2005 Texas Health & Safety Code CHAPTER 578. ELECTROCONVULSIVE AND OTHER THERAPIES

HEALTH & SAFETY CODE

CHAPTER 578. ELECTROCONVULSIVE AND OTHER THERAPIES


	§ 578.001. APPLICATION.  This chapter applies to the use 
of electroconvulsive therapy by any person, including a private 
physician who uses the therapy on an outpatient basis.

Added by Acts 1993, 73rd Leg., ch. 705, § 5.01, eff. Sept. 1, 
1993.      


	§ 578.002. USE OF ELECTROCONVULSIVE THERAPY.  (a) 
Electroconvulsive therapy may not be used on a person who is younger 
than 16 years of age.
	(b)  Unless the person consents to the use of the therapy in 
accordance with Section 578.003, electroconvulsive therapy may not 
be used on:
		(1)  a person who is 16 years of age or older and who is 
voluntarily receiving mental health services;  or
		(2)  an involuntary patient who is 16 years of age or 
older and who has not been adjudicated by an appropriate court of 
law as incompetent to manage the patient's personal affairs.
	(c)  Electroconvulsive therapy may not be used on an 
involuntary patient who is 16 years of age or older and who has been 
adjudicated incompetent to manage the patient's personal affairs 
unless the patient's guardian of the person consents to the 
treatment in accordance with Section 578.003.  The decision of the 
guardian must be based on knowledge of what the patient would 
desire, if known.

Added by Acts 1993, 73rd Leg., ch. 705, § 5.01.                            


	§ 578.003. CONSENT TO THERAPY.  (a) The board by rule 
shall adopt a standard written consent form to be used when 
electroconvulsive therapy is considered.  The board by rule shall 
also prescribe the information that must be contained in the 
written supplement required under Subsection (c).  In addition to 
the information required under this section, the form must include 
the information required by the Texas Medical Disclosure Panel for 
electroconvulsive therapy.  In developing the form, the board shall 
consider recommendations of the panel.  Use of the consent form 
prescribed by the board in the manner prescribed by this section 
creates a rebuttable presumption that the disclosure requirements 
of Sections 74.104 and 74.105, Civil Practice and Remedies Code, 
have been met.
	(b)  The written consent form must clearly and explicitly 
state:             
		(1)  the nature and purpose of the procedure;                                 
		(2)  the nature, degree, duration, and probability of 
the side effects and significant risks of the treatment commonly 
known by the medical profession, especially noting the possible 
degree and duration of memory loss, the possibility of permanent 
irrevocable memory loss, and the possibility of death;
		(3)  that there is a division of opinion as to the 
efficacy of the procedure;  and
		(4)  the probable degree and duration of improvement or 
remission expected with or without the procedure.
	(c)  Before a patient receives each electroconvulsive 
treatment, the hospital, facility, or physician administering the 
therapy shall ensure that:
		(1)  the patient and the patient's guardian of the 
person, if any, receives a written copy of the consent form that is 
in the person's primary language, if possible;
		(2)  the patient and the patient's guardian of the 
person, if any, receives a written supplement that contains related 
information that pertains to the particular patient being treated;
		(3)  the contents of the consent form and the written 
supplement are explained to the patient and the patient's guardian 
of the person, if any:
			(A)  orally, in simple, nontechnical terms in the 
person's primary language, if possible;  or
			(B)  through the use of a means reasonably 
calculated to communicate with a hearing impaired or visually 
impaired person, if applicable;
		(4)  the patient or the patient's guardian of the 
person, as appropriate, signs a copy of the consent form stating 
that the person has read the consent form and the written supplement 
and understands the information included in the documents;  and
		(5)  the signed copy of the consent form is made a part 
of the patient's clinical record.
	(d)  Consent given under this section is not valid unless the 
person giving the consent understands the information presented and 
consents voluntarily and without coercion or undue influence.
	(e)  For a patient 65 years of age or older, before each 
treatment series begins, the hospital, facility, or physician 
administering the procedure shall:
		(1)  ensure that two physicians have signed an 
appropriate form that states the procedure is medically necessary;
		(2)  make the form described by Subdivision (1) 
available to the patient or the patient's guardian of the person;  
and
		(3)  inform the patient or the patient's guardian of the 
person of any known current medical condition that may increase the 
possibility of injury or death as a result of the treatment.

Added by Acts 1993, 73rd Leg., ch. 705, § 5.01, eff. Sept. 1, 
1993.  Amended by Acts 1997, 75th Leg., ch. 1323, § 1, eff. Sept. 
1, 1997;  Acts 2005, 79th Leg., ch. 137, § 1, eff. Sept. 1, 2005.


