with truth. It had to do with Wikipedian policy. I get the strong sense that Wikipedia doesn't want primary sources exactly because primary sources are up for interpretation. They want secondary sources because secondary sources have fact checkers or a secondary source is a fact checkers themselves because they are experts in the field. Such a person would need keep abreast in the field. This addition is a prime example of primary sources being synthesized into original research and the pitfalls of citing primary sources. WP:SYN.--18:53, 26 July 2007 (UTC)

Scuro. Okay, that is a good answer. I know my comment was speculation and now at least I know it was irrelevant. Adherence to Wikipedian policy is more important, so I wouldn't want my nitpicking to prevent an editor from following the rules. I trust that you are right about the preferred treatment of primary sources and secondary sources. Whoever made the recent controversial changes should discuss their reasons in regard to the policies. Chris Dubey 19:26, 26 July 2007 (UTC).

You're not sure we want practical certainty in an encyclopedia? Practical certainty is the best any encyclopedia can aspire to. Rational people live by practical certainty. You and I can't be working with the same definitions here. Metaphysical certainty: it is true, and cannot be refuted for any reason. Practical certainty: really, we are certain of nothing in the postmodernist sense, but if we can claim to know ANYTHING we know this. E.x. we have practical certainty that the speed of light in a vacuum is the same from all viewpoints.

A logical fallacy can only revoke metaphysical certainty. E.x. 2 + 2 = 4 is not a metaphysically certain statement if my reasoning is "my professor told me". On the other hand, the logical fallacy appeal to authority is not dismissed as just a fallacy in a court of law because crimes and punishment don't take place in abstract logical bullshitland, but in the real world. Wikipedia bases its featured articles on (among other things) what has comprehensive authoritative sources. FAs have no more metaphysical certainty than a stub I start that says "All cows are green", yet the practical certainty any FA has over that is leaps and bounds even though my grounds are appeal to authority.--Loodog 19:45, 26 July 2007 (UTC)

User:Ali del mundo - you're too convenient. Please don't any of you take it personally - see WP:SOCK for why - but I've listed the three of you under suspected sock puppets. Once again, please don't take this personally - I will be quite happy for you to list me there with scuro, for instance - but I have had my time wasted by sock puppets in the past, and do not wish to have the current episode drag out longer than it needs to.

Regarding the current state of the article, I think it best at this point if we get the mediation cabal involved, unless one of the three of you is willing to provide evidence from the studies you are attempting to use - or misuse, in my opinion. Nmg20 16:15, 25 July 2007 (UTC)

Oh, the mediation cabal now, eh? It only makes sense that you'd request that after you've attacked the new short inclusion in every other possible way conceivable: from format, to placement, to length, to content, to the studies listed in the paragraph, the integrity of the researchers, the methodology used by the researchers, etc, etc. Then when you fail to make any progress on these, you start going after the contributors themselves, and flagging all manner of miscellaneous wikipedia policy doctrines like the ones for undue weight, reliable sources, synthesis, reliance on primary sources, etc. And now after all of this (which is plainly revealed in the histories and on this page), you want mediators to dive into this bottomless pit that you created? One of the most amusing arguments here are the arguments of undue weight and unreliable sources, because as Danrz said earlier, you yourself rewrote the entire paragraph and lengthened it, keeping the same conclusions and the very same sources and even added an extra source. Mediation is appropriate in cases where each side has non-frivilous, opposing, justified and genuine concerns. Mediation is not appropriate for dealing with people who will go to any length simply to have their way, no matter what it takes or whether or not they're justified. Justin997 22:23, 25 July 2007 (UTC)

I'm a way I'm glad that some editors have been so unreasonable and haven't attempted consensus at all. It has made me research Wikipedian policies that would have been useful in previous disputes with other editors and I'm sure will be useful in future disputes. In particular the policy of synthesis and primary sources which are great polices for those who attempt to insert unwarranted conclusions into articles. My whole beef all along has been that no institution or expert in the field has stated that ECT causes brain damage.

NMG20 tried to find the middle ground by giving far too much breadth to these studies that didn't examine brain damage with regards to ECT. Isn't that ironic that now you use that as an argument for inclusion. He did a nice of job of explaining those studies and he certainly didn't draw the same conclusion that now, or previously stood in that section. Justin, you haven't given an inch to a position that is unsupportable. What else can be done but a mediation cabal?--scuro 11:56, 26 July 2007 (UTC)

Synthesis of published material serving to advance a position

Paragraph in question from Adverse Effects section on main page:

• Although the majority of studies have found no evidence that ECT induces brain damage in humans or animals, there is modern evidence in the literature of brain damage in animals and compromised cerebral blood flow in humans following ECT. In 2005, Russian neuroscientists used sophisticated techniques to look for brain damage in BALB/c mice after electroconvulsive shocks at an intensity and duration that would correspond to modern ECT in humans. The researchers found "direct evidence that there are moderate (up to 10%) but significant levels of neuron death in defined areas of the hippocampus", and that the "main cause of neuron death is convulsions evoked by electric shocks."[47] In addition, a human study published in July, 2007 found that post-ECT patients showed significant increases in compromised regional cerebral blood flow (rCBF), as revealed by functional brain imaging (SPECT). Patients diagnosed with major depressive disorder often show mild hypoperfusion. The researchers used SPECT imaging to compare brain function in depressed patients prior to, and after a six week course of ECT. For comparison, the same testing was performed on healthy controls and depressed patients treated with standard antidepressant medication for six weeks. The results of the study found that the mild brain hypoperfusion "largely normalized" after a successful response to medication, but that there were significant increases in abnormal cerebral blood flow in post-ECT patients responding to therapy.[48]

WP:SYN Editors often make the mistake of thinking that if A is published by a reliable source, and B is published by a reliable source, then A and B can be joined together in an article to advance position C. However, this would be an example of a new synthesis of published material serving to advance a position, and as such it would constitute original research.[2] "A and B, therefore C" is acceptable only if a reliable source has published this argument in relation to the topic of the article.

and...

Although most articles should rely predominantly on secondary sources, there are rare occasions when they may rely on primary sources. An article or section of an article that relies on a primary source should (1) only make descriptive claims, the accuracy of which is easily verifiable by any reasonable, educated person without specialist knowledge, and (2) make no analytic, synthetic, interpretive, explanatory, or evaluative claims. Contributors drawing on primary sources should be careful to comply with both conditions.

The cited primary sources have several obvious Wikipedian flaws.--scuro 20:06, 25 July 2007 (UTC)

1) There was no synthesis in this new paragraph. The topic sentence of the paragraph simply states that there is evidence in the literature of X and Y, and then gives an example each of X and Y. That is not synthesis. X= brain damage (in animals), Y = abnormal cerebral blood flow (in humans).
2) The second policy copied above is about articles or sections as a whole "relying predominantly" on primary or secondary sources. You do know what "relying predominantly" means, don't you? Moreover, multiple secondary sources regarding the same issue of evidence in the literature for brain damage in animals were listed in the previous paragraph. Justin997 21:55, 25 July 2007 (UTC)

"Although the majority of studies have found no evidence that ECT induces brain damage in humans or animals, there is modern evidence in the literature of brain damage in animals and compromised cerebral blood flow in humans following ECT."

