Section 3999.348 - Electroconvulsive Therapy(a) Shock therapy is the only form of organic therapy, as defined by law, which may be used in the treatment of persons committed to the custody of the Secretary. No patient who is competent and capable of giving informed consent will be administered any form of shock therapy without having given his or her consent. Prior authorization of a superior court is also required before shock therapy may be administered for any treatment purpose other than as an emergency lifesaving measure. (1) Shock therapy as a lifesaving emergency medical measure may be administered to a patient who is competent and capable of giving informed consent and who has given consent, or a patient who is incompetent or incapable of giving informed consent, without prior court authorization. However, all pertinent clinical data relating to the nature of the emergency and the treatment given will be presented to the court for review within ten days of the first instance of emergency shock treatment.(2) When a patient is competent and capable of giving informed consent and has done so, and the court has authorized such treatment, shock therapy may be administered in a nonemergency course of treatment. No form of shock therapy may exceed three months of continuous treatment nor more than three months in any 12-month period.(b) Informed Consent. The term, "Informed Consent," means that a person must knowingly and intelligently, without duress or coercion, and clearly and explicitly consent to the proposed shock therapy. The patient's consent must be given in writing and in the presence of the attending physician. It must be preserved and be available to the patient, the patient's attorney, guardian, or conservator.(c) Determining need. If the attending physician determines that shock therapy is required for the health and safety of the patient, permission may be requested of the warden or superintendent to administer the therapy. (1) The warden or superintendent will appoint a committee of physicians, two of whom are board certified or eligible for board certification in psychiatry or neurosurgery, to review the patient's treatment record and the determination of the attending physician. At least one of the attending physicians must not be a full-time employee of the Department.(2) Before shock treatment may be administered, this committee must unanimously agree with the attending physician's determination that it is required and, if it is to be performed under the provisions of subsection (b), that the patient has the ability to give informed consent and has in fact given informed consent.(d) Withdrawal of consent. Any patient who has given informed consent may withdraw it at any time. The shock therapy must cease immediately.(e) Court petition. (1) A patient, or patient's attorney, guardian or conservator may file a petition with the superior court of the county in which the patient is confined for an order to prohibit the administration of shock therapy upon the patient. This petition must be served by the county clerk upon the warden or superintendent on the same day it is filed and constitutes a refusal of consent or withdrawal of any prior consent.(2) The warden or superintendent has ten days to file a response to the petition. The superior court may grant a continuance of ten additional days. The response must be served upon the patient, and upon the patient's attorney, guardian or conservator on the same day it is filed with the clerk of the superior court.(f) Correspondence regarding shock therapy. The patient is entitled to communicate in writing with his or her attorney, and by writing or visits with his or her parents, guardian or conservator regarding any proposed administration of shock therapy or organic therapy. Any mail regarding shock therapy will not be prevented from leaving the institution.(g) Incapable of informed consent. (1) If the patient is incapable of giving informed consent to a program of shock therapy, and the attending physician believes that such treatment is required for the health and safety of the patient, the attending physician may request the permission of the warden or superintendent. If the warden or superintendent agrees with the request and the committee, appointed pursuant to subsection (c)(1), also unanimously agrees that such therapy is required, the warden or superintendent will forward the request to the Chief, Medical Services, for review and recommendation to the Secretary. If the Secretary concurs in the course of treatment, the warden or superintendent will petition the superior court for permission to conduct the hearing. No treatment will be conducted until after a hearing at which the patient is represented by counsel and after a court order authorizing the treatment is issued.(2) In an extraordinary case, the attending physician may determine that shock treatment is required for a longer period of time than three months, or more frequently than three months in the period of one year. The same procedures as in subsection (g)(1) will be followed before any further shock therapy will be administered.(h) Patient rights. If the attending physician determines that a patient should be administered shock therapy, the patient will be informed of his or her rights under this article. A copy of Penal Code sections 2670 through 2680 will be made and will be given to the patient at that time.Cal. Code Regs. Tit. 15, § 3999.348
1. Change without regulatory effect renumbering former section 3369 to new section 3999.348, including amendment of section heading and section, filed 4-15-2019 pursuant to section 100, title 1, California Code of Regulations (Register 2019, No. 16). Note: Authority cited: Section 5058, Penal Code. Reference: Section 5054, Penal Code.
1. Change without regulatory effect renumbering former section 3369 to new section 3999.348, including amendment of section heading and section, filed 4-15-2019 pursuant to section 100, title 1, California Code of Regulations (Register 2019, No. 16).