BOSTON (Legal Newsline) - The highest court in Massachusetts approved the continued use of controversial electric-shock treatments on mental-health patients, saying there was not enough evidence to overturn a 1987 consent decree authorizing the procedure.
The Massachusetts Supreme Judicial Court ruled that the Judge Rotenberg Educational Center, which operates 44 group homes, can continue to use skin shocks to treat patients who engage in self-harm and violence. State mental-health officials, medical groups and mental-health advocates have long opposed the treatment, but parents of institutionalized patients have praised it as the only alternative to sedation and restraints.
The state Department of Developmental Services asked a court to end the consent agreement in 2013, but a judge ruled in 2018 that it must remain in place because of the state’s continued “bad faith” attempts to regulate the electric-shock treatment out of existence. The judge held a 40-day evidentiary hearing in 2016 that revealed medical authorities were hopelessly divided on whether the therapy is effective or humane.
“This case thus involves a heart-wrenching issue: continue to protect a controversial practice that has widely been criticized, or pave the way for its prohibition at the risk of subjecting these vulnerable patients to a life of sedation and restraint, or extreme self-injury,” the Supreme Court said in a Sept. 7 ruling.
The Rotenberg Educational Center accepts severely autistic patients who have been rejected from other institutions and uses non-pharmaceutical methods including skin shocks to treat them. Massachusetts agencies “resorted to pretextual and bad faith regulatory practices to disrupt JRC's operations in the 1980s and 1990s,” the court observed. In 1993, six years after the consent decree was entered, the department launched a campaign to "disrupt the operations of JRC by every conceivable means."
The Rotenberg Center was in the news in 2007, however, when a former resident called one of the facilities, impersonated a staff member and ordered employees to administer dozens of shocks to two patients.
The Supreme Court said it was “particularly troubling” that it could only refer to evidence that is now seven years old but the parties agreed to decide the appeal without additional findings. On that basis, the court said, it had to conclude the judge’s findings weren’t clearly erroneous.
“New developments” may change that finding, the court said, and nothing prevents the Department of Developmental Services from contesting the use of electric skin shock in individual cases or restricting it to cases where it is the “least intrusive, most appropriate treatment.”
“The fact that the department has largely chosen not to do so informs the context within which we rule on this issue,” the court said.