That certainly looks like you are using the conclusions of two studies that didn't examine if ECT causes brain damage, to in fact, support the notion that ECT does cause brain damage. Sentence #2- I think you are saying that is okay that the questionable paragraph used only primary sources because the previous ones didn't. That's a very original defense for inclusion! :D--scuro 12:16, 26 July 2007 (UTC)

Warning to editors and readers at large regarding sophistry:

Please read the "modern usage" section of the page sophistry to understand the basis of my position here with regard to these character(s). Sophistry has many variations and levels of expertise, and in this case involves the intentional crafting of deceptive and illogical claims that put the opponent in a perpetual state of defense. The fallacious logic is often immediately recognized by the opponent, but often not by outsiders not deeply involved with the exchange. The sophist does not concede to the superiority of logic made by the opposing party in response, but rather continues to make further logically deceptive remarks in response along with demanding and unnecessary queries, which typically infuriates the opponent with the hope that the opponent will get himself into trouble due to his own outbursts. Sophistry in this particular case also involves intentional misrepresention and equivocation of the results of scientific studies, forcing the opponent to exhaustively correct and defend. On Wikipedia, sophistry can be used as an ultimate means to unjustly prevent what's loosely referred to around here as "consensus", and to also create what looks to be a genuine, good-natured hot debate on the surface where there really is none. In short, people with no proper justification for changes they want made to a page can use sophistry and abuse the mediation process into either forcing an exhausted opponent to concede or to force an unreasonable compromise, such that they ultimately are allowed to publish disinformation to the community. It has been suggested that this page is at high risk for industry-funded manipulation of page content given the recent developments and publications in this area, and the sheer number of visitors to Wikipedia. (See the above argument about synthesis, etc, for one of seemingly countless examples. (Of course this is not synthesis, as Justin pointed out with logical analysis, and as anyone with a formal education in writing could tell you). Many more examples in the talk page section of "2005 Russian study and 2007 rCBF study".) Danrz 00:30, 27 July 2007 (UTC)

With WP:Good faith firmly in mind, there comes a point where you have to draw a line. I have repeatedly asked you or Justin to demonstrate that you have actually *read* the papers you are citing and using to advance your position here and in the article. I see no evidence - no quotes from the text, no understanding of the study design, no details of the conclusions they drew - to show that you have, and until you can demonstrate you've actually read the things, accusing other editors of "sophistry" is as comical as repeated claims that you have "pointed [things] out with logical analysis" without any reference to this putative logic.

Prove me wrong. Quote from those papers, as I have asked numerous times above, citing section and page numbers. Until then, don't accuse those of us who've actually read these papers of sophistry for having done so.

In response to Justin, the appropriate guideline for citing sources in a medical article is WP:MEDRS, the reliable sources section of WP:MED, the Wikiproject:Medicine. This specifically warns against precisely the sort of editing you and Danrz are inflicting on the article:

Using primary sources to "debunk" the conclusions of secondary sources

Individual primary sources should not be cited or juxtaposed so as to "debunk" or contradict the conclusions of reliable secondary sources, unless the primary source itself directly makes such a claim (see Wikipedia:No original synthesis) Controversies or areas of uncertainty in medicine should be illustrated with reliable secondary sources describing the varying viewpoints. Nmg20 03:30, 27 July 2007 (UTC)

Oh, no.... You're the one making the one making the claims here. If you claim the addition of the new paragraph violated the above policy then make out your case and explain why and show how. Justin997 03:25, 28 July 2007 (UTC)

Warning to Danrz

"It has been suggested that this page is at high risk for industry-funded manipulation of page content given the recent developments and publications in this area, and the sheer number of visitors to Wikipedia". You are violating the Wikipedian policy of good faith. Funny that earlier you accused me of not being well read enough to even know how to spell the ECT researcher Sackeim's name, yet now I am an industry funded manipulator of Wikipedia? Persist with this sort of weasely name calling and I shall take action. --scuro 04:14, 27 July 2007 (UTC)

Hi folks! Here's a great example of sophistry along with misrepresentation! If you have not already, please read my explanation of sophistry above.

The complainant is asserting that I have engaged in "weasely name calling", by calling him an "industry funded manipulator."

However, if you read quoted the sentence itself, you'll notice that the sentence simply states that the "page" is at "high risk" for something. I never said anyone did anything in this sentence. I never even said anything happened to the page either, for that matter. I said the page is at "high risk." And I never called a name in this sentence. Moreover, I said "it has been suggested", meaning that it's ambiguous as to who even suggested this to begin with.

Please note how this process works through the crafting of deceptive and illogical assertions, and how it is intended to place the opponent in a perpetual state of defense in order to refute the fallacious argument. Now, see, after the fallacious argument is debunked/refuted, the process starts right back over again with more fallacious claims! We should invite the editors from the logic and philosophy pages over, and get some popcorn!  :-) Danrz 06:12, 27 July 2007 (UTC)

"It has been suggested" that Danrz is far too close to this topic and should let it go. Keep your cool my friend. WP:COOL--scuro 11:51, 27 July 2007 (UTC)

Whoa, folks. Replying to perceived subtext is not sophistry unless it's disingenuous, which I don't believe it is here. As was wonderfully articulated in your warning to all editors, personal attacks, including calling each other sophists, do not build a useful discussion.--Loodog 12:16, 27 July 2007 (UTC)

Strange logic. The whole point of sophistry is to prevent useful discussion by forcing the opponent to respond to circular, deceptive, fallacious assertions. There is no building useful discussion with a sophist, which is why it must be exposed where there is clear evidence of it occurring and others warned so they don't fall victim to it. Sophistry is a particularly nasty form of social incivility. And the civil thing for a person to do is to warn everyone else where he has clear and convincing evidence that it is occurring, as is the case here.

And might I point out that we have three usernames on this page, all of whom appear to be supporting one another, and all employing the continuous use of fallacious logic in most every posting they make to this page? What are the chances?? This includes you, Nmg20, Scuro. Chris Dubey stated above, "you seem to be continuing to engage in a flawed defense of logical fallacies." And he was correct. Justin997 17:54, 27 July 2007 (UTC)

Look, this has gotten way the hell too personal for anyone to be able to distance himself from. Could any further comments please be directed toward the article?

To that end, I propose that the statement about compromised cerebral blood flow be removed. If you read the summary of the source, this was not said. It only says that while blood flow in response to pharmacological treatment normalized, the response to ECT "may follow a different course".--Loodog 18:26, 27 July 2007 (UTC)

That is what it says. And that's not what "may follow a different course" means. It states directly in the abstract that, "A response to medication was associated with normalization of rCBF deficits, whereas a response to electroconvulsive therapy was associated with an additional rCBF decrease in the parietotemporal and cerebellar regions bilaterally." In the full text, it calls the reduced rCBF after the ECT series a quote, "finding of reduced brain function." "[M]ay follow a different course" refers to the uncertainty of the future, and they suggest that researchers may wish to repeat and expand on the results of this study by checking to see if the rCBF improves or gets worse months down the road and "document the course of rCBF changes"; i.e. check to see if the reduced brain function gets better worse, or stays the same over the long term. Justin997 21:19, 27 July 2007 (UTC)

Justin - Chris Dubey is an editor with whom I believe I share a mutual respect. While we're both confident we disagree about many aspects of ECT in principle, in practice we've achieved consensus despite this. I've done this with pretty much every editor of the article thus far apart from you, Danrz, and the mysteriously-silenced Ali. So don't presume to speak for other wikipedia users (Chris Dubey stated above, "you seem to be continuing to engage in a flawed defense of logical fallacies."); your time would be much better spent reading the articles you are trying to talk about rather than just their abstracts. In all your bluster - all of it - you still haven't posted anything from any of the articles involved here. Just the abstracts.

