A/63/175 fertility on an equal basis with others” and to ensure their right to decide freely and responsibly on the number and spacing of their children (art. 23 (b)). b. Electroconvulsive therapy 61. The use of electroshocks on prisoners has been found to constitute torture or ill-treatment. 27 The use of electroshocks or electroconvulsive therapy (ECT) to induce seizures as a form of treatment for persons with mental and intellectual disabilities began in the 1930s. 28 CPT has documented instances in psychiatric institutions where unmodified ECT (i.e. without anaesthesia, muscle relaxant or oxygenation) is administered to persons to treat their disabilities, and used even as a form of punishment. 29 The Special Rapporteur notes that unmodified ECT may inflict severe pain and suffering and often leads to medical consequences, including bone, ligament and spinal fractures, cognitive deficits and possible loss of memory. 30 It cannot be considered as an acceptable medical practice, 31 and may constitute torture or ill-treatment. In its modified form, it is of vital importance that ECT be administered only with the free and informed consent of the person concerned, including on the basis of information on the secondary effects and related risks such as heart complications, confusion, loss of memory and even death. c. Forced psychiatric interventions 62. The use of psychiatry as a means of torture or ill-treatment for the purpose of political repression, 32 in the context of the fight against terrorism 33 and, to a lesser extent, in treatment inflicted in order to attempt to suppress, control and modify the sexual orientation of individuals has been well documented. 34 However, the Special Rapporteur notes that abuse of psychiatry and forcing it upon persons with __________________ 27 28 29 30 31 32 33 34 08-44075 See E/CN.4/1986/15, para. 119 and Amnesty International, Arming the Torturers, Electro-Shock Torture and the Spread of Stun Technology, 1997, AI Index ACT 40/001/1997. See also CAT/C/75, para. 143 and Human Rights Committee, views on communication No. 11/1977, Grille Motta v. Uruguay, adopted on 29 July 1980 (CCPR/C/10/D/11/1977) and communication No. 366/1989, Kanana v. Zaire, adopted on 2 November 1993 (CCPR/C/49/D/366/1989). M. V. Rudorfer, M. E. Henry, H. A. Sackeim, Electroconvulsive Therapy, in Tasman, Kay and Lieberman (eds.), Psychiatry, Second Edition, vol. 1, sect. VI, chap. 92 (Chichester: John Wiley & Sons Ltd., 2003. Reports from CPT have documented the administration of “Electro Convulsion Therapy” in its unmodified form in psychiatric establishments in Turkey. Out of the total of 15,877 ECT sessions administered at Bakirkoy, only 512 (3.2 per cent) were modified. See documents CPT/Inf (2006) 30, paras. 58-68 and CPT/Inf (99) 2, paras. 178-182. See MDRI, Behind Closed Doors: Human Rights Abuses in the Psychiatric Facilities, Orphanages and Rehabilitation Centers of Turkey, 2005, pp. 3 and 4. See the CPT Standards, op. cit., paras. 39-41. The World Health Organization and the Pan American Health Organization have also called for this practice to be stopped. See Human Rights Watch, Dangerous Minds: Political Psychiatry in China Today and its Origins in the Mao Era, 2002; Perlin et al., op. cit., and The Breaking of Bodies and Minds: Torture, Psychiatric Abuse, and the Health Professionals, E. Stover and E. Nightlingale (eds.), (W. H. Freeman, 1985), pp. 130-158. See the list of interrogations techniques used at Guantánamo Bay, including the use of the detainees’ individual phobias to induce stress, that “have adversely affected the mental health of detainees” (E/CN.4/2006/120, para. 78). See Amnesty International, “Crimes of hate, conspiracy of silence”, torture and ill-treatment based on sexual identity, 2000, AI index ACT 40/016/2007. 15