36 NORWEGIAN PARLIAMENTARY OMBUDSMAN National Preventive Mechanism ANNUAL REPORT 2017 Photo: Hallgeir Vågenes, VG / NTB Scanpix Stavanger University Hospital’s special unit for adults particular cause for concern regarding the treatment of one of these patients. The patient came from a minority language background and was subjected to a number of treatments based on the principle of necessity. The documentation suggests that inadequate consideration was given to whether the requirements for treatment on grounds of necessity were met. The findings also indicate that no interpreter was used and no attempt was made to call in an interpreter before an ECT treatment was performed based on the principle of necessity in a situation where the patients could not understand or communicate in Norwegian. Next of kin was asked to consent to the intervention on the patient’s behalf, based on the principle of necessity. ECT on grounds of necessity is a highly invasive and controversial treatment that carries a high risk of inhuman or degrading treatment of patients. The case sheds light on the considerable ethical challenges associated with a practice for which there is no clear basis in health law. It also gives cause for concern that the national health authorities are not notified when ECT is carried out based on the principle of necessity. This means that the health authorities are denied access to important information about a practice with far-reaching effects for the patients who undergo such treatment.