I'm not around now until October - I can hardly wait to see what the article looks like then. Play nicely. Nmg20 02:27, 29 July 2007 (UTC)

More sophistry. You are inentionally making false claims with the attempt to get readers to accept your claims without verifying them. Justin didn't speak for anyone, he quoted someone. And he made no representations outside of the meaning of the direct quotation. Justin also quoted from the full text of a study right before your reply, and you know this. And you tried to publish a pargraph to the page that was full of either ignorant or deliberate misrepresentations of the oxidative damage rodent study. And I thoroughly disproved and exposed your ridiculous representations of this material. And you're the one posting bluff and bluster here. You're the one making the claims, as Justin noted. You're not fooling anyone except yourself and whatever other usernames you may have on this page. Sophistry is a game often played by very intelligent but disreputable people. However, you miss out on the first of these attributes, and thus lack the skill to do it effectively. Danrz 04:10, 29 July 2007 (UTC)

whatever.....--scuro 04:34, 29 July 2007 (UTC)

Whatever, indeed. You and the other usernames have been engaging in the exact same type of fallacious argumentation in the exact same manner. Danrz 06:51, 29 July 2007 (UTC)

"Sophistry is a game often played by very intelligent but disreputable people. However, you miss out on the first of these attributes." Danrz, play nice. A direct insult against another user (which that is), violates Wikipedia:No personal attacks as well as Wikipedia:Civility. Please Don't be a dick.--Loodog 13:21, 29 July 2007 (UTC)

It's pointless to communicate. There is absolutely no give whatsoever on any single point. Everthing is contested with no attempt at compromise. Contrast that to say NMG20's attempts at appeasement. He(they) is{are} so unlike any other editor(s) that I have ever seen. Even Staug23 who felt very strongly about this topic would give when it was obvious to do so. In the fall when NMG20 comes back we will simply request the mediation cabal and the section will obviously be removed. Till then don't waste your time communicating. There are plenty of things still to be done with the article.--scuro 14:06, 29 July 2007 (UTC)

I'm nearly back, and at least have decent internet access. Is this debate still ongoing? It looks very much from the posts above as if the "debate" has continued to consist of all evidence being met by a steadfast refusal to engage with it and by vague appeals to "sophistry"... Nmg20 17:07, 25 September 2007 (UTC)

I have heard nothing from Danrz. I'll delete the passage to see if still wants to take this to a mediation cabal.--scuro 19:45, 25 September 2007 (UTC)

People treated with ECT - additions

David Helfgott (pianist portrayed in the film "Shine") Janet Frame (author of "An Angel at my Table")

Hello user 124.177.108.153. Additions to the list are welcome. Since this new information is about people it is best if you find a reliable citation that supports these claims.--scuro 11:57, 28 July 2007 (UTC)

People treated with ECT - delete section

This is just a laundry list that doesn't add much to the article. Anything of value in this section should be moved into the main article, and the section should be deleted.--Mumia-w-18 (talk) 13:17, 29 December 2007 (UTC)

fictional depictions of ECT

The fictional depictions of ECT section is a list and Wikipedia doesn't want lists. What should happen to this section is that either it be trimmed to a few notable depictions as in the nonfictional section, or it should be the basis of a new article and the information should be moved there. --scuro 20:19, 28 July 2007 (UTC)

Any preference...skim it down into paragraph form of notable depictions or move it?--scuro 04:37, 29 July 2007 (UTC)

What are the most notable depicts of ECT?--scuro 16:28, 29 July 2007 (UTC)

Placebos...

In a 2006 critical article, in the journal founded by Peter Breggin, and the officical ICSPP journal, Ethical Human Psychology and Psychiatry, psychiatrist and researcher Colin A. Ross, the author reviewed the placebo-controlled literature on ECT and found that, 1 month following treatment, ECT was not shown to be more effective than placebo in any studies. Further, many studies also failed to show ECT as being more effective than placebo during treatment.

Question: how in the hell do you design/administer a placebo ECT? Or were they comparing it to a pill/shot/whatever form placebo? --Lode Runner 09:51, 15 August 2007 (UTC)

The big clue here is that the study was published in Peter Breggin's "scientific" journal. Take a look at Breggin and all becomes clearer. Then one also has to ask, what is Ross doing publishing in Scientology's Freedom Magazine? http://www.freedommag.org/english/vol36I2/page16.htm. Ross was also the one who defended scientology from the recent BBC expose. http://digg.com/world_news/BBC_Scientology_documentary_Watch_it_in_full_online?t=6685752 I believe he has also received an award from Scientology. Have I made the point that the study could be biased?--scuro 13:00, 15 August 2007 (UTC)

The guy also wasn't actually doing any first-hand research so much as reinterpretting previous data.--Loodog 13:05, 15 August 2007 (UTC)

Move to delete passage?...it all reeks of quackery.--scuro 13:24, 15 August 2007 (UTC)

Do a google search for "ECT placebo" and you'll find tons of literature confirming the effectiveness of ECT, like this one, this one or page 15 here. Every study I've found shows ECT far more effective than medication, which is, in turn, far more effective than placebo. Agree with removal as per WP:UNDUE.--Loodog 14:04, 15 August 2007 (UTC)

So the "placebo", then, is an inert pill? If the passage is retained, I think this needs to be made clear, because placebo-controlled studies are meant to duplicate the superficial aspects of the tested treatment as closely as possible. Obviously, taking a "sugar pill" isn't ANYTHING like being shocked into having a seizure. I'm not saying that the comparison is *entirely* without merit, but at the very least it's pretty misleading. Saying that the ECT is more effective than medication (which in turn is more effective than placebo medication) is COMPLETELY DIFFERENT from saying that the ECT has been shown to be more effective than a placebo, because a placebo ECT would have to trick the patient--and ideally the doctor as well (hence the term "double-blind" study)--into believing he/she had been severely shocked. (For comparison, the term "placebo" has also been used to describe "fake" surgery, where the patient is put under anesthesia and cut open but not operated on--and yes, with placebo surgery there is a significant improvement over patients who've had no surgery at all.) In this case, it would probably be impossible to achieve (how on earth do you convince someone they've been severely shocked without actually shocking them?) thus a true placebo-controlled ECT study isn't actually possible, and the article shouldn't imply otherwise.

I have no opinion on any other issues that might remain, such as whether or not the entire passage should be stricken. The term "placebo-controlled", however, is blatantly false unless someone actually constructed a placebo-ECT experiment. --Lode Runner 18:31, 16 August 2007 (UTC)

A placebo for ECT wouldn't obviously be a pill. I think the closest you could get is take half your patients and sedate them without administering ECT. Take the other half and actually give ECT. Which is basically the sham surgery you can do. Problem is, from the depictions of ECT on the page, it seems you would feel very different afterward so as to be able to tell if you got zapped or not.--Loodog 19:59, 16 August 2007 (UTC)

Tenses

The paragraph beginning with "In 1976 Dr. Blatchley demonstrates the effectiveness" suddenly switches from the previously used past tense to the present tense which seems wrong to me. The following paragraph also uses the present tense while it seems to me that most of it should be past tense. Scatteredpixels 02:55, 25 August 2007 (UTC)

article structure 2

Previously NMG had suggested this structure for the article. No one had questioned it.