	§ 578.004. WITHDRAWAL OF CONSENT.  (a) A patient or 
guardian who consents to the administration of electroconvulsive 
therapy may revoke the consent for any reason and at any time.
	(b)  Revocation of consent is effective immediately.                           

Added by Acts 1993, 73rd Leg., ch. 705, § 5.01, eff. Sept. 1, 
1993.      


	§ 578.005. PHYSICIAN REQUIREMENT.  (a) Only a physician 
may administer electroconvulsive therapy.
	(b)  A physician may not delegate the act of administering 
the therapy.  A nonphysician who administers electroconvulsive 
therapy is considered to be practicing medicine in violation of 
Subtitle B, Title 3, Occupations Code. 

Added by Acts 1993, 73rd Leg., ch. 705, § 5.01, eff. Aug. 30, 
1993.  Amended by Acts 2001, 77th Leg., ch. 1420, § 14.805, eff. 
Sept. 1, 2001.


	§ 578.006. REGISTRATION OF EQUIPMENT.  (a) A person may 
not administer electroconvulsive therapy unless the equipment used 
to administer the therapy is registered with the department.
	(b)  A mental hospital or facility administering 
electroconvulsive therapy or a private physician administering the 
therapy on an outpatient basis must file an application for 
registration under this section.  The applicant must submit the 
application to the department on a form prescribed by the 
department.
	(c)  The application must be accompanied by a nonrefundable 
application fee.  The board shall set the fee in a reasonable amount 
not to exceed the cost to the department to administer this section.
	(d)  The application must contain:                                             
		(1)  the model, manufacturer, and age of each piece of 
equipment used to administer the therapy;  and
		(2)  any other information required by the department.                        
	(e)  The department may conduct an investigation as 
considered necessary after receiving the proper application and the 
required fee.
	(f)  The board by rule may prohibit the registration and use 
of equipment of a type, model, or age the board determines is 
dangerous.
	(g)  The department may deny, suspend, or revoke a 
registration if the department determines that the equipment is 
dangerous.  The denial, suspension, or revocation of a registration 
is a contested case under Chapter 2001, Government Code.

Added by Acts 1993, 73rd Leg., ch. 705, § 5.01, eff. Sept. 1, 
1993.  Amended by Acts 1995, 74th Leg., ch. 76, § 5.95(49), eff. 
Sept. 1, 1995.


	§ 578.007. REPORTS.  (a) A mental hospital or facility 
administering electroconvulsive therapy, psychosurgery, 
pre-frontal sonic sound treatment, or any other convulsive or 
coma-producing therapy administered to treat mental illness or a 
physician administering the therapy on an outpatient basis shall 
submit to the department quarterly reports relating to the 
administration of the therapy in the hospital or facility or by the 
physician.
	(b)  A report must state for each quarter:                                     
		(1)  the number of patients who received the therapy, 
including:            
			(A)  the number of persons voluntarily receiving 
mental health services who consented to the therapy;
			(B)  the number of involuntary patients who 
consented to the therapy;  and 
			(C)  the number of involuntary patients for whom a 
guardian of the person consented to the therapy;
		(2)  the age, sex, and race of the persons receiving the 
therapy;           
		(3)  the source of the treatment payment;                                     
		(4)  the average number of nonelectroconvulsive 
treatments;                 
		(5)  the average number of electroconvulsive 
treatments administered for each complete series of treatments, but 
not including maintenance treatments;
		(6)  the average number of maintenance 
electroconvulsive treatments administered per month;
		(7)  the number of fractures, reported memory losses, 
incidents of apnea, and cardiac arrests without death;
		(8)  autopsy findings if death followed within 14 days 
after the date of the administration of the therapy;  and
		(9)  any other information required by the department.                        

Added by Acts 1993, 73rd Leg., ch. 705, § 5.01, eff. Sept. 1, 
1993.      


	§ 578.008. USE OF INFORMATION;  REPORT.  (a) The 
department shall use the information received under Sections 
578.006 and 578.007 to analyze, audit, and monitor the use of 
electroconvulsive therapy, psychosurgery, pre-frontal sonic sound 
treatment, or any other convulsive or coma-producing therapy 
administered to treat mental illness.
	(b)  The department shall file annually with the governor and 
the presiding officer of each house of the legislature a written 
report summarizing by facility the information received under 
Sections 578.006 and 578.007.  If the therapy is administered by a 
private physician on an outpatient basis, the report must include 
that information but may not identify the physician.  The 
department may not directly or indirectly identify in a report 
issued under this section a patient who received the therapy.

Added by Acts 1993, 73rd Leg., ch. 705, § 5.01, eff. Sept. 1, 
1993.