By Jesse Marx
By Chris Parker
By Jake Rossen
By Jesse Marx
By Michelle LeBow
By Alleen Brown
By Maggie LaMaack
By CP Staff
Which is why he doesn't utter a word of protest as they carry his groceries away, or when his stomach starts growling at 10 p.m.
"There's nothing fun about it," he says of the fasting, and leaves it at that.
Of greater concern to him is the procedure itself. He knows he'll be unconscious during the ordeal, that it will be painless. Still, he's a bit anxious.
"You don't know if you're going to wake up," he says, his eyes widening as he confronts his own mortality. "It's not very likely, but it's still possible. When I did the first couple of them, I was a lot more scared than I am now."
He did those first few willingly—anything to get out of the hospital, which he found to be oppressive. It seemed like a fair trade-off.
But on June 10, 2008, he once again found himself in the basement courtroom of Regions Hospital listening to important strangers explain to other important strangers why it's in society's best interest to blast 140 volts of electricity through his cranium at regularly scheduled intervals. Today's hearing would decide whether the month-long court order should be allowed to expire.
One of the strangers, Dr. Peter Myers, whom Sandford had met only briefly, testified that Sandford had shown "noted improvement" since beginning ECT, in the sense that Sandford "now has the ability to remain calm." Dr. Myers also commended him for "exhibiting more organized thought patterns." However, continued the doctor, "he still remains a danger to himself and is in need of continued commitment and treatment with neuroleptic medication and electroconvulsive therapy."
Judge Warner agreed. She gave the go-ahead for three ECTs a week for up to four weeks, followed by one treatment per week for one year thereafter.
The ruling was based on solid precedent. In 1976, just as ECT was at the nadir of its popularity, a 14-year-old Minnesota boy was shocked against his and his mother's objections. The mother filed suit and went before the Minnesota Supreme Court. The resulting decision held that legally competent patients were immune from being shocked against their stated objections. Moreover, the case made clear that even incompetent patients were entitled to a court proceeding before being administered electroconvulsive therapy.
On its face, the Price-Sheppard decision appeared to bolster patients' self-determination—after all, the requirement for guardians to get court-approval before administering the volts is one that didn't exist before.
But in practice, court-ordered ECT has been on the rise since the ruling, for a number of reasons. The ruling assumed that a committed person is—by very virtue of being committed—incompetent. Second, attaining the court order is more of a bureaucratic formality than a serious deliberation.
"I would say the court grants the order for ECT in well over 90 percent of the cases," says Doug McGuire, of the Hennepin County Commitment Defense Panel, which represents patients in the proceedings. "It's very unusual for the court not to grant the ECT request."
Mental health courts require a lower standard to the petitioner ("clear and convincing evidence") than do criminal courts ("beyond a reasonable doubt"), but more importantly, the petitioner—almost invariably a doctor, as in Sandford's case—naturally wields more credibility than a person deemed unfit to care for himself.
"One of the issues that comes up is how vigorously the person's court-appointed attorney puts forth their objections to the ECT," notes Pamela Hoopes, the lead attorney for the Minnesota Disability Law Center.
ON OCTOBER 22, David Oaks was sitting in his office in Eugene, Oregon, when his phone rang.
As director of MindFreedom International, a coalition of self-described "mental human rights organizations" advocating what they call "a nonviolent revolution in mental health care," Oaks has fielded his share of strange calls. But Oaks had never heard a story like this before.
"My name is Ray Sandford," said the man on the phone. "I live in a group home in suburban Minneapolis. I'm getting electroshock treatment against my will. What do I do?"
Oaks dialed Lutheran Social Services to confirm the story. A worker familiar with Sandford's case verified that Sandford was indeed receiving court-ordered electroshock treatments. A copy of the court order confirmed it.
"I get calls all the time from people who are frightened, who are being pushed around and bullied by the mental health system," says Oaks. "But this guy has made sense the whole time. His was an extremely human response: 'I don't want it.'"
Taking up the cause, MindFreedom launched an online Campaign for Ray, with a website detailing Sandford's predicament. Oaks compiled a list of caretakers associated with Sandford—from doctors to judges to lawyers—along with their contact information, encouraging visitors to call them and demand they put an end to the treatment. In addition, MindFreedom sent out mass emails to its network of activists who, in turn, inundated the governor's office with phone calls.
The tactic seemed to be working. On April 15, Dr. Dean Knutson stepped aside as Sandford's psychiatrist. Eight days later, Lutheran Social Services submitted to the Ramsey County probate court a petition to resign as Sandford's guardian.