1. Introduction
2. Indications (who gets it, when, and why / at what point ~=Section 5 When is ECT used?)
3. Administration (section 1, Treatment procedure plus 4, the unedifyingly titled "ECT machines", and 9 Current use)
4. Adverse effects (combo of sections 7 Side Effects and 8 question of structural brain damage)
5. Mechanism of action (section 3 Mechanism of Action)
6. Legal status (Pull out relevant stuff from section 9, section 10 informed consent, section 11 involuntary ECT and perhaps section 12 history)
7. History (section 12)
8. Role in culture (with subsections covering sections 13-15)
9. References

I have attempted to make the article conform to this structure by moving information into the the proper subsections and removing excess titled subsections so that the article does not appear too cluttered. This is a work in progress and I hope that other editors will help with further organization of the material. --scuro 13:30, 9 September 2007 (UTC)

Alternatives?

What about a section (or at least mention) on alternatives, such as transcranial magnetic stimulation or vagus nerve implants?--Gloriamarie 18:21, 11 September 2007 (UTC)

ECT is not a first line treatment. Typically it is used when medication fails or can't be used. You could call ECT an alternative treatment to medication. As I understand it the treatments mentioned above are fringe treatments and as such should warrent no mention in this article. Do they not warrent their own article?--scuro 11:38, 12 September 2007 (UTC)

hi, my name is jon. ive had 72 treatments71.192.55.220 15:56, 26 September 2007 (UTC) i guess people dont post too often. anyway, ECT has helped me immenseley & as time goes by, i get memories back. ive also learned how such a contaversial & often misunderstood procedure, can help so much. if people educated themselves, they wouldnt be such skeptics. Cheers & positive thinking.71.192.55.220 15:56, 26 September 2007 (UTC)

different forms of ECT

There have been a number of different types of ECT offered over the years and at present there are still several types of ECT used. They have different outcomes and side effects. Mention of the different subtypes is made throughout the article. I'd like to create a new subsection about this but don't know what to call it or where to put it in the article. Does anyone else feel that this topic deserves a subheading and have further input?--scuro 11:56, 28 September 2007 (UTC)

Yeah, I agree with making the new section. If nothing else, a decent title for it would be "Subtypes of ECT."

I also feel that voluntary electroshock and involuntary electroshock should be considered different subtypes, but I have no scientific sources to show that they have different usual effects. It's just a thought; I won't beg for that.

Anyway, I approve.

Chris Dubey 19:15, 29 September 2007 (UTC).

Before we put this in, can we agree how it'll work? I think one of the few areas of agreement on the article is that the new structure put in place by Scuro makes it a bit easier to read and indeed manage - so how would you both (and any others with a view) see it fitting in? I could see a case for adding a new section before "indications" - maybe titled "subtypes" or perhaps the more general "classification", and then dealing with each separately through the article. Alternatively, we could include a subsection at the end of relevant sections outlining differences - so administration would be different for different types and so would warrant being split into subsections, but role in mass media probably wouldn't except to mention which subtype was used.

I'm in favour of the idea - just want to clarify how to do it without encouraging bloat! Nmg20 09:53, 30 September 2007 (UTC)

In the "Administration" section, Paragraph 2 specifies some of the subtypes, so the new subsection should certainly be added there. Then, any mentions of the subtypes in the other sections could be expounded upon with their relationships to the topic of that section. Chris Dubey 23:31, 5 October 2007 (UTC)

I agree that administration would be the logical section. The voluntary/ involuntary issue is handled in the legal section of the article. I'd be very surprised it there is any study looking at different types of outcomes based on that issue so I don't think the administration area is the place to put such information.

My first thought after reading your responses for a title was: Treatment Classifications...Sackheim uses, Treatment Technique...Rudorfer uses, Treatment Practices, to talk about all the parameters of treatment.

How much do you write in such a section? You would want to see the difference between each type clearly explained, the history of use, most popular, and current trends/best practices. Side effects I guess could be left for the adverse effects section. That's my 2 cents worth.--scuro 01:53, 6 October 2007 (UTC)

The issue of "brain damage" and user Mark v1.0's deleting of sentence in intro

Mark v1.0 has now twice deleted this statement from the into: "It is widely accepted that ECT does not cause brain damage". He has now personally been asked to discuss the issue in talk. The issue has been previously discussed at length and is supported with numerous citations from excellent secondary sources further down in the article which is included below. The intro should be a synopsis of important information from the article.

A number of national mental health institutions have concluded that there is no evidence that ECT causes structural brain damage. A report of the United States Surgeon General states, "The fears that ECT causes gross structural brain pathology have not been supported by decades of methodologically sound research in both humans and animals". All of the recent scientific reviews on this topic which reviewed the body of ECT research using autopsies, brain imaging, and animal studies of electroconvulsive therapy, have also concluded that there is no evidence that ECT causes brain damage. Current research is examining the possibility that, "...rather than cause brain damage, there is evidence that ECT may reverse some of the damaging effects of serious psychiatric illness"

Do you have something to share with us Mark that would warrant the deletion of the sentence in the intro?--scuro 15:47, 20 October 2007 (UTC)

Without further input I will be reverting Mark's deletion.--scuro 00:09, 21 October 2007 (UTC)

"share with us" you wrote and didn't give me 24hours . This is with one person, you Scuro. I don't see any other people writing about it currently. You asked to discuss in talk, the deletion. Contradictory statements do not need to be discussed, but acted upon. The two statements: One "It is widely accepted that ECT does not cause brain damage" and two "Certain types of ECT have been shown to cause persistent memory loss". These statements oppose each other. One has to go. Which one is correct?

Does ECT cause persistent memory loss? Yes.

Is it widely accepted that ECT does not cause brain damage? Yes as well.

The problem now is the definition of the term/phrase "brain damage". Can we agree memory is in the brain? Can we agree what damage is? I will be reverting Scuro's choice. --Mark v1.0 13:06, 21 October 2007 (UTC)

Nice to see you on the talk page Mark.

What we agree upon:

• i)Memory is in the brain.
• ii)Brain damage is the destruction of a significant amount of brain cells.

Possible points of disagreement:

• i)Memory loss or even persistent memory loss always=brain damage.
• ii)All forms of ECT cause persistent memory loss.
• iii)There is a body of evidence that supports that ECT causes brain damage.
• iv)There is any evidence that modern ECT causes brain damage.
• v)Sackeim states that ECT causes brain damage.

Disruptive editing http://en.wikipedia.org/wiki/Wikipedia:Disruptive_editing#Dealing_with_disruptive_editors The third step in the disruptive editing process is to seek input from other editors. Their input would be welcome now.

We have a statement that now has been removed for the third time by Mark v.1.0. The statement is supported by text in the article which is supported by highly esteemed national health institutes from the US and the UK. The statement is also supported by the most recent scientific reviews on the subject.

If two editors disagree on a subject consensus should be sought WP:CONS and unilateral editing should be avoided. I look forward to your response and the response of other editors.--scuro 14:09, 21 October 2007 (UTC)

An earlier draft that was shortened for the article.

