P.R. Laws tit. 24, § 6159i
No minor shall receive electroconvulsive therapy treatment without the previous informed consent and express authorization from one of the following:
(a) The minor’s parent with patria potestas or custody, or legal guardian, upon the opinion of one (1) child and adolescent psychiatrist, in consensus with the inter- or multidisciplinary team, who evaluates and recommends the use of this treatment and so entered in the minor’s clinical record.
(b) In the case this treatment is favorable to the minor, and after making reasonable efforts, if the persons authorized to consent could not be located or denied their consent, a petition shall be filed with the court. In this case, evidence shall be presented of the need for treatment, as well as the unsuccessful attempts to locate the persons authorized by law to give consent, so that the court may be convinced and order the use of this treatment.
The medical director and the inter- or multidisciplinary team shall review all orders for electroconvulsive therapy under the established criteria and the grounds for the use of this measure in order to establish the professional accountability of team members, and render a yearly report to the Administration.
The parent with legal or physical custody of the minor for whom electroconvulsive therapy treatment is considered, and the legal guardian, if any, shall be notified within a period not greater than forty-eight (48) hours prior to the treatment. The parent with legal or physical custody, or the legal guardian, shall have the right to refuse this treatment at any time after having accepted the same. However, if there should be any discrepancy as to having accepted or refused the treatment, a hearing must be held for the court to determine whether or not the treatment shall be in order and to issue an order to that effect.
All institutional providers of mental healthcare services that offer the electroconvulsive therapy modality shall institute a protocol that includes the accepted standards of the American Psychiatric Association (APA) and the entities that regulate the application of said therapy, in addition to the regulations that the Administration shall promulgate for these purposes. Said protocol shall be revised annually. It shall be the responsibility of the institutional provider of mental healthcare services to keep abreast of scientific advancements that may alter the procedure or administration of this modality of treatment.
History —Oct. 2, 2000, No. 408, § 8.10; Aug. 6, 2008, No. 183, § 44.