Top court in Massachusetts permits use of shock devices on institutionalized patients
The top court in Massachusetts has ruled that a school for developmentally and intellectually disabled people can continue to use electric skin shock therapy as permitted by a 1987 consent decree.
The Massachusetts Supreme Judicial Court said the state can’t lift the consent decree absent a legislative solution, “more robust evidence” that electric skin shock therapy is outside the standard of care for severely disabled patients, or a showing that the state is acting in good faith in its attempt to end the practice.
The Massachusetts Supreme Judicial Court ruled Sept. 7 in the state’s challenge to shock treatment of residents at the Judge Rotenberg Educational Center, formerly known as the Behavior Research Institute. It is the only facility to use the “graduated electronic decelerator,” intended to stop residents from self-destructive behaviors, such as gouging their eyes and from violently attacking others.
Families that support the treatment say it is a last-resort alternative to sedation, seclusion and restraints. Many of the patients at the Judge Rotenberg Educational Center are there after expulsion from other facilities.
The Massachusetts Supreme Judicial Court affirmed a judge’s 2018 conclusion, made following a 44-day evidentiary hearing ending in 2016, that the medical community was divided on the treatment approach to treat severely self-injurious and violent behavior. As a result, the judge found in 2018, the state failed to prove that the shock therapy was outside the standard of care as a method of last resort.
The judge also found that the state had acted in bad faith by seeking to eliminate or curtail the electric shocks through regulatory changes in 2010.
The Massachusetts Supreme Judicial Court noted that the state had asked it to rule without remanding for additional factual findings.
“Thus, we do not reach the propriety of electric skin shock treatment in 2023, as we do not have the record to do so, and we therefore do not foreclose the possibility that new scientific developments or a more recent evidentiary record would suffice to demonstrate a change in the standard of care,” the Massachusetts Supreme Judicial Court said.
The Massachusetts Supreme Judicial Court noted that the consent decree says the shock treatment can be used “only where it is the least intrusive, most appropriate treatment.” The device can be used only after a physician develops an individual treatment plan and the facility obtains permission from a probate court in the case of residents unable to give consent.
The Massachusetts Supreme Judicial Court also said nothing in its ruling prevents the state to contest the use of shock on individual patients.