Mental health institutions and recent research has overwhelmingly concluded that there is no evidence that ECT causes brain damage. A report of the United States Surgeon General states,"The Fears that ECT causes gross structural brain pathology have not been supported by decades of methodologically sound research in both humans and animals".[7] The American Psychiatric Association also states,"Researchers have found no evidence that ECT damages the brain"[8]. Current research has not found any evidence of brain damage. Rudorfer et al, in a significant review within the second edition (2003) Psychiatry concluded,"...that ECT does not cause brain damage".Sackeim et al., in several recent studies concluded that while memory impairment is a possible side effect, that even when it rarely lasts for long periods, "the memory impairment does not interfere with with mental functioning or cause persistent deficits in the formation of new memories or disrupt with basic cognitive functions such as intelligence". Coffey et al., using magnetic resonance images stated, our results confirm and extend previous imaging studies that also found no relationship between ECT and brain damage. In a review of the literature Devanand et al., stated, "There is no credible evidence that ECT causes structural brain damage.". The review examined these areas: auopsies on ECT patients, cognitive side effects, structurial brain imaging, animal studies of electroconvulsive shock, heat generation, and blood brain barrier disruption. They concluded that ECT induced cognitive deficits are transient. They dismissed early studies as methodologically flawed, with an additional discussion of more recent studies using CT and MRI scans and concluded that no evidence of structural brain damage as a result of ECT has been found.

--scuro 03:08, 22 October 2007 (UTC)

---

"response of other editors" wrote scuro. I concure a third party is necessary.

With your text here you always quote your expert supporting no brain damage. I'll quote the only expert I know of who's online

Dr.John M. Friedberg.

"The minimum, or threshold amount of energy, - 20 Joules (more for the elderly) necessary to trigger a convulsion is damaging, typically producing an organic brain syndrome usually limited to amnesia and apathy (or in 10 per cent, euphoria) but there have been numerous documented instances of acute cerebral hemorrhages and infarcts, ongoing cognitive problems, even spontaneous epileptic seizures both acute and chronic." --Mark v1.0 13:04, 22 October 2007 (UTC)

Dr. Friedberg would be considered fringe opinion. His speech at the Szasz Symposium entitled, "The Myth of Mental Illness" would put him outside majority and minority opinion in the field of ECT. What he states is irrelevant to this article except perhaps in a controversy section. By no means should anything he states be given any weight with regards to the article. Mark v1.0, unless you provide good citations I see no reason not reinsert the sentence,"It is widely accepted that ECT does not cause brain damage"., and will be doing so shortly. Furthermore, the continued removal of this sentence will be seen as disruptive editing and shall be reported.--scuro 15:58, 22 October 2007 (UTC)

---

ok forget Friedberg. I am sure you don't aprove of ect.org either.Electroconvulsive Therapy Causes Permanent Amnesia and Cognitive Deficits

[Brain_damage]defined here at wiki.Brain damage or brain injury is the destruction or degeneration of brain cells.

You personally admit [memory] can be lost from ECT? Memory is some kind of brain cell and ECT does something to the cell. What does ECT do to the cell? --Mark v1.0 02:19, 23 October 2007 (UTC)

Mark v1.0, I can be very reasonable. Simply lets do this by the guidelines of Wikipedia and this can be a good experience for both of us. Of course playing by the rules means that you can't use ECT.org because it is a personal website. What you can do is look on it for information and then find the original source documents which could be used on this article. The only difficulty I see here is that this issue has been extensively researched and it really doesn't look like ECT causes brain damage. But who am I? Certainly not an expert in the field or even someone with a scientific background. So it doesn't matter what "I admit", it matters what the article demonstrates through excellent citations.

Memory is an interesting topic. Certainly ECT does interfere with memory and it does look like certain forms of ECT can permanently erase memory. Is that brain damage? I don't think so but hey, I could be wrong. Can I recommend that you research memory? Make sure to stay away from the anti-psychiatry websites, honestly their bias is usually blinding and I think you could find good information on wiki approved websites. In the end you would make this article a better article. The research may not give you exactly what you want but I have found that if you work within the Wikipedia system, it teaches you many things that are far more valuable then simply expressing a stated opinion.

I'm not totally pro ECT, it's just that I am forced into that position far too often by people who play outside of the rules. Heck, I'd rather be learning about memory loss myself and improving the article, then playing cat and mouse. Take a look at the section above, I have plans to develop that section when I have time and it certainly won't be pro ECT, that is a section where you will see some warts. I'll make you a deal, restore the deleted sentence and we can work together to research the topic.--scuro 03:29, 23 October 2007 (UTC)

scuro ;You think losing memory is not brain damage. Memory is a great deal of who a person is. If I erased YOUR memory we could no longer have this discussion. We agreed memory is in some kind of physical cell in the brain, something happens to the cell from the electricity. This meets the definition of [Brain_damage]

To propagate the belief ECT does not cause brain damage is wrong. History, it is said, is written by the victor, and as you have very well demonstrated , psychiatry does not admit losing memory as being brain damage. --Mark v1.0 13:24, 23 October 2007 (UTC)

Again I am no expert by any means, but as I understand it memories are not stored in individual cells but instead, they are paths made through neurons and this interconnectedness creates memory. Is that right, and if so how does that work, is currently beyond my understanding. If we are looking specifically at ECT and brain damage, what exactly is occurring? How do we temporarily lose a memory or permanently lose a memory? Does it have something to do with a disruption of this neural path and can the path reconnect in some instances to restore the memory? Great questions to start exploring the subject. I really don't feel the black and white depiction of brain damage that you laid out is accurate. Avoid the judgements and the characterizations and instead let information be your standard. When you find good information usually it can be supported by excellent secondary sources.

I still haven't seen any credible support for the notion that ECT causes brain damage. Could you make that the focus of your next entry?--scuro 16:03, 23 October 2007 (UTC)

Mark v1.0 - Scuro was absolutely right to revert your removal inside 24 hours. WP:REF states that if a claim is "doubtful and harmful" to the whole article, it should be removed straight away. As I've just posted in my edit summary, that intro and indeed the rest of the article is the product of a lot of hard work from both pro- and anti-ECT authors here, and even a few neutrals - it's not just the scientific consensus, it's the Wikipedia one. That being the case - and given that the discussion is freely available on this very page - you need to read a lot more carefully before writing nonsense like "this is with one person, you Scuro".

Your main argument appears to be that memory loss = brain damage. By this rationale, everyone who forgets the name of someone they met 5 minutes previously is brain damaged. I don't think that's the case. Nmg20 20:54, 23 October 2007 (UTC)

Memory is a very complicated process of encoding, storing and retrieving information which involves multiple areas of the brain. Forgetting the name of a person one just met five minutes ago is the consequence of failure to transfer that information from working (short-term) memory into long term memory. There's an extremely brief period known as sensory memory where information is coming in, but it must also be attended to in order to go into working (short-term) memory, aka "conscious awareness". But even then, memories do not stay in working memory unless you keep them there or move then into long-term memory- forgetting is rapid with working memory- within 15-20 seconds actually. When we meet a new person, hear their name for the first time and continue on with conversation, or some other activity without continuing to attend to or use that name, new incoming info tends to interfere and push that info out of consciousness where it is lost. That is a normal memory process not due to brain damage, and not at all comparable to the memory loss involved with brain damage due to ECT. --Mark v1.0 02:39, 24 October 2007 (UTC)

Reports of memory loss are "characterized as somatoform disorders,rather than as evidence of brain damage" [Complaints of Loss of Personal Memories] With psychiatrists controlling the definition of what constitutes brain damage, there is little documented "credible support", but you knew this already.--Mark v1.0 04:40, 24 October 2007 (UTC)

This is pointless. Conspiracy theories don't cut it on Wikipedia and neither does original research WP:OR / WP:SYN. You can't talk about the process of memory and then plunk brain damage down right after and hope that the reader will accept the connection of the two ideas. You are connecting two things together without any supportable citations. That is called synthesis. Worse, there is no expansion of the idea of brain damage to logically connect it to memory. Even the synthesis lacks any sort of support. More bothersome is the innuendo that you project upon other editors and the whole field of Psychiatry also goes against one of Wikipedia's five pillars which is assume good faith.WP:AGF.--scuro 11:40, 24 October 2007 (UTC)

I undid Scuros edit of an unknown user who asked "who". The sentence should specify psychiatrists do not think ECT causes brain damage.--Mark v1.0 01:37, 25 October 2007 (UTC)

This is a small list of people who think ECT causes brain damage and have spoken about it.

