The former _ sister medical field
Electrical stimulation and electric shock are two different things. The latter sees a doctor, and the former causes harm.
Post | Yan Xiaoliu
Recently, the United Kingdom and the United States Food and Drug Administration lost a dispute.
The People's Court of the U.S. District of Columbia v. tours rejected the restraining order issued by the FDA a year ago with a resolution of 2: 1, saying that Rodenberg Justice Education School in Missouri was allowed to use electrical stimulation equipment again to treat personal injuries or attacks, and ESD was allowed to be manufactured and sold in foreign countries again.
According to the definition of FDA, ESD applies different levels of current stimulation according to the electrode pads attached to the skin to reduce or terminate special personal behaviors. According to FDA's inference, about 40-50 people go to JR management center for electrical stimulation treatment every year. Most of them suffer from more severe childhood autism.
Caption: In September, 20 10, The Guardian interviewed Rodenborg Justice Education School and found that some rehabilitation workers were required to wear electrical stimulation equipment. /TheGuardian
"JR Management Center is the only organization in the UK that applies ESD. It has been widely opposed for nearly half a century. British NBC News reported that this is a day care and boarding school rehabilitation institution, which accepts disabled people with severe physical development and emotional disorders over five years old.
Since 1988, the JR management center has continuously applied electrical stimulation therapy. "This belongs to aversion therapy. When people attack or abuse themselves, such as banging their heads against trees, throwing objects, attacking teachers or classmates, etc. The staff will remotely control the automatic switch to make the machinery and equipment emit electrical stimulation. In order to better prevent electric shock, everyone will automatically correct and avoid the above personal behavior. 20 12, Greg steig, a former employee of JR management center, told CNN.
Illustration: Workers carry a control system with them, which can remotely control signals and stimulate electrical stimulation. The photo was taken on 20 10. /CorbisviaGettyImages
"Electrical stimulation therapy is a very inhuman way. Look at the narrative, it is to use a dose of current to pass through the limbs or forehead. The person who is inserted will feel very painful because of his clear mind, just like being tortured. Professor Wang, the former director of Shanghai Mental Health Management Center, told the medical community that this is different from the "electric shock therapy" applied by neurology standards.
Electroconvulsive therapy, also known as electroconvulsive therapy, is a method to treat mental illness by applying a certain amount of current to the cerebral cortex according to the patient's head.
1940, electroconvulsive therapy was first used in clinical medicine in Britain. After the 1950s, anesthesia technology developed rapidly, and doctors could treat again after applying intravenous anesthetics and muscle relaxants. Anesthetics can ensure that patients lose consciousness for a short time and feel pain. The application of muscle relaxants can prevent physical injury caused by convulsions. Therefore, the patient may only have a toe twitch.
Accordingly, the "modified version technology" is called "non-convulsive electroconvulsive therapy". According to experts' understanding of the modified electroconvulsive therapy, the modified version overcomes the shortcomings of the traditional version and has been widely used to treat mental diseases such as depression and schizophrenia.
Caption: The outpatient staff of McLean Hospital affiliated to Harvard Medical School have tried electroconvulsive therapy. According to the data of 20 19 in our hospital, there are more than 10,000 cases of patients with depression and other mental diseases treated every year. /Wall Street Journal
Professor Wang emphasized that electroconvulsive therapy is widely used in many countries in the world, and the common current and insertion time have "standardized usage". According to experts' understanding of electroshock therapy, the working voltage of adults is 70- 130V, and the interval is 0. 1-0.5 seconds. Or the current intensity is 90- 120mA, _1-3s.
The effective reason of electroconvulsive therapy has not been determined. It is speculated that this may promote the release of neurotransmitters such as 5-5 hydroxytryptamine, brain-derived neurotrophic factor and norepinephrine, improve the data signal transmission of nervous system nutrients, and then improve the symptoms of mental illness.
"Expert knowledge of improved electroconvulsive therapy" emphasizes that the emergency indications of MECT include severe suicide, self-mutilation attempt, guilt, stupor, psychotic disorder or severe depression caused by special diseases such as pregnancy. In addition, when patients have serious life-threatening mental symptoms, MECT should be the first choice, such as severe depression with suicidal behavior.
Sherwin B. Nuland, the late general surgeon and author of "The Face of Death: 12 The Death Lessons of Dr. Nuland of Yale University", gave a TED talk on 200 1, and * * * enjoyed his two experiences of electroconvulsive therapy. "I was so depressed that I didn't even have the strength to pull the mattress out of bed. After being hospitalized, the doctor tried every means to try all the drugs that could be used at that time, but it didn't work. Because I didn't confess, the attending doctor gave me two rounds of electroconvulsive therapy for 20 times. For the first time, I feel saved and can overcome depression.
Explanation: Sherwin B. Nuran gave a TED talk at 200 1 and described his own "electroshock therapy". /Ted
According to the data, ESD has been used for smoking cessation, alcohol withdrawal, drug rehabilitation and drug rehabilitation treatment. In China, some institutions illegally use "electrical stimulation" to treat Internet addiction, which coincides with ESD. That is to say, according to the basic principle of "boring therapy", under the premise of not using anesthetics and muscle relaxants, the level is connected to the temple or fingers, and the current of 1-5mA is used as a benchmark to make excessive online behavior management and electrical stimulation produce conditional stimulation.
