(a) Only a physician licensed to practice medicine in Texas may administer ECT and a physician may not delegate the act of administering the therapy. A nonphysician who administers ECT is considered to be practicing medicine in violation of the Medical Practice Act, Texas Civil Statutes, Article 4495b.     
      (b) No person under the age of 16 shall receive ECT.     
      (c) Prior to receiving ECT, every patient, voluntary or involuntary, competent or incompetent, shall be given full explanation of ECT consistent with the definition of ECT in §405.103 of this title (relating to Definitions) and meeting the requirements of §405.108 of this title (relating to Informed Consent to ECT).     
      (d) If any patient,  without regard to  competency, objects to ECT and there is an alternative method of treatment (that is not contraindicated and which has a reasonable potential for success) to which the patient does not object, the alternative method shall be considered and, if mutually acceptable to the patient or the guardian of the person of the patient and the treating physician, shall be used.  It is not to be inferred, however, that ECT should be held as a treatment of "last resort." Full documentation of the factors considered in arriving at the decision to use ECT, the consent process, the treatment procedures, and patient response to treatment shall be entered into the patient's permanent medical record.     
      (e) The use of ECT for punishment, solely for control of behavior, for  convenience of staff, in  order to make patients more compliant, and the use of ECT in a discriminatory or abusive manner are explicitly prohibited.     
     Source Note:        The provisions of this §405.104 adopted to be effective January 1, 1992, 16 TexReg 7528; amended to be effective December 10, 1993, 18 TexReg 8790