Don Weitz, David Oaks, Juli Lawrence, Judi Chamberlin, Bonnie Burstow, Gary Moore, Peter Lehmann, Peggy S. Salter, Sue Clark-Wittenberg, Leonard Roy Frank, Chris Dowling, Jonathan Cott, Anne B. Donahue, Jackie Mishra, charles H. Kellner, Jacqueline Guest, Jan Wallcraft, G. Christiane Starks, Bertram P. Karon, Wendy Funk, Timothy W. Kneeland, Sally Clay, Sheila Gilhooly book"still sane" 1985, Nira Fleischman, Pat Gabel, Linda Andre, Elizabeth Plasick, Frank Adams, Ted Chabasinski, Jody A. Harmon, Janet Gotkin, Lou Reed, Gail Larrick, Marilyn Rice, Barbara Richer, Una Parker, Jeffrey Moussaieff Masson, Karen Whitehead, Dianna Loper, Sue Ann Kulcsar, Jeanne Claytor, George Ebert, Dorothy Oimette, Laurel J. Hodkin, Suza Gaudino, Gary Blackburn, Ronald Bassman, Carla McKague, Linda MacDonald, Steven Sears, Dorothy Washburn Dundas

It IS necessary to specify it is psychiatrists do not think ECT causes brain damage. I am working on a list of "excommunicated" certified doctors and nurses who think it causes brain damage. Undoubtedly you will discount these professionals second opinions. --Mark v1.0 05:09, 26 October 2007 (UTC)

Notability, not Laundry lists. Who are these people? Where are their scientific, publications in peer-reviewed journals, etc.? Nmg20 11:24, 27 October 2007 (UTC)

Influence of Involuntary Electroshock's Duress in Patient Reports

I just inserted a small mention of the influence of duress in involuntary patients' reports about the effects of electroshock. I am placing this section in the talk page because of my own desire to discuss it and the likelihood that this insertion will be contentious. I'm not trying to detract from the other debates that are occuring about this article, which are probably more important, but this is an issue that is being ignored in experimental evaluations of ECT and it should be considered somehow.

Put simply, suppose a patient is forced to take involuntary electroshock, and that patient understands that continued expression of the traits that her psychiatrist dislikes, such as depression, will encourage more of the electroshock. A probability exists that, in order to prevent more electroshock, the patient will start to claim the electroshock makes her feel good, even if this is false and even if the electroshock causes the patient detrimental emotions. I know of some cases in which this occured. If someone can find a scientific study that investigates this phenomenon, it would help. If not, then neglect or bias likely exists in the way researchers are treating this issue. Chris Dubey 19:42, 23 October 2007 (UTC)

I don't know of any study that looked at the different results for voluntary vrs. involuntary. If there was such a study it would have most likely have been done in the US or UK. That being the case the people receiving the ECT would be the people who are very high at risk of dying if left to their own means. You can't really do a correlational study because your populations wouldn't be at all the same. One group would be typically older ladies of means with Depression and the other group would be suicidals and those with catatonic depression.--scuro 01:46, 24 October 2007 (UTC)

Scuro you write a circular argument. The patients you describe did not magically appear out of thin air, I am pretty sure they had failed to be cured by psychiatry before the treatment of ECT.--Mark v1.0 05:05, 24 October 2007 (UTC)

?? The issue here isn't the ability of Psychiatry to cure all, it's the assessment of involuntary shock.--scuro 11:12, 24 October 2007 (UTC)

The study that examines different results between voluntary and involuntary electroshock probably doesn't exist, but it should. Neglect of the influence of duress in experimental results would seem to be a confirmation bias by the researchers, who would likely tend to see the results they want, even if untrue.

Perhaps the patients would be likely to die. However, I believe that's an ethical issue, not a legal one. Wasn't suicide decriminalized in the U.S., even though psychiatry treats it as a violation? I'm aware of my own bias about this. I'm a believer in nonconsequentialist libertarianism and believe in the right of each ethically innocent person to use their body and other property in any way that doesn't directly and physically interfere with the property of another person. This includes the moral right to suicide. From a different perspective, the perspective of medical ethics, one can also view the issue of involuntary electroshock. In medical ethics, the value of autonomy, "Voluntas aegroti suprema lex," disapproves of involuntary use of a patient's body. Apparently, involuntary electroshockers ignore that value.

I didn't expect this to get very far, but it's definitely an issue that should be considered in future research of ECT. Chris Dubey 14:29, 24 October 2007 (UTC)

There is philosophy and then there is pragmatism. From what I have read sometimes involuntary ECT can make a huge difference, completely turn someone's life around. I believe that generally one should have the right to control one's body. The US and UK have special laws about I-ECT. You may want to write a section about the philosophy of I-ECT. There was one but it was a little tweaked and I guess it got deleted. It sounds like you would have something meaningful to share.--scuro 19:54, 24 October 2007 (UTC)

Scuro, thanks for your compliments. I've been busy and trying to reduce my stress by taking breaks from Wikipedia. I still disagree with you about whether involuntary electroshock is good, but all I have for sources are personal interviews and my own unpublished observations and no scientific studies. So, I'm not going to continue my weak argument now. I believe in the correctness of my beliefs, but I admit that I need more to fulfill Wikipedia's policies and that I should not use the encyclopedia as a platform to express my beliefs. I'm not ready to add another section about philosophical perspectives of electroshock, knowing how weak the last one was. However, I'll probably still comment occassionally about this article from a philosophical perspective, especially if I notice philosophical errors that aren't protected by Wikipedian policy. Chris Dubey (talk) 03:31, 21 November 2007 (UTC).

Please do, Chris: I think it's extremely important to the article that the anti-electroshock camp, into which I think it's fair to put you?, has advocates like yourself who are willing to cooperate on the article. I don't know what your background is, but if you can source the theory (and it sounds like you can) and then apply it to ECT (and it sounds like you can), have you considered contacting for instance the Journal of ECT and seeing if they'd be interested in publishing something about philosophical perspectives of electroshock? The worst they could say is "no", and they might suggest journals which would be interested in such an article. Nmg20 (talk) 21:31, 22 November 2007 (UTC)

As I told Scuro, I am a follower of deontological (nonconsequentialist) libertarianism. It is both a political and ethical philosophy. As I believe most true libertarians would, I disapprove of involuntary electroschok and approve of voluntary electroshock. A true libertarian values the freedom of an innocent person to use their body as they wish and also values personal responsibility for one's body, rather than desiring others to be responsible for it. I'm laughing as I read your suggestion, but with good humor. I haven't even considered publishing hardcopy nonfiction about electroshock. I'll think about it. However, I have written a little bit about it on my Webzine "Shimmersplash." I am also attempting to publish a novel that partly discusses the ethics of electroshock. Chris Dubey (talk) 00:59, 29 November 2007 (UTC).

