Discusses various legal aspects of electroconvulsive shock therapy (ECT) and addresses the ethical concerns that may arise alongside a particular legal issue. Though legal regulation of ECT has provided safeguards to prevent unwanted ECT from being administered, it has raised clinical concerns. Treatment delays or failures could lead to deleterious psychological, social, financial, and personal effects. Informed consent, substitute consent, negligent administration of pre-ECT medication, negligent performance of the pretreatment examination, negligent posttreatment supervision, and negligent administration of ECT are all areas of malpractice issues that have involved ECT. The concept of a right to effective treatment has also received attention. Increasing legal restrictions appears to be one of the major threats to the accessibility of ECT for patients. Continued education of those inside and outside the psychiatric field may be effective in combating myths and biases. (PsycINFO Database Record (c) 2012 APA, all rights reserved)