Professor Wang said that this kind of practical operation violates the essence of diagnosis and treatment. "The key to diagnosis and treatment should be to help others avoid pain and suffering. Electrical stimulation therapy is to add severe pain to the pain of disease. This method is not considered suitable for our country.
The Associated Press quoted several announcements as saying, "Significant complications and side effects are the key reasons for the FDA's ban on ESD.
In April 20 16 and March 2020, the FDA published two articles, saying: "Self-abuse and aggression often appear in the same person, and people with IQ or developmental disabilities are more likely to show this kind of personal behavior. Because they are disabled, such patients can't communicate, can't make treatment decisions independently, and become a vulnerable group in diagnosis and treatment. However, there is direct evidence that the application of ESD will lead to many serious psychological states and physical risks, including depression, anxiety, post-traumatic acute stress disorder, pain, partial burns and institutional injuries, and it is also very likely to turn into violent behavior or self-abuse personal behavior.
"Fifteen years later, I still have nightmares. 20 18 Jennifer submits a short story of private prosecution on the video platform. From 2002 to 2008, under the age of 18, she was sent to JR management center for "behavioral intervention rehabilitation". In the meantime, she escaped once while taking care of her. After being arrested, she "put on ESD. "
"I want to bring a bag with a signal receiver 24 hours a day. There are different numbers of cables and power levels in the package. The elastic band and transmission belt for nursing are tied to everyone's thigh root, calf and arm, or wrapped around the abdomen. If they feel the need for stricter treatment, they will also be tied to everyone's fingers, soles of their feet or thighs. Jennifer said.
Talking about the "healing experience", Jennifer said: "It's very painful, and the muscles of the whole body are suddenly involved and tense to the extreme. It's like being bitten by hundreds of bees. In addition to physical pain, what is even more frightening is that once worn, electrical stimulation may gradually appear at any time and place.
Caption: Jennifer painted the scene when she received electrical stimulation. /YouTube
In March 2020, FDA issued a "prohibition order", saying that the direct evidence of ESD effectiveness is low, but the direct evidence of applying alternatives is strong. "ESD has unscientific and unrealistic risks that lead to symptoms or damage, and the related risks cannot be corrected and eliminated by adding or changing the logo, so prohibiting the use is the corresponding measure.
The FDA said that the above restrictions took effect on April 6 of the same year, and there was a six-month buffer period thereafter, allowing "JR Management Center to accept ESD patients and gradually access the replacement plan. Such as active personal behavior application and drug therapy, have been proved to improve and resist self-abuse or aggression.
"Once the prohibition is announced, parents will pull up banners and strongly protest outside the foreign FDA building. Other parents, with the cooperation of JR Management Center, filed a lawsuit in the People's Court of tours, D.C., to revoke the restraining order.
"ESD was chosen because there was no way out. The Guardian interviewed the relatives of the patients and wrote.
Due to lack of oxygen at birth, Goldberg, 30, suffered a permanent head injury and was very unstable. The older you get, the harder it is to control your aggression. During my ten years in JR Management Center, my parents allowed me to have ESD treatment, and the maximum number of electrical stimulation can reach 17 times a day.
Regarding the Guardian's explicit question "Why?" Goldberg's mother said, "Everyone regards ESD as abuse. But as a parent, the real abuse is to see that the child has no medicine available, or to lie flat as a dead man after taking medicine. ESD enables our children to lead a normal daily life.
In mid-July, 2002/kloc-0, JR management center was interviewed by news media about the trial, and once again paid attention to: "Before applying for ESD, everyone must seek the permission of the legal guardian and get the approval of the family court. We will make persistent efforts to protect the safety and life of the people we love most, and take ESD as the ultimate way to save lives.
"Children, children's brain development is not perfect. In most cases, the symptoms of mental illness are not as obvious as those of adults, and can be reasonably operated and relieved according to drugs, natural environment adjustment and psychotherapy. If there is a very serious suicidal behavior, after careful evaluation, you can choose an improved version of electroconvulsive therapy, but not ESD. Professor Wang said to me.
Materials from:
[ 1]. d . c . circuitoverturns sfdabanonshockdevicefordisabled students . Reuters
[2]. FDA cannotbanuseofelectricshockdevices for harmful behaviors . medpage today
[3]. appealscourtaxesfdabanoelectricshockonthedisabled . NBC news
[4].SherwinNulandTED200 1
[5].FDA prohibits the use of electrical stimulation devices for self-harm or aggression. United States Food and Drug Administration
[6].FDA recommends that electronic stimulation equipment be prohibited from causing self-harm or aggression. United States Food and Drug Administration
[7] Children's Fund for Human Rights
[8]. escaping the judgerotenberg center . YouTube @ JenniferMsumba
[9]. Improve the knowledge of electroconvulsive therapy experts. Change medical journals. 20 19，8: 129- 134
From: medical field
Original article title: "The Last Electric Shock Treatment Center in the United States: Although Controversial, it operates as usual"
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