It's a pleasure to discuss issues with someone who disagrees with me about ECT, in a civilized manner. This is the way Wikipedia is supposed to work. I look forward to your future contributions.--scuro (talk) 12:22, 23 November 2007 (UTC)

You don't have to be actively suicidal to be a victim of involuntary electroshock. It happened to me after being drugged into oblivion. "What you read" doesn't trump what I experienced. Involuntary treatment is a crime against humanity. 208.181.100.36 05:50, 7 November 2007 (UTC)

What you have to share belongs on a blog or a website like ECT.org. Personal experiences are not allowed to be used as a citation to alter or add material to Wikipedia articles. WP:RS--scuro 11:08, 7 November 2007 (UTC)

Just show us the beef

I'm going to ask ya to show us what is up yer sleeve. If you have been hidin' dem citations up there your going to have a lot of angry people at this table.--scuro 03:52, 24 October 2007 (UTC)

Are you talking to Mark or to me? Chris Dubey 14:30, 24 October 2007 (UTC).

Mark, it's fine to claim something, it's another thing to be able to truly support a notion.--scuro 19:41, 24 October 2007 (UTC)

What did I claim? That I and many other believe and consider ECT as brain damage.--Mark v1.0 00:55, 26 October 2007 (UTC)

I'm not going down this road and getting sucked into a debate. You have a position that is unsupported. Citations are required when challenged. One unacceptable citation was offered. This was made aware to you with the reasoning behind it. You continue to disruptively edit. Consensus will be sought that a complaint should be made for disruptive editing, and if given a complaint will be lodged.--scuro 03:23, 26 October 2007 (UTC)

I do not want a debate either. I am trying to clairify the sentence on who accepts. You deny that other people think ECT is brain damaging. I am compiling a list of people who think and have said ECT is damaging. The sentence has to specify who accepts "ECT does not cause brain damage". As I can prove it is NOT widely accepted.

The sentence should be "It is widely accepted by psychiatry that ECT does not cause brain damage".--Mark v1.0 19:20, 26 October 2007 (UTC)

The references supplied go beyond "psychiatry", whatever that is supposed to delinate, to include: a panel from NICE, the institution called the Surgeon General and all the staff involved in their declaration, and researchers who would most likely not like to be labeled as Psychiatrists. There are other references that are highly significant but lets start with these ones first. If you want to change the wording you better have some pretty solid references directly supporting your contention...or once again it will look like disruptive editing.--scuro 19:39, 26 October 2007 (UTC)

Right. I have references. Loodog added reference 4 to support "who". As in stating who is widely accepting ECT does not cause brain damage. Ironically that same reference 4 [1]says "3.5 (page 10) individuals find their memory loss extremely damaging". I have other references but I have no idea how to add them (or correct existing ones) to http://en.wikipedia.org/wiki/Electroconvulsive_therapy#References . I hope you have patience while I learn.--Mark v1.0 04:25, 31 October 2007 (UTC)

The case for a disruptive editing complaint against user Mark v1.0

This user does repeatedly reverts and deletes material.

• -doesn't follow several wikipedian conventions.
• -Never backs up edits with proper citations.
• -Uses subjective and personal stories as his critera for edits.
• -doesn't respond to requests to change behaviour.

Should a complaint be made?--scuro 15:49, 25 October 2007 (UTC)

He's not far off IMHO. Give it a week or so. Nmg20 20:29, 25 October 2007 (UTC)

Who is my judge?--Mark v1.0 00:51, 26 October 2007 (UTC)

http://en.wikipedia.org/wiki/Wikipedia:Requests_for_comment#Request_comment_on_users

Your peers will file a complaint after the procedure below is followed. The Wikipedian community will judge you. If other editors feel that user Mark v1.0 is disruptively editing they should follow the procedure below. (Mark v1.0 you would be wise to revert your last edit)

Before requesting community comment, at least two editors must have contacted the user on their talk page, or the talk pages involved in the dispute, and tried but failed to resolve the problem. Any RfC not accompanied by evidence showing that two users tried and failed to resolve the same dispute may be deleted after 48 hours. The evidence, preferably in the form of diffs, should not simply show the dispute itself, but should show attempts to find a resolution or compromise. The users certifying the dispute must be the same users who were involved in the attempt to resolve it.

Mark, you may want to also read this guideline. WP:IDIDNTHEARTHAT

--scuro 03:49, 26 October 2007 (UTC)

"doesn't follow wikipedian convention" if I don't know what they are I can't follow them. Is this a title or an accusation in itself? you don't list the conventions I break.

"Never backs up edits with proper citations" backing up edits? what is that? who decides what is "proper"? The persons sentence I just edited?

"Uses subjective and personal stories as his critera for edits" I just asked for help for that. I don't know how to get into references.http://en.wikipedia.org/wiki/Talk:Electroconvulsive_therapy#Help

"doesn't respond to requests to change behaviour", translating into english, I don't agree with you, . This is not against wikipedia rules I am pretty sure.--Mark v1.0 04:35, 31 October 2007 (UTC)

In a nutshell Mark, on a controversial topic like this, with editors who oppose a number of your edits....I would simply post in talk before editing the page. That holds especially true if you are new to this. You must attempt to seek consensus when there is disagreement.

No action has been taken and that will only happen if we continue to see unilateral disruptive edits. Besides, more then one editor has to agree with that term for action to be taken. If you are unsure ask. Often beside our posts you will see shortcuts like this WP:CON( -read that one, it is an important concept.) They guide you to important information and the reason an editor disagrees with you.

I'm glad to see that you want to be part of the Wikipedia community. No worries...just watch out for stepping on editors toes, it's crowded in here. --scuro 11:47, 31 October 2007 (UTC)

List of People who do NOT accept "ECT does not cause brain damage"

Translation; People who think ECT causes brain damage . I qualify them as experts as they have experienced the effects of ECT, or studied and wrote of ECT for the past 20 years or longer. (edit to alphabetical order, etc) Linda Andre, ECT survivor, Director of The Committee for Truth in Psychiatry (CTIP) Pat Butterfield, ECT survivor, founder of "ECT Anonymous" Gary Blackburn, ECT survivor Judi Chamberlin, ECT survivor, author book "On Our Own" Sue Clark-Wittenberg, ECT survivor, blog and youtube testimony against ECT Sally Clay, ECT survivor, editor Jeanne Claytor, ECT survivor, Jonathan Cott, ECT survivor, author of 16 books Chris Dowling, ECT survivor, Dorothy Washburn Dundas, ECT insulin survivor, BA in sociology from Boston University Clover Smith-Greene ,ECT survivor ,author "Escape from Psychiatry",www.escapefrompsychiatry.org Don Weitz, insulin shock survivor, book "Shrink Resistant: The Struggle Against Psychiatry in Canada" (additional coming)

Professionals Ronald Bassman Ph.D., ECT survivor, author "A fight To Be" Bonnie Burstow, Ph.D.,author "Radical Feminist Therapy: Working in the Context of Violence" Ted Chabinski, ECT survivor, Attorney Anne B. Donahue, ECT survivor, Attorney Harold Sackeim, Ph.D., pro ECT Kenneth W. Thomas RN, B.S., website www.nurses4humanrights.org/about/ (additional coming) --Mark v1.0 02:43, 1 November 2007 (UTC)

The list gives no context. Who are these people and why are they important? Could I insert Dr. Phil into that list or does he not belong? From my vantage point, it's not at all clear. By listing these names I assume that they are experts in the field of ECT or some scientific field. The question after all is does ECT cause brain damage so we would want to hear only from objective individuals who would have the scientific credentials to speak to that question. We would not want subjective opinions. Does anyone on that list fit the bill as an objective expert in the field? If so, provide a citation where they specifically speak to the issue of brain damage.

