CHAPTER 578. ELECTROCONVULSIVE AND OTHER THERAPIES
HEALTH AND SAFETY CODE
TITLE 7. MENTAL HEALTH AND MENTAL RETARDATION
SUBTITLE C. TEXAS MENTAL HEALTH CODE
CHAPTER 578. ELECTROCONVULSIVE AND OTHER THERAPIES
Sec. 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, Sec. 5.01, eff. Sept. 1,
1993.
Sec. 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, Sec. 5.01.
Sec. 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, Sec. 5.01, eff. Sept. 1,
1993. Amended by Acts 1997, 75th Leg., ch. 1323, Sec. 1, eff.
Sept. 1, 1997.
Amended by:
Acts 2005, 79th Leg., Ch.
137, Sec. 1, eff. September 1, 2005.
Sec. 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, Sec. 5.01, eff. Sept. 1,
1993.
Sec. 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, Sec. 5.01, eff. Aug. 30,
1993. Amended by Acts 2001, 77th Leg., ch. 1420, Sec. 14.805,
eff. Sept. 1, 2001.
Sec. 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, Sec. 5.01, eff. Sept. 1,
1993. Amended by Acts 1995, 74th Leg., ch. 76, Sec. 5.95(49),
eff. Sept. 1, 1995.
Sec. 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, Sec. 5.01, eff. Sept. 1,
1993.
Sec. 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, Sec. 5.01, eff. Sept. 1,
1993.