If not, then consider what Wikipedia states about those who don't get the point( WP:IDIDNTHEARTHAT ); "When a stance passes the point of reasonableness, and it becomes obvious that there is a wilful refusal to 'get the point' despite the clear statement of policy, and despite reasoned opinions and comments provided by experienced, independent editors, administrators or mediators, then refusal to get the point is no longer a reasonable stance or policy-compliant - it has become a disruptive pattern, being used to make or illustrate a point".--scuro 19:56, 26 October 2007 (UTC)

Mark, to put that another way: I could name as many individuals who believe the Earth is 6000 years old, but this does nothing that it is widely accepted that the Earth's age is more toward 6 billion than 6 thousand.--Loodog 20:10, 26 October 2007 (UT

Wikipedia is not about that loaded word,..."the truth". It's about exactly what Loodog stated, and that is what is "widely accepted". To show that you need good citations.--scuro 20:16, 26 October 2007 (UTC)

If I have open heart surgery does that make me an expert on the procedure? If I head a Zeta Reticulans group does that make an expert on qualifying if UFO's exist? Wikipedia qualifies what an expert is and what material you can use to support statements. You want reliable sources wp:rs Also be careful of drawing conclusions when none are made. In Wikipedia this is called original research. WP:OR For instance, show me a quote where Sackeim states ECT causes brain damage. I fear you are incorrectly inferring that he does.--scuro 04:22, 1 November 2007 (UTC)

"IF I have open heart surgery..." sorry Scuro you can not compare ECT to heart surgery. Why? Reasons for heart surgery are based on physical tests such as a Cardiac MRI and others. http://heartdisease.about.com/cs/cardiactests/l/bltests.htm . Then you bring in religion "Reticulans", thank you, because as you know there is no lab test for any mental illness that ECT is prescribed for. Scuro and Loondog you are obviously pro ECT, pro-psychiatry, I am anti ECT. Any source I claim as a source for proof of brain damage will likely be discounted by you protECTers as an invalide source due to it coming from an anti ECT person/place. Just because I am and others are anti ECT, anti-psychiatry, it does not discount our humanity or our legitimacy to discuss the subject. I make the assumption the reader of wikipedia ECT is unbiased. If I am unbiased and read "widely accepted" I would assume this means most everyone accepts. I would not think it is widely accepted by experts. Scuro you are saying people who have had ECT can not form the opinion that ECT causes brain damage because they are not doctors? Comparison to, my car is stolen and I can't report it because I am not a police officer? I can't tell anyone my car was stolen?--Mark v1.0 19:53, 2 November 2007 (UTC)

RE:Sackeim he does not say the exact wording of "brain damage". I am not ready to start my arguement yet. Shortly I will be ready.--Mark v1.0 19:53, 2 November 2007 (UTC)

If your car is stolen, it doesn't make you an expert on crime to be cited in a wikipedia article. You're saying that anyone who's ever bought an iPod is an expert on Apple stock, mp3 players, music, the economy, not to mention all technologies that went into it.--Loodog 20:38, 2 November 2007 (UTC)

That is an interesting theory that we fall into two groups either pro or anti ECT. Science is neither black or white and neither am I. For instance I am open to new information and after reading about the application of ECT across the world, I put this sentence into the article, "This significantly uneven application of ECT around the world continues to make ECT a controversial procedure". Is that a pro-ECT statement? Don't brand me with bias, stop trying to make this personal. Flaming is also not appreciated, stop bringing up old irrelevant issues like the validity of ECT.org with regards to references. Don't also try to put words in my mouth either. ECT patients can have an opinion about ECT it just doesn't belong on this page.WP:RS Stick to the task at hand and that is to improve the article, otherwise move on.--scuro 18:18, 3 November 2007 (UTC)

Help

I want to fix a listed reference that has a bad URL link. I found the correct URL link and was intending to replace it, but when I go to edit references, the edit page appears to be nearly blank. How do I fix it?--Mark v1.0 04:06, 31 October 2007 (UTC)

You go back to the text where the reference was placed and fix it there.--scuro 20:38, 31 October 2007 (UTC)

Ok thanks Scuro, I am begining to understand. You can delete this "HELP" when you recieve the thank you (delete to clean up talk page)--Mark v1.0 03:43, 1 November 2007 (UTC)

John Forbes Nash

Although many sources (most of them concerning the movie) seem to think Nash received ECT, more authoritative biographies state that he received insulin shock therapy, but that his family refused to allow ECT to be performed. The reason was that they feared damage to his brain (perhaps to his mathematical ability).

I therefore removed him from the list of famous persons who have received ECT. Apollo 21:37, 14 November 2007 (UTC)

Might be worth noting the misconception in the article itself too. —Pengo 13:33, 5 February 2008 (UTC)

NEJM

Recent ECT review in NEJM JFW | T@lk 02:07, 29 November 2007 (UTC)

Bias

The intro is biased. ECT is not controversial, at least not in medicine, it is as valid - and often as life-saving - as cardioversion. Electroshock is an old name... is like saying "Surgeons, also known as barbers, are the professionals who cut holes in people in order to get them cured." There is an excelent review on the NEJM (Volume 357:1939-1945 November 8, 2007 Number 19) —Preceding unsigned comment added by Elrafael (talk • contribs) 01:53, 9 December 2007 (UTC)

It's not controversial in medicine, no, but I think it's fair to say it's controversial in the public domain, and as that's who we're writing for I think it's important we keep the disclaimer in there. Nmg20 (talk) 00:07, 10 December 2007 (UTC)

I'd have to agree. The use of the procedure still does not even have general standards around the world. Even within North America standards are changing, and probably still will change. Combine that with short term and possible long term memory loss and you have controversy. --scuro (talk) 04:25, 10 December 2007 (UTC)

controversy

this page could use a controversy section. the discussion page speaks for itself; there is clearly much controversy surrounding ECT, and controversial topics should include "controversy" sections (i can think of a million articles that do). i mean, cmon, this is ECT, a process that seems rather primitive and dangerous. there's loads of controversy surrounding this. a google search for ECT controversy turns up 201,000 results. and we've all seen it in the movies. let's be honest about this: the controversy, as it stands, is like a huge elephant in the room on this page. 160.39.130.95 (talk) 04:21, 17 December 2007 (UTC)

At the moment, the controversial aspects of the treatment are dealt with as they purport to the different sections of the article. Examples include unmodified variants still in use in some parts of the world, cognitive deficits, almost all the adverse effects section, and the legal status section. If there are specific things which aren't already in the article you think should be, then please mention them with references here - otherwise, perhaps calling controversy the 'elephant in the room' is a bit strong when "controversial" is the 9th word in the article is a bit, er, controversial...? Nmg20 (talk) 19:25, 17 December 2007 (UTC)

Hi, user 160.39.130.95. I believe there was a controversy section earlier and that it got transformed into its own article, but for some reason it's gone now. If you want to add something, I just recommend that you give a proper citation and name the source. Chris Dubey (talk) 00:11, 18 December 2007 (UTC).

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